Dermal fillers hard and swollen 4 months after - could a granuloma form that fast?

Anytime you get sick, whether it be Covid or the Flu, your immune system can react to dermal fillers in the face, as they are foreign to the body. This would cause the area to swell and be tender, the filler will feel hard and palpable. It is described in the literature as a late onset inflammatory immunological response. While late onset filler reactions are rare, they do happen. In this case I typically recommend a dose of oral steroids and follow up in a week. If that does not reduce the inflammation, I would recommend dissolving and residual bumps of the filler. Using hyaluronidase to dissolve filler does not affect your natural tissue, tear troughs and cheeks are common areas to dissolve without any issue.