Why Does Restylane Cause Little Bumps Under the Skin?

Bumps close to the skin after a Restylane injection is caused by the injector pushing on the plunger as the needle is being withdrawn.  It causes bumps that will sometimes have a bluish hue to them.  This is called the Tindall effect.  It is seen whenever the product gets too close to the skin or the skin is especially thin (i.e. around the eyes).  Other lumps that are deep but not blueish should be gently massaged smooth at the time of the injection.  To prevent the Tindall effect:


In areas where the skin is thin, Restylane needs to go deep, below muscle and on the bone

Slow down and don't press the plunger when withdrawing the needle 


What to do if you have it


If it's early, be patient and it will likely fade

If it's been there a while, you can dissolve spots with Hyaluronidase

Hi RealSelf Admin. Bumps and lumps occur when dermal fillers are placed too superficially. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck, Dr. Nima!

This only occurs when seeing an inexperienced injector. Be sure to see a facial sculpting expert who is board certified to ensure they are injecting correctly. Best, Dr. Emer. 

Any filler injection has the risk of causing irregularities that can be felt, whether these are nodules, granulomas, or simply an irregular amount of filler in one location.
In most cases, the filler will be palpable immediately after injection and can be gently and carefully massaged by the injector without moving it away from the area where the filler was placed and designed to improve. In most cases, any irregularities will smooth out and the injectable will soften over time. If irregularities persist several weeks after injection, some gentle massage at home may also be helpful. With the hyaluronic acid products like Restylane, hyaluronidase can be used to dissolve the product in select cases if needed. The most common cause of irregularities would be improper product placement due to injection technique. Always see an expert physician injector to minimize your risk of problems.
Most patients do quite well without any issues and are very happy with the results. 
All the best,

It’s not unusual for small bumps to occur following
Restylane injections. These bumps occur at the site of the injection and are
related to the injection technique. When Restylane is injected closer to the
surface of the skin these bumps commonly occur. They can be prevented by
avoiding superficial injections. Once they occur, they can be treated with
massage. In most cases, a response is generated within a week of this maneuver.The
best way to avoid this complication is to consult a specialist with training
and certification in this area. It’s also important that this specialist have
experience with injectable fillers.If
you’re concerned about this problem, it should be discussed with your provider.
Your provider should be able to address your concerns.

Thank you for the question. Bumps that you can feel, or irregularities (in color or surface) that can be seen, are generally the result of the injection technique.  If Restylane (or any other hyaluronic acid filler) is placed too close to the skin surface, these issues can result. Particularly in the lower eyelid region, a gentle touch and a clear understanding of the anatomy are keys to a smooth, natural-appearing result.

A patient question regarding bumps under the skin following a Restylane injection by their doctor can be explained by a couple of causes. The first one is that early lumps or the ability to feel the hyaluronic acid filler( Restylane or Juvederm) for the first several weeks is normal. Whenever we place a filler under the skin, the body's first response is to say "hey what is this?". During this initial stage the patient often experiences some swelling and will feel the filler. As the body begins to recognize the filler- since we are loaded with the hyaluronic acid) this stage subsides. Sometimes, patients interpret the fact that they can no longer feel the filler, that it has disappeared.

  If a patient has lumps after 6 weeks it could be persistent reaction by the patient's body, such as a nodule, or possibly technique. In these cases if the lumps are visible, they can be softened or completely removed by injecting a Hyaluronidase.

Properly done, Restylane and Juvederm should not leave lumps. There are several techniques that are used for dermal fillers, and the original one is called "serial puncture" in which a series of injections are done along the wrinkle.
This is more likely to leave bumps in my opinion, and I more commonly do "linear threading" in which the product is layered along the wrinkle being filled. There are several variations on each of these, but lumpiness should be avoidable.

If you feel bumpiness after Restylane, it is likely that you have a small concentration of product around an injection site. When this occurs, it is possible to massage the area to smooth out the bumps, although this procedure is something we like to avoid as it may lead to shorter duration for the product if too much massage is necessary.

To avoid bumps, make sure to choose a practitioner carefully. If the injections are done with the proper care, you should not have much bumpiness at all. In a last resort scenario, your practitioner can use Hyaluronidase to reverse the effects of the Restylane if severe bumpiness is present.

Thank you for your question. Sometimes bumps under the skin is caused when the injector pushes on the plunger as the needle is being withdrawn. If the product is placed superficially (close to the skin) than you will see a bluish tint, this is called the Tyndall effect. Lumps that are deep and not bluish you can gently massage to help smooth out the product. If the bumps do not dissipate or you are unhappy with your results the product can be dissolved with an enzyme known as hyaluronidase. It is very important to have your injections done with a professional to help avoid this complications. Best of Luck!