The lump that arrives late

Where the risk is higher

Three factors come up repeatedly, and all three are decided before the needle goes in rather than afterwards.

Depth. Our treatment page puts it plainly: depth is the single biggest factor in whether the result looks even. Placed too superficially, the same material that would have been invisible deeper has nowhere to disperse.

The area. Thin, mobile skin is less forgiving than the cheek. The tear trough is the clearest example and is why we approach that area conservatively, or not at all. Skin thin enough to show a small irregularity is skin thin enough to make that irregularity a problem.

How much, how often. A course of three sessions about a month apart exists partly for this reason. Spacing gives the tissue time to respond to what is already there before more is added.

If you find one

Tell the clinic that treated you, and do it early. A small, soft, recent nodule and the same nodule left for six months are not the same clinical problem, and the first is considerably easier to deal with.

Do not massage it hard, do not try to squeeze it, and do not book another session of anything over the top of it on the assumption that more product will even it out. Bring it to an examination before anyone injects anything else into that area.

Redness, heat, tenderness or rapid change are a different situation from a quiet firm lump, and they want to be seen sooner rather than at your convenience.

How they are treated

Treatment is chosen after an examination, so what follows is the range described in the literature rather than a plan for your case.

One point is worth knowing in advance, because it surprises people. The injection that dissolves hyaluronic acid filler does nothing to this material. Hyaluronidase works on hyaluronic acid. Poly-D,L-lactic acid is not hyaluronic acid, and a clinic offering to simply dissolve it has misunderstood what was injected.

Small, soft and asymptomatic nodules are sometimes watched, since the polymer is on its way out regardless. Inflammatory nodules are commonly treated with injected corticosteroid, sometimes combined with other agents, aimed at settling the reaction rather than removing the material. Where infection or a biofilm is suspected the approach changes to antibiotics first, because steroid into an infected nodule makes matters worse. Surgical removal exists and sits last, for the minority that do not settle.

The pattern across all of those is the same: identify what kind of nodule it is before treating it. That is the step that needs an examination and cannot be done from a photograph in a message.

If you have already flown home

Contact us anyway. We would rather hear about it from the other side of the world than not hear about it, and we will help you find appropriate local care. Bring the date of your sessions and what was used; a local doctor who knows it was a poly-D,L-lactic acid product is working with information, and one who does not is guessing.

Reading this in context

A lump that appears in the first days is usually swelling or bruising. A result that seems to disappear around week two is normally the expected dip, which we cover in why week two looks like nothing. This article is about the thing that turns up later than either, when you had stopped thinking about it.

This risk belongs to the poly-lactic-acid class rather than to skin boosters in general, which is one reason the three treatments are not interchangeable. And no gallery will show you a nodule, which is part of what a before and after cannot tell you. The short version of the treatment itself is on the Juvelook page, and the papers cited here are listed with the others on our Sources & References page.