Restylane cheek filler pain after 4 months

Question

I’v had Restylane cheek fillers (to help with nasolabial fold and give a lift) injected about 4 months ago. Only 0,5 ml on both sides, so it was minimal. I had no swelling at all after the procedure, but ever since I got them I get this numb kind of pain in my right cheek, and I feel the filler very prominently. It’s not a constant pain and seems to get worse in hot weather. No redness or itching.

Anna Chacon, MD, FAAD · Answer

Experiencing pain or discomfort months after receiving Restylane cheek fillers is not typical, especially with a minimal amount like 0.5 ml per side.

Here are some possible explanations and steps you can take:

Residual Inflammation or Irritation: While uncommon, the filler material might be causing some irritation or low-grade inflammation, especially if it is exacerbated by heat.

Nerve Sensitivity: The injection process could have affected a nerve, leading to intermittent pain or numbness.

Filler Placement: If the filler was placed too superficially or unevenly, it might be causing discomfort when interacting with facial muscles and tissue.

Granuloma Formation: Though rare, the body can sometimes react to fillers by forming small lumps known as granulomas, which can cause discomfort.

Infection: While you mentioned no redness or itching, a low-grade infection could still be a possibility.

Steps to Consider:

Consult Your Injector: The first step is to return to the practitioner who performed the procedure. They can assess the area and determine if there is an issue with the filler placement or an adverse reaction.

Seek a Second Opinion: If you are not satisfied with the initial consultation, consider seeing a board-certified dermatologist or plastic surgeon.

Imaging: In some cases, imaging studies (like ultrasound) can help to see the exact placement of the filler and identify any abnormalities.

Treatment Options: Depending on the cause, treatments might include massage, medication to reduce inflammation, or, in some cases, dissolving the filler with hyaluronidase.

It's important to address any persistent or unusual symptoms with a healthcare professional to ensure proper care and peace of mind.

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