Will these lumps resolve on their own given time or will I need to get this dissolved? (Photo)

Question

Hi. I've had filler under my eyes in the top of the cheekbone (circled in red) and it's very visible, uneven and lumpy. Do I just not have the kind of skin that can take fillers, or did my injector use the wrong type of filler for the area or inject it too superficially?

Nima Shemirani, MD · Answer

Hi @Jubilant616333. Most facial filler products that are injected into this area should ideally be placed in the tissue plane directly on top of the bone, or at least underneath the eyelid muscle layer. If a facial filler product is placed too superficial in the skin, or on top of the muscle layer, the product may settle in with an abnormal appearance and can look to be lumpy, swollen, or irregular. The filler products that are preferred to treat this area will have some degree of affinity for water molecules so all of these products will exhibit some degree of hydration and swell once injected into the body. Hyaluronic acid facial filler products that were previously injected into an improper tissue plane can be dissolved by hyaluronidase injections.

Best of luck,

Dr. Nima!

Best of luck,

Dr. Nima!

Raffy Karamanoukian, MD, FACS · Answer

There are many options if you are unhappy with fillers. Hyaluronidase enzyme continues to be an excellent option for patients with fillers that need to be dissolved. Fillers can swell and migrate unpredictably, especially when a filler with a high-edema quotient is used in thin areas. Our office uses disciplined approaches to help patients with acute or chronic issues related to hyaluronic acid fillers. We begin by assessing for any tissue compromise and advocate early treatment to avoid complications with vascular occlusion. In chronic issues, it is important to gradually break up and dissolve filler so there is no further migration of loose filler substrate. Conservative staged dilution may also help avoid volume loss. If the filler is not dissolving, we may consider stronger concentrations or surgery or determine if there is biopolymer that is synthetic and permanent.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

you need at home dermarolling, in office laser sand morpheus, and to start proper skincare (see link).  reverse the fillers and see a comprehensive physician that does a lot of this.  Best, Dr. Emer.

Dmitriy Schwarzburg, MD · Answer

Fillers like Juvederm and Restylane that are made of hyaluronic acid can be dissolved easily by hyaluronidase. These fillers dissolve on their own with time. But if you are not satisfied with the outcome, you can have it dissolved. Consult with your doctor to know more.

Solomon Facial Plastic - Thornhill · Answer

Hi there.
It is difficult to assess from the photo and would likely require in person assessment. That being said, it is possible that the filler was injected to close the the surface of the skin. Typically in that region injecting deep on the bone gives better results with fewer complications. In theory a hyaluronic acid filler should be broken down by your body overtime, that being said, when a filler is injected in the wrong plane, it can be very stubborn and will not be metabolized easily. Likely dissolving it is your best course of action, especially because you are unhappy with your result.

Will these lumps resolve on their own given time or will I need to get this dissolved? (Photo)

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