Radial Sound (Shockwave) Therapy Resolves Delayed-onset Nodules Following Injection of Hyaluronic Acid Dermal Filler: A Case Study.

Delayed-onset nodules, a potential complication of injectable hyaluronic acid (HA) fillers, can be distressing to both patient and clinician. Current treatment options, including oral corticosteroids and antibiotics, have potential side effects and may be ineffective or contraindicated in some patients. Hyaluronidase is an enzyme used to degrade HA fillers. Although it is generally effective for resolving such nodules, it can interfere with the favorable aesthetic effects of filler treatment. This report describes a novel and successful method of treating delayed-onset nodules in facial tissue. Radial sound (shockwave) therapy was used to treat multiple delayed-onset facial nodules in two patients following HA filler injection. Substantial improvement was observed in both patients after the initial 10-minute session, and all nodules resolved fully by the third or fourth treatment. There were no side effects or downtime. Patients were satisfied with the results, particularly because the aesthetic effects of the HA filler were maintained.