Lumpy between eyes over a year after filler. What could cause this and can it be fixed? (Photo)

Question

I had dermal nose filler over a year ago. The nurse who filled the area insists she only filled the top of my nose, but I do recall her going a touch higher towards the bridge between my eyes. Over time I now have a lumpy section that almost has Klingon vibes. I have shown it to her and she insists it is natural, perhaps due to other areas hollowing, and not her work, but it feels hard and thick, slightly sore, and looks so unnatural numerous people have asked me about it. What do you think could be causing this and should I seek a second opinion either from a doctor or injector?

Kishen Nara, MBBS, FACCSM(Surg) · Answer

Warning: For adult viewing only. 
Thank you for sharing your photo and description. I appreciate you sharing your concerns.
Filler placement in the nasal bridge may constitutes non-surgical rhinoplasty. This procedure requires immense skill, experience, precision and after-care. There is an extensive consent process involved including the potential risks and complications of the procedure. To give you an idea, even 0.1mL may make a considerable difference.
It is difficult to make an assessment without seeing you in person. Moreover, I cannot see any before injection photos to make an objective comparison. The "Klingon" appearance which you referred to may refer to the fullness of the facial area nasal to the medial canthus including the appearance of widening of the nasal bridge at the level of mid pupillary line. Not uncommonly, this appearance occurs following facial surgery especially with blepharoplasty procedures or rhinoplasty. However, it is usually self-limiting once swelling resolves after several months.
In your situation, this may be due to several reasons:-
-localised swelling due to filler placement. As a comparison to above, the filler remains after the procedure, where there may be a venous lymphatic plexus transient obstruction.-migration of filler. Depending on the type and quality of filler used, this may potentially influence the position of the filler. Other factors that influence this may involve the depth placement and technique used for filler placement.-granuloma formation. Any facial filler, has a potential risk of developing a granuloma. There is an encapsulation around the filler that results in a full appearance and firm feel during palpation.-cyst formation-infection is fairly unlikely.
Where to from here?It is imperative that you seek a second opinion from a qualified medical practitioner who is formally trained in aesthetic medicine and surgery. They would be able provide you with a detailed assessment and tailored plan for you.
Sometimes it is important to take a step back and assess the situation through cosmetic imaging. Some radiologists and radiographers are experienced in analysing facial filler related issues or complications through specific imaging tests and views such as with the use of radiographs, ultrasounds or magnetic resonance imaging. You may want to consider this depending on the advice of your physician. These findings, with the help of our radiology colleagues, may alter the management strategy.
Is this transient? This is always a possibility, without performing a clinical assessment on you it is impossible to say. Some patients may have other active health issues that require further assessment.
If this is due to filler migration, dissolving it through enzymatic medication such as with "hyalurodinase" may be useful. This in itself is complex as there are different ways of doing this. There are also different preparations of hyalurodinase. The expected results following this will be dependent on your assessment.
There are various ways of treating granuloma due to facial filler injections. Surgical excision is of course an easy statement but requires meticulous planning if this is considered.
Seek the best advice and opinion you can get from medical practitioner experts who are formally trained in aesthetic medicine and surgery. Take time to make your decision. 
Disclaimer: The content of this description is for educational purposes only. It is imperative to seek a second opinion from a medical professional who is qualified, experienced and skilled in aesthetic surgery and medicine.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concerns and photo. Based on your description and visible swelling between the eyes, this may be related to delayed-onset filler complications, particularly considering that:

The area feels lumpy, thick, and sore

The appearance is persistent over a year post-injection

You recall filler placement extending near the bridge between the eyes, even if unintentionally

There are a few potential causes to consider:

Residual Filler: Hyaluronic acid-based fillers can, in some cases, persist longer than expected—especially in low-movement areas like the nasal bridge. Improper placement or overfilling can also contribute to visible lumps.

Encapsulated Filler or Granuloma: Over time, the body can form a fibrous capsule or inflammatory nodule around filler material, leading to hard, palpable, or even visible lumps. These can be tender and resistant to spontaneous resolution.

Swelling or Inflammatory Reaction: A delayed immune response can occur even long after filler placement. This can cause intermittent swelling, discomfort, and distortion of facial contours.

Migration: Filler may migrate from the original site, particularly in areas where lymphatic drainage is slower, like the glabella (area between the brows).

Your injector’s assessment may be based on their records or technique, but persistent symptoms—especially soreness and aesthetic changes—warrant a second opinion, ideally from a board-certified dermatologist or plastic surgeon experienced with filler complications.

If the lump is indeed due to hyaluronic acid filler, it can often be corrected with hyaluronidase (a dissolving enzyme). In more resistant or encapsulated cases, additional treatments such as steroid injections, ultrasound-guided intervention, or minor surgical excision may be necessary.

In summary:
Yes, it can likely be fixed, but the right approach depends on identifying the exact cause. Given your symptoms and the duration, further evaluation by a specialist is recommended.

Camille Cash, MD · Answer

There is no harm going to another experienced injector for an evaluation.  If it is migrated filler you can consider dissolving it with hyaluronidase.  Even if you do nothing it should improve over time if filler is the cause.

Lumpy between eyes over a year after filler. What could cause this and can it be fixed? (Photo)

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Lumpy between eyes over a year after filler. What could cause this and can it be fixed? (Photo)

Answers (3)

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Everything you need to know about Dermal Fillers

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