Facial Plastic Surgery, Ear, Nose and Throat

Facial Plastic Surgery

including Cosmetic and Reconstructive Surgery, Injectables, Chemical and Laser Peels, IPL, and Cosmetic Dermatology

Otolaryngology

including Ear, Nose, Sinus, Throat, Voice, Snoring and Sleep Apnea, Thyroid and Parathyroid, and Skin Cancer

How Can I Avoid Restylane Bumps?

Restylane does not cause bumps under the skin unless:

  1. It is injected too superficially
  2. It is injected unevenly

Skin reactions or prolonged inflammation related to the injection of Restylane are extremely rare (I, personally, have never seen it). Areas where the skin is thicker, such as the nasolabial folds, are much less likely to end up with bumps, compared with areas where the skin is very thin, such as the tear troughs below the medial lower eyelids.
I recommend that patients do nothing other than gently apply ice to areas injected with fillers, including Restylane, for the first 3 days following their treatment. This allows for most of the initial swelling to resolve.
After the 3rd day and before the 7th day post-injection, I recommend massaging any area with a visible bump, excess fullness, or asymmetry, several times a day, until it smooths out. This massage can be performed with a fingertip or the tip of a Q-tip.

Patients should recognize that injected fillers may be palpable for several months, however, only visible lumps or bumps are of concern. It would certainly be a mistake to massage an injected filler out of the area that it was meant to fill.

The good news, in case of a Restylane or Juvederm bump that fails to resolve in a timely fashion, is that these materials (hyaluronic acid gels) can easily be dissolved with the injection of hyaluronidase (Amphadase or Vitrase).

Bumps composed of other injectables, such as Radiesse or Artefill, are more difficult to treat. Injection of steroids along with vigorous massage would be a good first step. Surgical excision is rarely, but sometimes required as a last resort.

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