Nodule after filler: what it is and why it happens

A nodule is a palpable, and sometimes visible, raised or hardened area where a dermal filler was injected. It is one of the most common complications of facial harmonization and has different causes, which makes assessment the first step before any management.

What types of nodule are there?

A practical way to classify them is by when they appear:

• Early (days to a few weeks): usually product accumulation, placement that is too superficial, swelling or uneven distribution. They are generally not inflammatory.
• Late (weeks to years): can be inflammatory, tied to the body's reaction to the product, to a low-grade infection or to a foreign body granuloma.

Signs such as redness, warmth, pain and fluctuance suggest an inflammatory or infectious process and call for prompt assessment.

Why does the product change the management?

When the nodule is hyaluronic acid, hyaluronidase can break down the product, which gives the professional a corrective tool. Fillers that do not respond to the enzyme, such as biostimulators and permanent products, are harder to manage. The Tyndall effect, the bluish tint of a superficial product, can come along with a nodule in thin-skinned areas such as the tear trough and the lips.

Management, which may include observation, guided massage, enzyme, medication or tests, is set by the qualified professional, depending on the case and the rules of their professional council (in Brazil). The general topic is covered in safety and complications.

In Harmy

History stores the photo of each session and, with "Add actual result", the result photo aligned by the eyes, which helps document the progress.

Also called: filler nodule, lump after filler.