Virginia Facial Plastic Surgery Blog

I am an RN who works in a medical spa. I had Hydrelle injected into my nasal labial folds and bilateral corners of my upper and lower lips. (Above the vermillion border, not into, nor into my lips.)

This was injected around May 15th. Approx 2 weeks ago in Mid July, two months later, I developed a small area of edema accompanied by pain and heat at the site above my left lip. I had been stung by a wasp the day before and consulted with a doctor who thought I was having a possible systemic reaction or infection from the wasp venom. I was given Antibiotics (Augmentin) and steroids (Medrol dose pack). I had decreased swelling for approx. one day, then over the next 2 days the area began to increase in size and nodules started appearing on the right side as well. I was leaving for vacation out of the country for 5 days, so I brought along Aloe Vera w/Lidocaine gel, Arnica, Hydrocortisone 1% and Calamine Lotion, along with the medications I was still taking, thinking I would have a variety of remedies available and surely the medications would help.

I saw no improvement, in fact the areas began to expand in size and depth. More nodules began to arise, not just on top but on the bottom as well and began to multiply and migrate into my lips. I started to see white areas develop about the size of a pinhead on the nodules, like a whitehead and a small amouint of bruising was even present on the left side of my mouth. I could only sleep for about 4-5 hours a night because of the pain and inflammation. I had no relief with any of the “remedies” I brought and saw no improvement in the condition. It just seemed to be getting worse.

I ended my Medrol dose pack while out of the country and was still taking the augmentin. My lips felt like they were going to explode. I ended up going to a pharmacy in Honduras and was given Prednisone and Allegra. No relief from that either. I now have about 3 nodules on the right and 3 on the left of each side of my mouth/upper lip area and they appear to be forming one big mass. On the bottom I have one nodule on each side and am experiencing much pain and anxiety over this issue.

I returned home last night and one of the first things I asked about was if I had received a call related to my questions about Hydrelle. I know that due to the Sulfites in Hydrelle, I thought maybe I was having a delayed reaction to the product and/or sulfites, despite the fact I have no sulfite allery or any other allergies. I have used and injected almost every product on the market over the last 5 years and have never had any complications using them or injecting them and have been in this business 5 years. No one had returned my call.

I had originally called Coapt before my trip and was told to contact the manufacturer, that there was no longer any Rep avilable, that “she was no longer with the company.” Coapt then told us today when we called that we had a “new rep” and was given a number to contact him. He did return the call but said there is no longer any “reps” for the company but we could still order product from the manufacturer. I then asked him if he knew of any possible delayed reactions to the product or sulfites and that I was in pain and looked like a freak. He told me there was no longer any reps for the company and that “all ties to Coapt had been cut” but I could e-mail Anika at Hydrelle@Anikatherapeutics.com or call Anika at 781-457-9000.

I reported this information to my director of the med spa for clarification as there seemed to be some confusion about our rep situation. He googled Hydrelle… Well, look what we found!! The product was taken off the shelf immediately.

I was able to reach our “old rep” and although she also is no longer affiliated with the company, has offered her help and has also offered help in contacting Dr. Naderi. I am planning to use what you all have done to get this, yes, POISON out of my body! I have read each one of your comments and no longer question what this mysterious issue is I am dealing with…it’s the product!!!

I have empathy for all of you as I know what you have gone through. I am going through it now… I will go step by step to rid the product from my body & resolve this medical mystery. Please keep the information coming… the more we know, the better we can treat. Thank-You.

Dr. Naderi, I have had complications from Hydrelle. Injected in the nasolabial folds I had immediate swelling the next day, ice took care of that, then a couple of weeks later developed lumps at the injection sites. Went to see an MD who also does these injections and thought the product “migrated” up next to my nose-not where it was originally injected. Put on Medrol pack, selling went down. As soon I as I was off the steriods the lumps reappeared. Went to see a Plastic surgeon who injects fillers, Not Hydrelle. We discussed treatment and decided on steriod injections. As the needle was inserted into the one of the lumps, pus oozed out. She said it’s probably infected, cultures were sent two times now, both came back negative for infection, was on Keflex also for two rounds. The PS has determined these are “sterile abcess’”. I now have 5 sm. scars on my face from drainage of the abcess’. The right side seems as it has settled down after a silver product used for wound healing was placed inside one of the abcess’. The PS tried to use that as a drain but I believe the material was too thin and it closed around the silver an blew up the whole right side of my face. Next day, took it out myself per MD. Some purulent drainage also oozed out after the silver was removed but then the swelling also subsided.
Now one week later the left side of my face I had one sm. lump the size of a pea, PS decided to leave it alone and see what happens. Three days later that lumps has grown to about 1 inch by 1/2 inch and skin is redenned on the lump ?cellulitis. Have to push up my next appointment and that area will also have to be drained. I have been out of work a month now with these complications as I am an RN who works with many people on precautions for MRSA and cannot risk that getting into any open areas.
If there is any class action law suit being filed I will definetly be on that list. This product needs to be taken off the market. I will update this blog on my progress. What a Nightmare!!!

