Could Hardness and Lumps from Juvederm Ultra Plus Be Permanent?

Question

5 months ago I was injected with Juvederm ultra plus in the nasolabial and noticed lumps and hardness after initial swelling. After several rounds of hyalurindase it's still there. I notice changes in my face throughout the day dependent on foods i eat. I verified product lot number/exp date with company and the Juvederm is legit. What could this be? Are the lumps likely permanent or will they eventually resolve?

Jonathan Kulbersh, MD · Answer

Any lumps that are present following a treatment with Juvederm Ultra Plus are not permanent. The filler is temporary, and will last between 6 and 12 months depending on the patient and the location of the injections. Lumps can be due to:

	1) Swelling
	2) The product itself

	After 5 months, your swelling is gone, so you can rule that out. When used properly, hylauronidase should dissolve 100% of any remaining product. It is difficult to give you precise advice without knowing more about your treatment, how much product was used, and where exactly it was injected. Did a board certified physician perform your treatment with Juvederm Ultra Plus? If you are not getting results with the hyaluronidase, it may be necessary to obtain a second opinion. It could be residual product, but only an exam can tell. Good luck!

Paul S. Nassif, MD · Answer

Hyaluronidase should completely dissolve any Juvederm that is present. I would recommend following up with your physician, as he/she will be able to examine you in person and help determine the cause of the lumps. I hope this helps, and I wish you the best of luck.

Kenneth Hughes, MD · Answer

Sometimes granuloma development occurs and responds less impressively to hyaluronidase.  However, the hyaluronidase can help with these chronic issues.  Steroids may help to soften the tissues.   Tincture of time cannot be excluded here wither.  There are other options that can be tried later as well, including excision.  Kenneth Hughes, MD Los Angeles, CA

Sam Naficy, MD, FACS · Answer

I have never heard of Juvederm lumps being permanent.  Juvederm can last up to 1 year but it is soft and breaks down gradually over several months to a year.  Typically hyaluronidase breaks down Juvederm when injected directly into it. I would advise you to seek a second opinion, you may have a cyst or something else going on in that area.

Benjamin Barankin, MD, FRCPC · Answer

Any filler can result in lumps and bumps that most commonly last 1-2 weeks; it is quite rare to have a longer lasting lump, which is likely a granuloma. This can be dissolved with hyaluronidase in many cases or with a cortisone injection, and rarely excision of the lump is required. Dr. Benjamin Barankin, Toronto Dermatology Centre.

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