Granulomas vs filler deposits - how to differentiate?

Question

I had 2 ml Restylane injected into the dermis on my neck on May 19. There have been lumps all over it since then and the skin is itching. Is it easy for s doctor to differentiate if the lumps are granulomas or filler deposits that will reabsorb as time passes by? Do granulomas disappear on their own? Thank you.

Jason Emer, MD · Answer

Reverse the filler and start RF treatments such as exilis ultra or venus legacy to soften the area.  Best, Dr. Emer.

Alexander Rivkin, MD · Answer

Hi Maggie and thanks for your question. I assume from your question that you had your neck injected for the horizontal necklace lines across the neck. These are notoriously difficult to inject without causing lumps. Over the years, I have seen that you need to use the softest filler possible to get a smooth result. Your lumps are extremely unlikely to be granulomas. They are collections of filler. You should try to massage them out if possible. See what your doctor recommends you do, but if you can't get the lumps to go away, your doctor may have to dissolve them with hyaluronidase.

Harold J. Kaplan, MD · Answer

Hi Maggie, normally granulomas are very hard.  Restylane would be softer typically than a granuloma.  One easy way to find out is to inject Hyaluronidase into a bumpy area and if the bumps resolve quickly, it is Restylane.  We inject Vitrase to solve this problem for outside patuints that are unhappy with their injections elsewhere.  To see an example of one of these reversal treatments for a patient treated in our Orange, CA office, click on the link below.

Granulomas vs filler deposits - how to differentiate?

Answers (3)