Dr Naderi,
I am a midlevel practitioner out of Texas and would like to share my experience with Hydrelle with you. Out of 6 patients we have utilized this product on, two have reported problems within 2-4 weeks after its use. In specific these compications have resulted in product migration, local “puffiness” and inflammation that continues to be bothersome and overt hard lumping of the product regardless of techniques successfully used with other fillers successfully such as application of heat and massage. I am really very concerned and disappointed about this issue as the representative that sold our facility the product has already dropped the product and no longer represents the product therefore we are on our own to attempt to return the product (30+ syringes). We are currently sending it back with a letter which sites our concerns and would appreciate the support of others in this endeavor. I recently attended an aesthetics seminar and was informed by several of the physicians present that Hydrelle is causing granulomas, abscesses and is the most risky filler for a clinician to utilize both for the patient’s safety and the practice’s reputation.
The sales receipt states all sales are final however how can they enforce this if our patients are experiencing complications and the product does not safely achieve the effects it was marketed for at the time of purchase as it has continued to claim. I have not experienced or heard of comparable complications with other fillers and feel like this company must be stopped and must be forced to return this dangerous product that they are continuing to sell without consequence.
Is there any way you would allow me to submit the testimonials on your website as further evidence of the hazards of this product that others are experiencing?
Many thanks for your time and thoughts on this urgent manner.
Respectfuly Yours,
Ann

drnaderi
You said: “I actually believe Coapt Gel is similar to Radiesse and although it was supplied by Coapt, it is not a Hyaluronic Acid like Hydrelle. I never used Coapt Gel though so I am not 100% certain and there is very little information out there on the substance”.

That confused me – are you saying Coapt Gel is not a Hyaluronic Acid compound, that it is not like Hydrelle? I am confused with your comment. It seems to have the exact same properties and causes the same injuries as Hydrelle. Boils, hard lumps, etc etc… 19 months and still here.

I too have suffered with injury to the left side of my face from a product called Coapt Gel, but from what I can tell, it is the same composition as Hydrelle. I have sort of “waited out” the injury at first, thinking it might go away like a lot of fillers do…(just doing things like laser for all the broken capilaries around the area, steroid shots, antibiotics, and recently (last week) got a large boil in that area – I kept thinking it would wear off with time. After 19 months, I see it is here to stay unless some of the suggestions above will be helpful.

I feel for all of you – it doesn’t seem like anyone really has the answer. I mean, maybe our big, unsightly lumps could be plastic surgically removed… I wish someone had the answers. If they can do beautiful work on a person’s face via a facelift, why can’t they simply removed the infected area of our face???

It has been a nightmare for all of us. I am glad to find a website that we can all get a little comfort from.

Please write me if you’re so inclined. slane111@charter.net

Sherry Lane

Hi Dr. Naderi
My Doctor is taking this more than seriously. He is doing everything he can to help me. I have been going to my doctor every week. It has been one month today that I have been suffering. I was on an antibiotic. I am on Prednison (steroid) and now we’re trying Allopurinol. He has injected me with the Hyaluronidase several times already in high doses…nothing is melting away. Nothing. It seems to only be adding to the mass and dept of the lumps. He is extracting the poison out with the needles and then pressing to get the rest of the poison out. It just comes right back. The faster he sucks the stuff out…the faster they fill back up. And we have no idea what these lumps are filling back up with. Is it the Hydrelle? Is it puss? Is it my own fluids? The cultures came back negative for infection, fungus and everything else including white blood cells. There are not even white blood cells helping to fight whatever it is. How can that be? What is this stuff that’s seeping out of my face if its not the Hydrelle and its not an infection?

