Can Restylane Cause Additional Scar Tissue when Injected into Scar?

I'm sorry you had that experience with your Restylane.  First of all, it should not cause any permanent change to your scar or cause more scar tissue to form.  Over time, the Restylane will just fade away and your scar should look just as it did before the injection.  Second, if you don't want to wait for it to go away by itself, there is a medication that can be injected into the area to dissolve the Restylane. If you wish to have that treatment, I would contact your treating physician and communicate your concern.  

Injecting any dermal filler into a scar is no guarantee that it will correct or even improve the scar appearance. Proper assessment and testing a very small amount is sometimes most appropriate before treating the entire area. Follow up with your provider and discuss options for removal with hyaluronidase.

Restylane should not cause further scar tissue when injected. The lumpiness is most likely just product, as the neck is a common place for product to lump up.  It can easily be dissolved with some hyaluronidase, and should resolve without sequelae.  I would see a board-certified dermatologist or plastic surgeon to be appropriately assessed and treated. Good luck.

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.

Restylane should not cause a scar or increase an existing scar. Just so we are speaking the same language--a scar is thickened collegen within the dermis of the skin. That being said, Restylane can make a scar look worse--can create more elevation. This is not causing more scar tissue, but elevating the scar with the product itself. If the scar is elevated, I recommend massaging the area twice daily. This often works well, but takes 2-4 weeks. If not, the area can be injected with hyalurinidase to dissolve the Restylane.

 

Good luck.

 

Robert S. Bader, M.D. 

If your scar is flat then there was no reason to inject Restylane in it.  I generally use it for deeper acne scars.  If it is very lumpy you should go back and have Hyaluronidase injected into the bumpy scar to dissolve it.

I'm sorry you don't like the filler. Nothing permanent was done, which is good. However, I will say you should absolutely NOT be massaging the area. You can create lumps and bumps by moving the product around yourself. So I ask patients never to do this - it's a bad idea. If you want to remove some or all of it, it can easily be done with hyaluronidase. Nothing permanent has been altered, but I'd also suggest that if you're massaging it this much, you might be irritating the skin there in general and making it look red and worse. Leave it alone, apply cool water and hydrocortisone to it, and return to your injector for an evaluation.