"Doctor, this feels like a rock" — A question I received yesterday

"Doctor, this feels like a rock" — A question I received yesterday

Let me start with the conclusion.

If the filler injected into your body feels like hard lumps,

it's not that the filler has "hardened"

but rather your body is attacking the filler.

Let me explain the reason in this article.

Here's what makes this different

Foreign body reactions (granulomas) are

inflammatory nodules created by immune cells

layering around filler that's recognized as foreign material.

Unlike simple clumping or swelling,

granulomas don't resolve over time

but actually become progressively harder.

They feel rock-hard to the touch

and don't move easily when pressed.

Why do some patients experience less effectiveness?

Last month, a 47-year-old woman came to see me.

She had received large amounts of body filler

in her chest area at another clinic 3 years ago.

The first year was fine,

but at some point, 2-3cm sized

hard lumps began forming on both sides.

The ultrasound showed typical granulomas.

Here's something important to understand.

Body fillers, unlike facial fillers,

are injected in volumes of tens to hundreds of cc at once.

Facial procedures typically use 1-2cc.

The volume difference is tens of times greater.

Foreign body reaction rates for hyaluronic acid-based fillers

are reported at around 0.3-0.9%,

but illegal fillers containing non-absorbable materials

like acrylamide or PAAG

show granuloma formation rates

of 5-10% years later according to literature.

The larger the injection volume

and the more unclear the ingredients, the exponentially higher the risk becomes.

To be honest,

dissolving large amounts of filler in the body

is not easy.

If it's hyaluronic acid, we can dissolve it

to some extent with hyaluronidase,

but fillers of unknown composition

often require surgical removal through incision.

This is how I approach it in my practice

While each case varies,

I usually divide my approach into three categories.

But this isn't entirely straightforward.

Body tissue is deeper and thicker than facial tissue,

so even with hyaluronidase,

complete dissolution often doesn't happen in one session.

It requires 2-3 divided treatments,

and I always inform patients first

that 100% restoration is difficult to achieve.

However, patients who discover issues early

often achieve relatively clean resolution,

so the answer is to come in quickly if you have suspicions.

The three most common questions I receive in my practice

Q1. It's been 5 years since my procedure, but I'm just now feeling lumps. Is this still a foreign body reaction?

A. Yes, this is definitely possible.

Granulomas quite often appear

as delayed reactions months to years later.

Especially after immune system stimulating events

like colds, vaccinations, or dental procedures,

some patients experience sudden swelling.

I recommend starting with an ultrasound examination.

Q2. Can removal procedures be completed in one session? What are the costs?

A. Honestly, completion in one session is rare.

Depending on the composition, volume, and location,

it typically takes an average of 2-4 divided sessions.

Costs vary greatly depending on lump size and method,

so accurate information can only be provided

after an ultrasound examination.

Q3. Won't they disappear on their own if left alone?

A. This is a common misconception.

Granulomas do not disappear by themselves.

Rather, fibrosis progresses over time,

making them harder and pulling on surrounding tissue.

Getting evaluated quickly before pain

or deformation occurs is much more advantageous.

KakaoTalk consultation is also available before your visit.