Restylane lumps. Will warm heat help to massage them down?

Question

I had restylane filled under my eyes on Thursday last week. It is now mon. I've had this done before without a problem. This time the lumps are pretty pronounced though I know it's a bit early, I'm wondering if maybe I should massage them and I have tried. They're a bit sore. Will applying heat before massage help make the material more malleable? Thanks for any help with this.

David W. Kim, MD · Answer

Hi Pikachoo,I agree that it's still pretty early after your filler treatment. A warm compress is certainly safe to try, but I would avoid too much manipulation of the injected areas, as this can cause more inflammation/swelling. At the 2-week mark, if there are still lumps, your provider can easily reduce these with an enzyme (hyaluronidase) that neutralizes filler. This early on, the lumps may be due to bruising/swelling, rather than too much volume, so I wouldn't try to neutralize them just yet. Hang in there and best of luck!

Carlos Mata, MD, MBA, FACS · Answer

Hello there,Thank you for your question.  I would return to the provider who injected you.  They will be able to best assess the situation and massage the lumps or possibly use hyaluronidase to dissolve some of the extra volume.  Hope this helps.All the best,Carlos Mata, MD, MBA, FACSBoard-Certified Plastic Surgeon

Nima Shemirani, MD · Answer

Hi @Pikachoo.  Applying heat and massaging the region can help to alleviate the bumps. If the bumps are still presents after two weeks, I recommend dissolving the product with Hyaluronidase. Best of luck, Dr. Nima!

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question.  Yes, applying heat and massaging the region will help to alleviate the bumps. If this does not give a satisfactory result, see your doctor for injection of Vitrase which will dissolve the product. Good luck,

Payman Kosari, MD, FAAD · Answer

Within two weeks, and especially within the first week after your treatment, fillers can do funny things.  With that said, you have had this done before and are approaching your 1st week so if you feel as if there is an overt lump, try lightly massaging it which may blend it in.  If it doesn't work, a couple of drops of hyaluronidase will fix the issue.

Gordon Andan, MD · Answer

Thank you for your question. Fillers like Restylane® can take around 2 weeks for results to develop. As you mention, 4-days post-treatment is a bit early to start manipulating the filler yourself. While massage can help smooth out lumps, you’ll want to be careful to not move the filler too much. I recommend cold compresses for now to help with the swelling. If the lumps don’t smooth out in a few days, some light massage might help.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question.  It's difficult to make exact recommendations without assessing you in-person.  That said, generally speaking, the skin under the eyes and in the tear troughs is quite sensitive, and is particularly prone to swelling and bruising after filler injections.  This swelling can last for up to two weeks.  Moreover, products like Restylane can initially feel slightly lumpy under the skin - over the course of a few weeks, the fillers absorb water and soften, gradually blending into your skin.For now, I would recommend applying cool compresses to the treated areas to help reduce swelling.  Warm compresses actually increase blood flow, and may make your swelling worse.  I would avoid massaging the Restylane yourself - I find that many times, this actually increases inflammation and in some cases, even displaces the filler.  If in another week or so you are still noticing lumps, please follow-up with your injector to discuss your concerns.  Your injector may be able to gently massage the filler to better blend it in, or dissolve any remaining lumps with hyaluronidase.  Best of luck!

Melvin Elson, MD · Answer

Massage and warm compresses might help but it is still a little early to tell what it is going to look like. Check with the doctor who injected you and see if hyaluronidase into the area is indicated but wait another 7 days to let swelling go down

Robert Whitfield, MD · Answer

Being seen and examined by an injector will help determine the best next steps.  I have dissolved filler if need be in these situations.

Vicki J. Levine, MD · Answer

You may have to get an injection of hyaluronidase to dissolve the filler. You may or may not need an oral antibiotic

Restylane lumps. Will warm heat help to massage them down?

Answers (10)

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