Ellansé Nodules and Lumps

Hello, I am Dr. Liu.

Direct Answer: The situation you are describing sounds very much like a relatively late-onset lump/nodule, fibrosis, or delayed inflammatory reaction after Ellansé (少女針) injections. This condition can be treated, but an in-person consultation and examination are required first; it cannot be assessed based on appearance alone. Given that the right side has been there for six years and suddenly worsened this year, while the left side is also starting to appear—compounded by a foreign body sensation, pressure, and a slight protrusion—it is no longer advisable to simply wait and see without treatment.

Possible Conditions to Differentiate
Unlike Hyaluronic Acid (HA), Ellansé cannot be directly dissolved with hyaluronidase. The collagen-stimulating components inside it may cause localized collagen hyperplasia, encapsulation, lump/nodules, or fibrosis, and can suddenly become prominent years later due to factors such as physical condition, immune response, or local irritation. The under-eye area is extremely delicate and must first be evaluated using palpation and high-resolution ultrasound to confirm:
1. Which tissue layer the lump is in
2. How large the affected area is
3. Whether it is a nodule, fibrosis, granuloma reaction, or a mixed type
4. Whether it is close to major blood vessels or periorbital structures
5. Whether there is residual material or inflammatory reaction on both the left and right sides

General Treatment Approach
The treatment plan will only be determined after confirmation: some cases can be treated locally with medications under ultrasound-guided, while others require phased softening and resolution of the inflammatory reaction. Clearly defined, concentrated, and palpable lump/nodules can also be evaluated for minimally invasive management or removal. The under-eye area should not be rushed, nor treated blindly; safety and precision are more important than speed.

During the month before your in-person consultation, I recommend doing a few things first:
1. Do not vigorously massage, apply heat, use Gua Sha, or undergo high-temperature facial treatments (such as saunas, hot yoga, or thermal facial devices). These sometimes make localized inflammation or swelling more pronounced.
2. Temporarily refrain from undergoing unclear injection treatments. Ellansé is not hyaluronic acid and cannot be resolved with hyaluronidase; repeatedly injecting normal saline, corticosteroids, or other medications without ultrasound localization can also further mess up the tissue.
3. When you feel localized swelling and discomfort, you can apply a short, light cold compress with a clean gauze or towel for 5–10 minutes each time. Do not press on the lump/nodules, and do not ice it for too long.
4. Take photos under fixed lighting and at a fixed angle every day or every few days to record changes. You can also gently mark the position where you feel the lump/nodules by hand. This information will be very helpful during your consultation.

When to Seek Immediate Medical Attention
If the under-eye lump/nodules suddenly becomes red, swollen, hot, and painful, rapidly increases in size, changes skin color, or if you experience changes in vision, do not wait—seek medical attention immediately.

There is no need to panic just yet, but your condition indeed requires a thorough examination, and it is not recommended to simply wait for it to absorb on its own.

This online reply is for general health education purposes and does not constitute a diagnosis, nor can it replace an in-person consultation and ultrasound examination.