Lumps After Dermal Fillers / Dissolving Fillers

What causes lumps after dermal fillers?

Lumpiness is fairly normal after dermal fillers. Most often this is due to swelling immediately after a treatment. This should resolve within a week but rarely can take several weeks to fully resolve. When lumpiness does not resolve, it may be due to other causes including filler lumps, scar tissue, nodules, and granulomas. Most importantly, for every cause of lumpiness Asterie Clinic has a treatment protocol for addressing them.

What is hyalase?

Hyalase or hyaluronidase is a liquid that has enzymes to spead up the breakdown of hyaluronic acid. This is the injection that allows hyaluronic acid dermal fillers to be reversed. This increases the safety and cosmetic profile of dermal fillers as they can be reversed for cosmetic and health reasons. While it starts to work almost instantly and the filler is reversed within a few days it can take some time to see the full results of the hyalase as we have to wait for the associated swelling to settle. For cosmetic reasons, we often evaluate the results of hyalase after 2 weeks. Reversing filler for safety reasons will have its own follow up protocol.

Should I be worried if there is a lump after dermal fillers?

This depends on the type of lump. It is always better to be safe than sorry and we are happy for you to communicate your worries to us. Lumpiness is extremely common after filler injections and is most likely swelling. Haematomas where a blood vessel has burst is less likely but can lead to more pronounced swelling. Rarely swelling is associated with a vascular occlusion where a blood vessel has been blocked off by filler. This is more concerning and needs to be reversed. It is often associated with pain and discoloration of the skin.

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Procedure photos/before and afters

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Frequently Asked Questions

When are fillers reversed for safety reasons?

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Fillers are reversed for safety reasons if a blood vessel has been inadvertently occluded by filler. Thankfully this is an extremely rare complication. If you suspect this of happening, you should contact your injector immediately.

How to treat swelling after fillers?

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The most effective way to treat swelling after fillers is to apply ice before, during and after injection (for a few days). Ice packs are one of the few treatments that are actually effective for bruising. Hirudoid cream, arnica cream and bromelain cream have not been shown to be effective.

The following medications can also be associated with more bruising and swelling:

  • NSAIDs (non-steroidal anti-inflammatory drugs) e.g. aspirin and ibuprofin
  • Herbal supplements including ginko, and ginseng
  • Fish oil

Can all fillers be dissolved?

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Not all fillers can be dissolved. Only hyaluronic acid fillers can be dissolved. Collagen stimulating fillers cannot be dissolved which is why these types of fillers should only be used by injectable experts who know their anatomy and have low rates of cosmetic dissatisfaction.

Why should I get my fillers dissolved at Asterie Clinic?

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At Asterie Clinic, we have an ultrasound scanning device on site which can help us confirm the exact location, size and type of filler. This means that the filler can be injected with more precision and only if we confirm that it is indeed filler causing the lump.

What are other alternatives to dissolving fillers?

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For superficially injected filler, we can sometimes manually extrude the filler with a needle puncture. Superficial filler often looks blue under the skin and has a semi-transparent quality.

Filler lumps can occasionally be massaged especially in the early stages before they have started to integrate with the surrounding tissues.

What is the process of getting fillers dissolved?

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If you have had hyaluronic acid filler dissolved in the past, the process is fairly straightforward as we know that hyalase is unlikely to cause an allergic reaction.

As hyalase can in rare cases cause severe allergic reactions for first-timers we perform a skin patch test to ensure that you do not react to the product. This involves injecting the forearm with a very small dose of hyalase to test if it causes a mild allergic reaction. If you pass the skin patch test we can proceed to dissolving the filler. After dissolving filler for the first time we prefer to observe you in clinic for an hour or so to ensure that you do not develop an allergic reaction.

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