Treating Lumps and Bumps From Fillers
Posted: 6:00 a.m. Sunday, May 27, 2017
By Anita Mandal, M.D.
Question: I’m in my 60’s and had fillers put in my marionette lines and nasolabial folds 4 years ago. But I got a bump in my smile line several months later. I never went back to show the doctor who injected me. The bump did eventually go away after a year. I’d really like to have more fillers but am worried about getting another bump. How can I avoid this problem from happening in the future?
Answer: There is no way to 100 percent eliminate the chances of developing a bump from injectable filler treatments. Even in the presence of perfect injection technique, using the safest fillers on the market, the risk of bumps, even if rare, does exist. Understanding and accepting this low risk is part of being a realistic patient with realistic expectations when having this medical procedure.
The good news is that there are various ways to treat bumps resulting from injectable fillers. Most importantly, notify your doctor the first time you become aware of a bump and make an appointment to see him or her. While treating a bump is not a medical emergency, waiting many weeks to months to see your doctor may decrease the chances of correcting the problem. As a patient, you have a mutual responsibility in participating in your medical treatment and after care.
If a bump is caught early on after it appears, manual massage can sometimes completely make a bump go away. However, it is important to see your doctor as soon as possible and have him or her show you how to effectively massage the bump. Improper massage techniques may not work.
If massage alone doesn’t work, then certain dissolving products can be injected into the bump. With hyaluronic acid (HA) fillers, such a Restylane and Juvederm, Vitrase can help dissolve bumps. For non-HA fillers, such as Sculptra, Radiesse and Bellafill, Kenalog injections can be very effective. Sometimes 5-flouracil is mixed with the Kenalog for greater effectiveness.
While some doctors claim to have surgically cut out bumps, in my practice experience, surgical excision is an extremely rare option. It is also important to note that many bumps can resolve on their own over time without any aggressive intervention. For instance, the FDA study on Bellafill which followed more than 1000 patients over 5 years, showed an extremely low granuloma rate of about 1.7 percent. By the end of the
5 years, nearly half had resolved on their own and most of the others were in the process of resolving without any aggressive intervention.
It cannot be overemphasized how important it is to contact your Facial Plastic Surgeon soon after you first notice a bump. Your doctor can then discuss the best treatment approach and take advantage of early intervention to improve your chances of a good outcome.