Small lumps after fillers can soften and disappear in two to three weeks, and gentle massage can help. However, very few people retain some small lumps that are not visible to the naked eye. These can stay much longer and these are small granulomas that form. At some point they may be injected with vitrase, an enzyme that breaks down the filler.
The good news is that yes, those pesky lumps of filling will actually disappear. In fact, it is very rare for patients to experience irritation or lumps after the procedure, but if you do, you should expect them to dissipate after a few days. It seems that the vein on the forehead is more prominent than before the procedure, which means that there is more pressure in the vein, either from occlusion or from external pressure. This should be addressed by your doctor as soon as possible.
My overwhelming preference is Restylane. It has a higher G prime, which will lead to greater lifting capacity. It is also much better for the tear area because it is less hydrophilic (less water absorption). It also gives more structure to lips that are small and lacking definition.
Juvederm also tends to spread, leading to correction in a general area and not exactly where it is placed. I use Juvederm in shallowly placed temples. In general, in my opinion, there are more applications for Restylane. Very often, the asymmetry that is seen after filling is something that already existed.
That's why photos are very important. The patient often looks at the treated area much more critically than before treatment. If in fact it is due to the filling, everything has to be negotiated with the office. Since you've been out for a month, the swelling should have subsided by now, but if you were away for just a few days, I'd tell you to wait two weeks before you inject again.
I have only been slightly impressed by the fillers for acne scars. The problem is that often the skin is tied and the filler does not lift the depressed area well. For a quick fix, it's the only thing available. In addition to lasers, there are TCA and RF crossover devices such as Lutronic's INFINI.
The nose is particularly prone to skin necrosis, especially if you have had a previous rhinoplasty or scarring. Vascularization may be compromised by filling by compression of vessels or by direct (internal) intraluminal injection. The first signs are pallor, which occurs almost immediately. Later signs are a blue reticular pattern that may occur in areas far from the actual injection site.
Late signs are dying of dark or black skin. You need to spot things in time to avoid necrosis, so it's better to see someone right now for evaluation. Sometimes you'll see improvements before you leave the office. You can probably replace yourself in a couple of days, but waiting a week is safe.
Most patients have some swelling after injecting Restylane on the lips because the product is hydrophilic, loves water and therefore absorbs water and swells a little. If you underwent a blunt cannula technique and only a small amount of filler, swelling should be minimal. Some of my patients go out for lunch or dinner after treatment with Restylane or Belotero. Sculptra is an ideal volumizer because it is long-lasting but Radiesse is also a great volumizer and will cost less than other fillers with shorter lasting results.
I don't like Juvederm around the eyes because of its characteristic of attracting water, which can lead to prolonged swelling. It should get better, but if not, hyaluronidase will help dissolve it. Bruises can take up to 14 days to get better and sometimes a gentle massage of areas with lumps can help to eliminate non-uniformity. Angioedema is a rapid and rare excessive swelling that some people experience after any type of manipulation on the face (dental, trauma, injections).
In my experience, it occurs most often in people who are taking “ACE inhibitors” for blood pressure.
