Why Does Restylane Cause Numerous Lumps?

I began to research the use of Restylane, and found many women's reviews of this product. Many cited lumps that formed and were painful. Why is this? Please advise.

Doctor Answers 7

Fillers and "lumps"

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With proper technique one should not feel any appreciable "lumps" after injections by an experienced physician. You should ask about your physician's training and background and should seek out a board certifed plastic surgeon, facial plastic surgeon or dermatologist. Do not be afraid to ask to see pictures of patients with the same filler or even talk with other patients. Why a patient would allow a non-physician (nurse practitioner, esthetician, physician's assistant, etc.) to do fillers, even if they are permitted in that state, is beyond me. It is important that all aspects of one's medical history and skin examination be ascertained and this can only be properly performed by a physician.

Philadelphia Plastic Surgeon

This shouldn't happen if the doctor is well trained and knows what they are doing

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Lumps and bumps directly correlate with the skill of the person injecting. Unfortunately, there are many folks out there who are doing these procedures with little or no experience. Usually, it is at the medispas where they hire out to cheap nurses or PAs to do the injecting while the MD owner is out on the golf course.

Go to someone who is skilled and does his/her own injecting and is a doctor. You also need to check them out as not all doctors are alike and trained as well as they should be. Sadly, this is a buyer's beware area and it pays to do your homework.

Good luck!

Joel Schlessinger, MD
Omaha Dermatologic Surgeon
4.9 out of 5 stars 50 reviews

Should not be lumpy

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Restylane (or any other filler) should not leave visible lumps, nor should it be painful if injected properly. There is the possibility that there may be some areas where you feel the product under the skin, especially in the first few days after injection. These should dissipate with time.

The good news is that if there were visible bumps after Restylane, Perlane or juvederm they can be reversed by injecting hyaluronidase. These fillers are excellent products and, when injected properly, have a very high patient satisfaction.

Edgar Franklin Fincher, MD, PhD
Beverly Hills Dermatologic Surgeon

Lumps after Restylane can be poor injection technique except in the eyelids

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In thicker skin lumps are less common as the skin hides any irregularity.

The most common areas where lumps are seen is in the eyelids and the lips, both areas of thin skin. The closer the filler is to the skin , the more likely visible lumps.

The lumps are caused by irregular injection of filler, the filler being close to the surface of the skin and occasionally bleeding that occurs during injection.

I do not use fillers under the eyelids for this reason.

Restylane Injections

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Any filler that is injected too superficial will leave bumps in the areas. This is why you should see a board certified plastic surgeon who are trained in these techniques, whereas some places you have physicians, or nurses or PA injecting the product who simply took a weekend coarse or watched a video.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Restylane and Lumps, What's the Deal?

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Hi CB,

It's not the tool, it's the craftsman. Restylane should not cause lumps, improper injection by the injector causes lumps. It doesn't matter what filler is injected, if not performed properly, lumps will occur.

Restylane is a very good hyaluronic acid product, as is Juvederm. Most cosmetic practices use both fillers.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Your research is not accurate

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Dear Cool

The internet is the great equalizer. However, it is human nature that if you have an issue you go out and tell 100 people. With the internet it is more like you go out and tell 10,000 people. Lumps can form from Restylane treatment like any service. There are a lot of techniques that can be used at the time of service to minimize these. But by far more important is that lumps caused by Restylane can easily be adjusted by the injection of an enzyme that removes the fullness. This is true of any hyaluronic acid filler like Restylane, Perlane and Juvederm. Other classes of filler don't have this ability to be adjusted if a lump should form after service.

WIth regard to treatment comfort, by and large it is very comfortable to have Restylane. The one location where topical anesthesia does not cut it is the lip edge. Here a ring block with local anesthesia is needed for all but the most stoic individuals.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.