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 supposed 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. When frozen hyaluronic acid is the cause (which usually happens when fillers from the Juvederm and Restylane families are used), it can be easily corrected by injecting hyaluronidase directly into the lump. Instead of waiting for post-treatment bumps or lumps 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 recommended that only an experienced injector massage the treated area, after having made a thorough assessment of the situation.
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. The injector should massage the area deep enough to disperse the filler, but not so hard as to reduce the new volume that has been added to the dermal layer of skin in the injected area. However, bumps or lumps 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. Any bumps or lumps 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 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. Patients can be taught the correct technique for massaging the area around the injection site to disperse any filling lumps or lumps that were not present at the time of treatment. Thicker fillers like Radiesse tend to produce more swelling and residual bruising than thinner fillers like Restylane.
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. 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.
