Patients should be aware that injected fillers may be palpable for a few months, but only visible lumps or bumps are of concern. It would be a mistake to massage an injected filler outside the area it is intended to fill. Lumps or bumps that appear after receiving a dermal filler injection are rare, but if they do occur, they usually go away on their own within a week or two. For faster results, the injecting nurse can massage the area to smooth out any irregularities, or hyaluronidase can be used to dissolve the filler.
If you can see the lumps, perform a gentle massage (only if recommended by your doctor) and if you can still see a lump at two weeks, contact your doctor. Lumps and bumps can occur with any injection of dermal filler. In fact, it is very common for patients to feel bumps on their skin days after treatment. Any bumps or bumps that appear after receiving an injection of a dermal filler using hyaluronic acid should be massaged with the injector after administering the injection, to disperse the filler and soften the skin.
The results should be immediate, however, if the massage is not effective and the lumps or bumps persist, an injection of hyaluronidase can be given to dissolve the filler at that point. Any lump or lump that doesn't go away on its own after a week or two or that doesn't respond to massage can be treated with hyaluronidase to dissolve the filler. It is recommended that only an experienced injector massage the treated area, after having made a thorough assessment of the situation. While it's normal to feel small lumps (depending on the thickness of the filling used), if you feel a particular lump, you can massage it gently between your finger and thumb for a period of time and it will help “break down” the lump.
Instead of waiting for post-treatment bumps or bumps to go away on their own, you can schedule a follow-up appointment with your injector to have a firm massage of the area to settle the filler and soften the skin more quickly. It is important to note that it is only possible to effectively massage hyaluronic acid fillers such as Juvéderm and Restylane for the first two to seven days after receiving an injection. However, bumps or bumps caused by swelling or bruising will usually go away on their own after a week or two, or sooner if the proper massage technique is applied or if a hyaluronidase injection is given. If this occurs, it could be due to several factors such as poor injection technique (using too much filler or too much pressure when injecting the filler), improper skin massage after the injection, or displacement induced by pressure and intravascular injection (injecting the filler into a vein or artery). Soft lumps are easier to handle as they are more likely to be just undissolved fillers or lumps that your provider can soften with a firm massage.
Thicker fillers like Radiesse tend to produce more swelling and residual bruising than thinner fillers like Restylane. While a follow-up visit to the injector is recommended if massage is desired to accelerate filler sedimentation, an injector can also instruct the patient on how to effectively massage the area on their own. After giving a dermal filler injection, most injectors will examine the area for bumps or bumps and massage them out before the patient leaves the clinic. This will be done with care as an aggressive massage could cause the filler to spread too far and lead to undesirable results. If the massage is not effective then a hyaluronidase injection can be used to break down some or all of the filler, after which it is desired to inject additional filler to add volume and improve overall results.
