What to Do when Restylane Won't Dissolve?

I had Restylane injected under my eye area a year and a half ago. It has not dissolved on its own.

It seems to have caused some extreme heaviness in my cheek area that has cause my mouth to look like its pointing downward. The left cheek is much bigger and both sides look different. Also, when I smile the cheek pushes up so high into the eye area and causes so many lines under my eyes it looks terrible.

Can I use something to remove it?

Doctor Answers 14

You need a careful examination

Michelle,

The Restylane should be completely gone by now. You really need to either go back to your original injector or seek out someone who specializes in injections and periorbital surgery. It sounds like you may need some type of intervention, but you need a complete evaluation prior to rushing into anything.

David Shafer, MD

You need a careful examination

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Michelle,

The Restylane should be completely gone by now. You really need to either go back to your original injector or seek out someone who specializes in injections and periorbital surgery. It sounds like you may need some type of intervention, but you need a complete evaluation prior to rushing into anything.

David Shafer, MD

Massage-Dont have any injections around the eye-extreme case surgical removal

I dont do filler injections around the eye-there has been a reported case of blindness following filler injection close to the eye

I dont use hyaluronidase injections-some experienced doctors do-but I would not around the eye.

I agree with Dr. Wallach- after a year most of what you feel as a lump is scar tissue-Restylane dissolves fairly rapidly-studies show most gone by a year and a half.

I would just continue to firmly massage the lumpy area-you can mold scar tissue over time with massage.

I have removed lumps caused by fat injection below the eyelid, but Restylane would be more difficult. The scarring from surgey would probably be worse than the lump.

I do believe you will improve with massage-don't give up.

Massage-Dont have any injections around the eye-extreme case surgical removal

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I dont do filler injections around the eye-there has been a reported case of blindness following filler injection close to the eye

I dont use hyaluronidase injections-some experienced doctors do-but I would not around the eye.

I agree with Dr. Wallach- after a year most of what you feel as a lump is scar tissue-Restylane dissolves fairly rapidly-studies show most gone by a year and a half.

I would just continue to firmly massage the lumpy area-you can mold scar tissue over time with massage.

I have removed lumps caused by fat injection below the eyelid, but Restylane would be more difficult. The scarring from surgey would probably be worse than the lump.

I do believe you will improve with massage-don't give up.

Go back to your physician and study your before and after photographs; Restylane is not the cause!

Restylane is comprised of hyaluronic acid which typically lasts between six to nine months. After a year and a half, I seriously doubt that the changes you described are totally attributed to Restylane. There could be other things going on.

I suggest that you go back to the physician who performed the injections and confirm that this was the product that was utilized. I hope that pre-injection photographs were taken in order that you can diligently study and compare them to recent ones.

It is my hunch, that the changes described are due to the horrible "a" word...aging!

Stephen A. Goldstein, MD

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Go back to your physician and study your before and after photographs; Restylane is not the cause!

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Restylane is comprised of hyaluronic acid which typically lasts between six to nine months. After a year and a half, I seriously doubt that the changes you described are totally attributed to Restylane. There could be other things going on.

I suggest that you go back to the physician who performed the injections and confirm that this was the product that was utilized. I hope that pre-injection photographs were taken in order that you can diligently study and compare them to recent ones.

It is my hunch, that the changes described are due to the horrible "a" word...aging!

Stephen A. Goldstein, MD

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Restylane is not the cause

It sounds like you have a somewhat complicated problem that requires detailed examination. I doubt that Restylane is the culprit. Restylane would be long gone at a year and a half.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Restylane is not the cause

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It sounds like you have a somewhat complicated problem that requires detailed examination. I doubt that Restylane is the culprit. Restylane would be long gone at a year and a half.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

It may be that you didn't get Restylane, but another, more dangerous filler

Restylane is a great product in that it is very easily dissolved if it is not doing what you want it to do, but my concern is that you didn't receive the real thing. There are many other fillers out there, some of which are very scary as they don't go away after 6 to 12 months and can even be permanent and cause permanent scarring.

The most concerning of these fillers is silicone, but there are others like Radiesse, Sculptra and Artefill that may be what was used here. I agree with the other doctors that you probably won't benefit by surgery and may end up worse. While hyaluronidase is an option, with this being close to the eye that may be a problem.

