With any injections into the skin with dermal filler, lumpiness may occur. Lumps after dermal filler is a common issue and can be normal and temporary, or it may need to be reviewed.
It is very common to have temporary lumpiness in the skin in the first few weeks after dermal filler. What usually happens is that it will integrate into the skin by about week 4.
Causes of temporary lumpiness in first few weeks after dermal filler
- Lumpiness may be due to bruises, this will resolve
- Lumpiness may be due to swelling at the injection site which will resolve
- Lumpiness may be felt during the first few weeks while the product is smoothing and integrating with the tissue
Lumpiness is very common to feel in your skin in the days after injection of dermal filler into the face, including the upper lip body and the cheeks and the chin area and along wrinkles and folds when injected to lift these. It will usually resolve within a couple of weeks.
How to Prevent Lumpiness with dermal filler injections?
Bruising prevention is important
- Ice may be used prior to injections.
- The injector can prevent bruising by using a cannula for injections. Cannula can be used for some injecting, but not with very superficial injections. Safety is an issue which also determines whether your injector will choose to use needle or cannula
- The injector should make sure with each injection site that pressure is applied to the area as quickly as possible and for as long as necessary to stop the bleeding. Ice should the be reapplied to the area that was bleeding
- If given the OK from their prescribing doctor, the patient can make sure they have stopped any blood thinning drugs (including vitamins) 2 weeks prior to the injectable appointment.
Medications / Vitamins associated with increased bruising (ie blood thinners)
- NSAIDs (non-steroidal anti-inflammatory drugs) eg aspirin, Naprosyn, Ibuprofen
- Herbal supplements including ginko, garlic and ginseng, St.John’s wort, danshen, don quai and feverfew
- Many other medications / herbs are included, please discuss with doctor
Injection technique is important for preventing lumpiness
The injection technique of laying down many fine lines in an area instead of depositing large lumps of filler will reduce the incidence of lumps. This creates a very smooth look (maybe not at first, but when swelling has resolved).
What do I do if I notice lumps after my dermal filler injections?
First, rule out infection (this will be a combination of the following: redness, tenderness, swelling, pain and pus) This is rare, but can occur. Contact the clinic in this circumstance as antibiotics and other treatments may be required
The main thing about lumpiness is, do not panic, it is very common in the first few days up to a couple of weeks after treatment.
If you can only feel the lumps and not see them, then panic even less, because this isn’t usually a problem.
If you can see the lumps. Keep your eye on them. Perform gentle massage (only if recommended by your injector) and if you can still see a lump at 4 weeks, contact your doctor.
Treatment of lumps
- Massage: This is very effective, but often needs to be stronger in pressure than patients realise
- Manual removal of product by the injector
- Hyaluronidase / Hylase; The injector can inject the lump of a dissolver to remove the product. Please see an article where we dissolved some tear trough filler
Dermal Filler Lumps Tips
When you’re having your injections, always remind your injector where you have had a big bruise in the past, as the injector may be able to be more careful or avoid that area when possible. Often patients will get bruises in the same area.
Also let your injector know if you have had a history or lumps from dermal filler in the past that did not resolve for over 4 weeks post injections.
Also, come a little early to your appointment and ask if you can sit somewhere quietly for a few minutes before the appointment with ice on your face.
Lumpiness is extremely common in the body of the upper lip. Even with perfect technique this can occur. This area needs extra and strong massage. Have your doctor demonstrate how to massage the area.
When to review a filler lump?
Lumps after filler should be reviewed as an emergency if there are any signs of infection.
If there are not signs of infection, it is typical to review your filler results at 4 weeks when the swelling and bruising is resolved and the product has integrated.