Ellansé aftercare:
massage rules, swelling, and what to watch for

Should you massage after Ellansé?

No, not unless you have been told to for a specific area. Ellansé is polycaprolactone microspheres suspended in a carboxymethylcellulose gel carrier, placed deep in a chosen plane. The gel gives correction on the day and the microspheres stay where they were put as a scaffold for collagen. Massage moves product, and product that has been moved into a thinner or more mobile area is exactly how a nodule in a non-dissolvable material begins. The five-five-five massage routine that patients read about belongs to Sculptra, whose poly-L-lactic acid particles are spread deliberately; the Sculptra aftercare page covers that, and the two should not be confused.

If massage has been instructed for an area, the technique is shown before you leave and the written aftercare states the area, the pressure and how long to continue. In the absence of that instruction, the rule is hands off: no pressing, no rubbing, no checking the shape with your fingers, and no gua sha, facial rollers or face masks that press on the area. The Ellansé page explains why the product is placed deep, staged and dosed for the collagen it will produce rather than for the gel you see on the day.

What should you do on the first day after Ellansé?

On the first day, leave the treated area alone and keep it cool. A clean, cool compress held lightly for short spells eases tenderness and limits swelling; do not press hard and do not put ice directly on the skin. Keep the entry points clean and dry, cleanse gently with lukewarm water and a mild cleanser, and avoid make-up over the entry points until they have closed so that bacteria are not carried into them.

Avoid alcohol, hot showers on the face, saunas, steam and hard exercise for the rest of the day, because heat and raised blood pressure widen blood vessels and add to swelling and bruising. Paracetamol is reasonable for tenderness if you can take it; avoid anti-inflammatory painkillers unless the clinic has said otherwise, as they can increase bruising. Sleep face-up with the head raised on an extra pillow while the area is tender, so that the treated side is not pressed into the pillow while the tissue is settling around the product.

Look at the skin over and around the treated area several times during the first day, including before bed. The written aftercare given before you leave names the areas and the plane and takes priority over this page.

“Massage spreads Sculptra. It moves Ellansé. That is why the instruction for one is not the instruction for the other.”

Dr Sin YongOn massage after collagen biostimulators

What should you avoid in the days after Ellansé?

For the following days, avoid anything that presses, heats or vibrates the treated area. No facials, facial massage or at-home devices; no HIFU, radiofrequency or laser over the same zones; no dental work unless the clinic has agreed, because prolonged wide mouth opening and pressure on the cheeks can shift product and dental procedures carry bacteria into the bloodstream. Tight goggles, helmets and face masks that press on the treated area are worth adjusting.

Do not have the area topped up or adjusted by anyone else, and do not judge the shape until swelling has settled. As the gel carrier is absorbed the early volume recedes, so a face that looked full on the day can seem to have lost its result; the collagen that forms around the microspheres afterwards is the actual result, and it is not the same shape or quantity as the gel. Adding more product during the gap is how the lower face ends up heavier than intended later, with no way to take it back.

Keep a note of the product name, the areas treated and the date, because any doctor who treats you later needs to know that what is in the face is polycaprolactone, which cannot be dissolved, and not hyaluronic acid, which can. The dermal filler aftercare page covers the general rules for injectables; this page covers what is specific to a non-dissolvable material.

What is normal after Ellansé, and what is a nodule?

Normal after Ellansé is swelling and tenderness over the treated area, small bruises at the entry points, a feeling of firmness where the gel sits, and some asymmetry while swelling settles at different rates on each side. The firmness softens as the gel integrates. These settle on their own and are covered in the written aftercare.

A nodule is different. It is a discrete lump you can feel, or see, that is growing, hard or painful, or that appears later, once the gel has gone. With polycaprolactone, nodules usually relate to placement that is too superficial, to volume concentrated in one spot, or to mobile areas where the product is worked by muscle. Management depends on what the lump is, which is why ultrasound comes before any intervention: a lump may be polycaprolactone, old hyaluronic acid filler, a cyst or scar, and each is handled differently. A nodule is examined, not massaged. Inflammatory nodules are managed medically; a firm over-stimulated area may be treated with Time Freeze Laser LCLR® in its Sculpting mode, which is built to target the excess tissue response and take it away. The Ellansé nodules page explains the assessment.

Not normal, and time-critical, is anything that suggests the blood supply to the skin is affected: skin that turns white over or near the injected area, or that develops a dusky, purple, blue or net-like mottling, and pain that is severe or getting worse rather than settling. Any change in vision after an injectable is an emergency. Increasing redness, warmth or pus at an entry point needs review the same day.

When should you call the clinic after Ellansé, and what happens at review?

Message the clinic on WhatsApp during clinic hours, and say that it is urgent, if you notice any of the following:

• Skin turning white, or developing a dusky, purple, blue or net-like discolouration, over or near the treated area.
• Pain that is severe, or that is getting worse after treatment instead of settling.
• A lump that is growing, hard or painful, at any time after treatment, including long afterwards.
• Increasing redness, warmth, swelling or pus at an entry point.
• A heavy or drooping feeling in the treated area that is not explained by swelling.

Go straight to the nearest hospital emergency department for any change in vision, new facial weakness, slurred speech or weakness of a limb, or swelling of the lips, tongue or throat with difficulty breathing. Do not travel to the clinic first and do not wait for a message reply. The complication care page sets these signs out in full.

The review is timed for once the gel has gone and collagen has begun to form, because that is the first point at which the real result can be judged; Dr Sin Yong under-treats at a first visit for that reason, and any further placement is staged rather than finished in one go. At review the treated areas are examined at rest and in movement, any unevenness is mapped with ultrasound, and the plan is adjusted. If you were injected elsewhere and have a lump or heaviness, bring the product name, areas and dates; what is already in the tissue is scanned before anything is added, and the answer is more often subtraction than addition. The consultation process page describes how that assessment works.