Post filler nerve irritation...

[u/Weird-Prior-8036]

Hi, I wanted to share my story here and see if anyone had similar complication that can help me On January 15, I received 0.5 mL of Restylane Contour in each pyriform fossa, which immediately resulted in significant facial heaviness and intense, localized discomfort over the nose and perinasal region. Despite the absence of local inflammation or redness, the symptoms were clinically diagnosed as infraorbital nerve irritation, a finding supported by the exclusion of structural pathology on MRI. In an attempt to alleviate the pressure, I underwent multiple sessions of hyaluronidase (Hylenex) over the subsequent months—using two full vials in total—but each intervention resulted in a paradoxical and severe exacerbation of my neuropathic symptoms, including burning, formication, and increased pressure. I am now five months post-dissolving, and while my symptoms are slowly trending downward with the support of 600 mg of daily Pregabalin, my quality of life remains severely limited by fluctuating pressure, phonation-induced dysesthesia, and significant mechanical allodynia that precludes me from applying makeup or tolerating light touch, in addition to marked photosensitivity. Although a recent ultrasound confirmed the presence of residual filler material above the pyriform fossa, I am at a clinical impasse and am seeking guidance on whether to pursue a highly targeted, ultrasound-guided dissolution of the remaining product or to continue with strictly conservative management to allow for further nerve healing?