You need a careful examination
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
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
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.
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.
Something does not add up
You are attributing a large number of findings related to aging to an injection of Restylane more than a year ago. Even if the Restylane was injected around the eyes, in an off-label use manner, the Restylane cannot be the reason for the corners of your mouth turning down.
The only filler that I have seen to cause the symptoms you describe is silicone microdroplets. I have had many patients who present for facelifts with silicone in their cheeks and describe the same symptoms.
Are you sure you got Restylane? If you would like, you could pursue another consult with another plastic surgeon for a second opinion. It sounds like the effects of aging and gravity have not waned in spite of Restylane injections, which is totally normal.
Best of Luck.
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.
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.
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.
See your doctor for Restylane bumps after 18 months
While it's possible that Restylane may be still present in your cheeks 18 months after injection, it's unlikely. It sounds like there is something else going on. Before suggesting what it might be, it's best to visit your practitioner for an evaluation. If it is still Restylane, Hyaluronidase can be used to break down and dissolve the Restylane. First step is to back to your physician or be seen by another.
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.