This case shows the utmost importance of choosing your surgeon wisely. There are many people who are getting into this field that have little or no experience or qualifications and many who have a good name but farm their fillers and botox out to nurses or PAs/NPs. So be careful in the future and good luck with this issue.

It may be that you didn't get Restylane, but another, more dangerous filler

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Restylane is a great product in that it is very easily dissolved if it is not doing what you want it to do, but my concern is that you didn't receive the real thing. There are many other fillers out there, some of which are very scary as they don't go away after 6 to 12 months and can even be permanent and cause permanent scarring.

The most concerning of these fillers is silicone, but there are others like Radiesse, Sculptra and Artefill that may be what was used here. I agree with the other doctors that you probably won't benefit by surgery and may end up worse. While hyaluronidase is an option, with this being close to the eye that may be a problem.

This case shows the utmost importance of choosing your surgeon wisely. There are many people who are getting into this field that have little or no experience or qualifications and many who have a good name but farm their fillers and botox out to nurses or PAs/NPs. So be careful in the future and good luck with this issue.

Hyaluronidase

Hyaluronidase will dissolve any hyaluronic acid filler.

Juvederm works extremely well in my hands, albeit as an off-label use, to treat the hollowing of the lower eyelids. Very conservative volumes are used.

Min S. Ahn, MD, FACS
Westborough Facial Plastic Surgeon
4.6 out of 5 stars 35 reviews

Hyaluronidase

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Hyaluronidase will dissolve any hyaluronic acid filler.

Juvederm works extremely well in my hands, albeit as an off-label use, to treat the hollowing of the lower eyelids. Very conservative volumes are used.

Min S. Ahn, MD, FACS
Westborough Facial Plastic Surgeon
4.6 out of 5 stars 35 reviews

Persistent Restylane problems

Restylane is a powerful and effective dermal filler that usually lasts approximately 6 months. It sounds on your case your Restylane has lasted much longer than that. This may be due to some leftover Restylane in your tissue or it may be due to swelling or a small amount of scar tissue in your skin around the original Restylane injection. At this time, scheduled a consult with a board-certified plastic surgeon who will be able to determine the cause for this firm tissue. If you have Restylane left over in this area, they may recommend an injection with a hyaluronidase solution to help break up the leftover Restylane.

Persistent Restylane problems

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Restylane is a powerful and effective dermal filler that usually lasts approximately 6 months. It sounds on your case your Restylane has lasted much longer than that. This may be due to some leftover Restylane in your tissue or it may be due to swelling or a small amount of scar tissue in your skin around the original Restylane injection. At this time, scheduled a consult with a board-certified plastic surgeon who will be able to determine the cause for this firm tissue. If you have Restylane left over in this area, they may recommend an injection with a hyaluronidase solution to help break up the leftover Restylane.

Cheek firmness after restylane injection

Hyaluronidase is a naturally occuring enzyme that is produced by bacteria to help them dissolve the hyaluronic that exists in normal tissues. This can be used to help dissipate the restlyane if that is the cause of your problem. Other possiblities include a hematoma with fibrosis.

Cheek firmness after restylane injection

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Hyaluronidase is a naturally occuring enzyme that is produced by bacteria to help them dissolve the hyaluronic that exists in normal tissues. This can be used to help dissipate the restlyane if that is the cause of your problem. Other possiblities include a hematoma with fibrosis.

When Restylane won't dissolve

I would go back to your Restylane injector and have him / her dissolve your Restylane with Hyaluronidase; An enzyme which literally breaks up hyaluronic acid, the active ingredient in Restylane, Perlane and Juvederm.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.8 out of 5 stars 114 reviews

When Restylane won't dissolve

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I would go back to your Restylane injector and have him / her dissolve your Restylane with Hyaluronidase; An enzyme which literally breaks up hyaluronic acid, the active ingredient in Restylane, Perlane and Juvederm.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Heaviness and Restylane

It does sound that the heaviness more than one year after the Restylane could be caused by multiple reasons, which may not be Restylane.

You should see your physician for evaluation as most of the REstylane probably has dissolved by now. If it is the Restylane it would be an exceptionally rare situation that deserves an in-office examination.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Heaviness and Restylane

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It does sound that the heaviness more than one year after the Restylane could be caused by multiple reasons, which may not be Restylane.

You should see your physician for evaluation as most of the REstylane probably has dissolved by now. If it is the Restylane it would be an exceptionally rare situation that deserves an in-office examination.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 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.