Can Restylane Cause Additional Scar Tissue when Injected into Scar?

Sorry to hear about your result following Restylane treatment to improve the appearance of your scar. In general, filler will not create any additional scar tissue when injected into a scar.  If you do not like the way the filler looks, it can be removed with the enzyme hyaluronidase. Not to worry, the area will look the same as it did before the injections and no permanent damage has taken place. From here, I would recommend expressing these concerns to your physician who performed the injections, and discuss the option of dissolving the filler. Thank you and I hope this helps!

Fillers, such as Restylane for shallower depressed scars and Perlane for deeper ones can be used alone or preferably as an adjunct to some other treatment modality that yields permanent results--such as subcision and medical microneedling, etc. Used alone, fillers may plump up and help smooth the scar with the surrounding surface, but, since they will eventually be metabolized away, they constitute only relatively temporary solutions for scars. If a scar is already flush with surrounding skin surface, they would not be of value and could very well result in worsening of the appearance of the scar by causing temporary lumping and heightened prominence of the region.

The relatively temporary nature of hyaluronic acid fillers, such as Restylane, is of course a decided advantage in instances where there has been inappropriate or excessive use. The fact that it can be quickly dissolved with hyaluronidase is another advantage. There have been reports (and my personal experience in over fifteen years of using Restylane corroborates this) that the installation of a filler may stretch the fibroblasts and collagen fibrils in the dermis and lead to new collagen formation (neocollagenesis). In a case where a scar is flat, this might theoretically lead to bumping in a previously flat scar. For this reason, I would be quicker to use the hyaluronidase to dissolve the injected material in such an instance. That having been said, one week after injection is generally too soon to make such a determination, since tissue swelling from the injection and post-injection massage and molding, may be contributing to initial tissue distortion and bumping and a worsening of its appearance. A month following the treatment is probably the best time to decide how to proceed in any case where a hyaluronic acid filler may have been injected inappropriately or in excessive amounts.