Cause of Allergic Reaction to Restylane?

Question

Does developing granulomas a month after Restylane injections indicate an allergic reaction to the protein that binds it?  Would Radiesse be a safer alternative?

Harold J. Kaplan, MD · Answer

We have not had a single patient in our practice present with the symptoms you describe.  This is most likely because a reaction specifically to the ingredients in hyaluronic acid products such as Restylane and Juvederm is very uncommon.

	With that said, and given your history, we agree that Radiesse is a viable alternative for you to look into.

William Ting, MD · Answer

True skin allergic reaction to hyaluronic acid fillers such as Restylane or Juvederm is exceedingly rare. Granuloma formation can seldomly happen after hyaluronic acid injection and often is attributed to less than perfect hygiene skin preparation prior to injection rather than the hyaluronic acid itself.

Monika Soni, MD · Answer

Thank
you for your question. It’s very rare to have an allergic reaction to
hyaluronic acid fillers, such as Restylane or Juvederm. Your reaction is most
likely due to the ingredients in hyaluronic acid products and this is very
common. However,
I do recommend having a follow up with injector to have this evaluated and
treated. Best of Luck!

Hardik Soni, MD · Answer

Thank
you for your question. It’s very rare to have an allergic reaction to
hyaluronic acid fillers, such as Restylane or Juvederm. Your reaction is most
likely due to the ingredients in hyaluronic acid products and this is very
common. However,
I do recommend having a follow up with injector to have this evaluated and
treated. Best of Luck!

Steven F. Weiner, MD · Answer

Granulomas are when the body reacts to a substance and considers it  foreign material.  The is an intense inflammatory response, but not an allergy.  This creates redness and swelling.  Steroids are usually given to reduce the swelling.  Sometimes, dissolving the filler with hyaluronidase will resolve the problem too.
You can form granulomas with any filler.  Also, it doesn't happen every time you get the same filler.
Interesting, I was told that Radiesse forms the least amount of granulomas of the fillers, but I can't substantiate that.  Radiesse does form more nodules than other fillers, which is bumps that are not swollen and do not hurt.
I don't have any personal experience with the granulomas, but have been to several meetings where they were discussed.

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