What is being treated

Filler injections add volume under the skin to restore fat lost with aging, reshape an area of the face, or fill wrinkles.  A risk of filler is a lump seen or felt after the treatment.

The treatment of lumps after dermal filler injections depend on the type of filler used and the clinical situation.

For most fillers, swelling can occur in the days after the treatment.  If this swelling is causing a contour abnormality, it may subside on its own with time.

If suggested by your provider, massage may help with filler lumps if the filler itself is malleable and there is a heaped area of filler material.

With hyaluronic acid-based fillers (Juvederm, Restylane, Belotero), the injection of an enzyme, hyaluronidase, will dissolve filler material. This is done if it is thought that too much filler is located in one location or if one simply wants to remove filler.

Lumps caused by inflammation (granulomas) due to the body’s reaction to the filler substance can be more difficult to address.  Doctors have used anti-inflammatory injections such as localized steroids (Kenalog) and antimetabolites (5-FU) to reduce inflammation but there can be adverse effects from steroid injections including loss of fatty tissue.

If the filler in question is a permanent material (Artefill, Aquamid), often a surgical treatment is required to remove lumps.  This may involve an incision to access the filler material.

Lumps after fat injections have also been treated with anti-inflammatory injections, surgical fat removal, or mini liposuction techniques.  The treatment of choice depends on the location and depth of the fat lumps.  Oil cysts caused by fat injections are often corrected with needle drainage.

Risks

There may be residual lumps, skin irregularities, skin color changes (hyperpigmentation, redness), or visible scars if an incision is created to remove filler.  Many of these issues can be corrected with further treatments.