Under-eye lumps after Sculptra, Radiesse, Ellansé or Juvelook: why they do not dissolve, and what can be done
Medically reviewed by Dr Sin Yong · Last reviewed · 7 min read
Published 9 October 2026 · Reviewed by Dr Sin Yong
Collagen-stimulating fillers work differently from hyaluronic acid, and they behave differently when something goes wrong. Sculptra, Radiesse, Ellansé and Juvelook are not broken down by hyaluronidase, so a lump under the eye from one of them cannot be “dissolved” in the way an HA lump can. It can be assessed and managed.
Short answerLumps from Sculptra (PLLA), Radiesse (CaHA), Ellansé (PCL) or Juvelook are not dissolved by hyaluronidase. Most CaHA nodules in a large review resolved; persistent ones are managed according to what ultrasound shows, with published options including intralesional steroid with or without 5-fluorouracil, and excision as a last resort. Dr Sin Yong uses Time Freeze Laser LCLR® Sculpting mode for Ellansé nodules, excess Juvelook and migrated Sculptra; he uses it under the eye too, after assessment and ultrasound.
Does not dissolve PLLA, CaHA, PCL or PDLLA; it can dissolve only an HA component, such as the carrier in Juvelook
How long they stay
PLLA and CaHA usually up to about two years, occasionally longer (Wollina 2024)
CaHA nodules
In 5,081 treatments, 3% had adverse events, 96% of them nodules; most resolved (Kadouch 2017)
First step
History and ultrasound to see the material, its depth and whether it has clustered
His approach
Time Freeze Laser LCLR® Sculpting mode where appropriate; built to break up and take away the excess
Why can’t these lumps be dissolved?
Hyaluronidase is an enzyme that breaks down hyaluronic acid. Poly-L-lactic acid (Sculptra), calcium hydroxylapatite (Radiesse) and polycaprolactone (Ellansé) are different materials, and the enzyme has no effect on them. They work by provoking the body to lay down collagen around the particles over months, which is also why a lump from one of them can be firm and why it may appear or change after the injection appointment. PLLA and CaHA usually persist for up to about two years and occasionally longer (Wollina, J Cutan Aesthet Surg 2024).
The under-eye is a particularly unforgiving place for these products: the skin is thin, the muscle moves constantly, and small clusters are easily seen and felt. In a review of 5,081 calcium hydroxylapatite treatments, 49% of adverse events occurred in dynamic areas such as around the eyes and mouth (Kadouch, J Cosmet Dermatol 2017).
Collagen stimulators are not hyaluronic acid. Hyaluronidase does not break them down.
How a non-HA lump is assessed
Dr Sin Yong starts with what was injected, when and how much, then examines the area at rest and in expression. Ultrasound shows whether the material is clustered or spread out, how deep it sits, whether there is inflammation around it, and whether any hyaluronic acid is also present, because many under-eyes have had more than one product over the years. The plan depends on those findings.
“A calcium or collagen filler cannot be dissolved. It can only be assessed and managed.”
Dr Sin YongOn non-HA fillers
Ultrasound shows whether the material is clustered, how deep it sits, and whether hyaluronic acid is also present.
What the options are
Waiting. In the 5,081-treatment calcium hydroxylapatite review, most nodules resolved (Kadouch 2017).
Intralesional treatment. For persistent nodules and granulomas, published options include corticosteroid, often combined with 5-fluorouracil to reduce thinning of the skin (Lemperle, Plast Reconstr Surg 2009; Vleggaar, J Drugs Dermatol 2014). This follows a diagnosis, not a guess.
Time Freeze Laser LCLR® Sculpting mode. For excess collagen-stimulator material in the face, including under the eye, Dr Sin Yong uses the Sculpting mode of Time Freeze Laser LCLR®, which is built to break up and take away the excess. He uses it for Ellansé nodules, excess Juvelook, layered hyaluronic acid and migrated Sculptra. He uses it under the eye; whether it suits a particular under-eye is decided at assessment.
Removal. Surgical excision is a last resort for a nodule that does not respond, and carries its own scar.
Where hyaluronic acid has been layered with a collagen stimulator, the HA component can still be dissolved. More on collagen stimulators: filler correction, Ellansé, Sculptra.
Frequently Asked Questions
No. Sculptra is poly-L-lactic acid, which hyaluronidase does not break down. Lumps are assessed with ultrasound and managed according to what is found.
Ellansé is polycaprolactone and is not dissolved by hyaluronidase. Dr Sin Yong uses Time Freeze Laser LCLR® Sculpting mode for Ellansé nodules, including under the eye; whether it suits a particular under-eye is decided at assessment.
In a review of 5,081 calcium hydroxylapatite treatments, most nodules resolved. Persistent ones are assessed and managed.
Juvelook combines poly-D,L-lactic acid (PDLLA), a collagen stimulator, with a hyaluronic acid carrier. Hyaluronidase can dissolve the HA component but not the PDLLA, so excess Juvelook is managed as a collagen stimulator.
References
Kadouch JA. Calcium hydroxylapatite: a review on safety and complications. J Cosmet Dermatol. 2017;16(2):152-161. doi:10.1111/jocd.12326. source
Wollina U, Goldman A. Spontaneous and induced degradation of dermal fillers: a review. J Cutan Aesthet Surg. 2024;17(4):273-281. doi:10.4103/JCAS.JCAS_137_23. source
Lemperle G, Gauthier-Hazan N. Foreign body granulomas after all injectable dermal fillers: part 2. Treatment options. Plast Reconstr Surg. 2009;123(6):1864-1873. doi:10.1097/PRS.0b013e3181858f4f. source
Signorini M, Liew S, Sundaram H, et al. Global Aesthetics Consensus: avoidance and management of complications from hyaluronic acid fillers. Plast Reconstr Surg. 2016;137(6):961e-971e. doi:10.1097/PRS.0000000000002184. source
Convery C, Davies E, Murray G, Walker L. Delayed-onset nodules (DONs) and considering their treatment following use of hyaluronic acid fillers. J Clin Aesthet Dermatol. 2021;14(7):E59-E67. PMID 34840652. source
