About six months earlier, the woman in her mid-forties had had the tear troughs under her eyes padded and her chin remodeled using hyaluronic acid in a practice. Well, two days before she came to me, she had noticed swelling under her eyes and on her chin: pea-sized nodules that hurt to touch. I had never seen anything like this before, even though I work a lot with hyaluronic acid and other filling materials, so-called fillers, to plump up and smooth wrinkles. Side effects and reactions can occur after injections. However, redness, swelling or allergic reactions usually occur in the first few days after treatment – and not months later. I asked the woman whether she had had anything injected at another practice after the procedure. She said no. I prescribed an anti-inflammatory painkiller and advised her to wait.

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