I also notice that these lumps have a mind of their own. Once in a while everything is calm. The redness isn’t too unbearable and the swelling is mild…then all of a sudden for no reason at all…I get a flareup. The lumps just start to heat up and swell for no reason. Then I get even larger lumps…they are so painful. Very painful to even be touched so imagine the pain when we’re trying to press the stuff out of them! There are even huge lumps developing outside the injection site areas. I’m getting huge boils on my chin and under my chin…no where near the site where the Hydrelle was injected. The bruising is horrible as well. My face looks so awful. Nothing works Dr. Nothing.

I fear that I will be going through this for at least a year because when the websites brag about how great Hydrelle is compared to my wonderful Restalyne…they claim that it lasts up to a year! That is unacceptable! That is why I am worried about sueing the company. I am a professional sales person. I am with clients every day. Can you imagine how humiliating it is? I cannot hide. I can’t stop the pain or the symptoms.

I spoke w/Madelyn Lyell from the company and sent her pictures…she doesn’t know what to tell me either. They are looking for a medical director to hire. How is that going to help? What person in their right mind would take that position now? They need some scientists to get in there and figure out what the hell is in this product and how it can be stopped. The FDA needs to be sued as well. How can they approve this product when all of us women are suffering like this? How have they not pulled it from the market?? I am miserable and in constant pain and I deserve restitution as well as a cure. We are all victims and we all deserve restitution and a cure.

It happened to me. I usually use Restalyne but for some reason my doctor told me that he was having good feedback from clients who used the Hydrelle. I said go ahead. Whatever. I trust your judgement. Well everything was fine until 15 days later. Out of nowhere I started to get swelling all around my mouth…it was very red and itchy. I tried to ignore it…but then I realized that I now looked like the Cowardly Lion from The Wizard of Oz!! It looked awful and it felt just as bad. I tried to take things in stride. Called the doctor right away. He had never seen this reaction before…especially 15 days later. He injected me with an antedote that’s supposed to immediately take the product out of my face. It didn’t work. He also put me on a steroid pack. The swelling went down a bit but it was still very noticable. Then all of a sudden I developed hard pockets of something that I can only imagine was the Hydrelle…solidifying in my face at each injection point. It was very noticable and very hard…very painful. I went back and they put me on an antibiotic…but then the steroids had been finished and I wasn’t on them anymore…all of a sudden the redness and swelling came right back. I was the Cowardly Lion all over again. I called the doctor and told him that I needed the steroids again because my face was back to where it was before I took the steroids. I fear that I am going to have to be on the steroids for a very long time because once they’re out of my system…the symptoms come back immediately. Now I am in alot of pain. Especially on the left side of my face. The hardness is all purple and so noticable. I tried to ignore it but now its even more painful. Its beginning to affect my sinuses and my teeth. I have a huge ball on the side of my bottom lip that looks and feels like I’ve been punched in the mouth. I can’t take it anymore. I don’t know what to do. I am a business woman. I am out with clients all day and I can’t hide!
I am so afraid that my face is going to be permanently scarred. I can see it already and I don’t touch my face because of the pain and I’m afraid to get an infection…plus the scarring. I’m so upset.
I don’t want to blame the doctor because I’m sure he didn’t know it would happen but I wish he didn’t offer to change my injectables up and use this awful product.
Does anyone know what can be done besides having more needles put into my face and being scarred for life?

S.lynn, steroid use brings down inflammation. Multiple treatments with oral or injectable steroids may be needed. The injectable steroids work more locally with less systemic side effects but have a local side effect of tissue atrophy!

Good luck Amy.

S.lynn, the resolution of the Hydrelle complications may take weeks or months and multiple treatments may be necessary.

Amy, I spoke with the CEO of Coapt a while back and nothing came out of the teleconference. She admitted there is a problem but then said that Restylane had lots of problems as well. The fact is that most of us have injected thousands of syringes of other fillers including Restylane with no where near these kinds of problems Hydrelle has caused for us and our patients.

It may be a fine product with modifications and more research down the line but I don’t see them pulling it from the market as I saw them set up a vendor booth at the 10th International Symposium of Facial Plastic Surgeon this past week in Florida.

Help,

I’m from Holland and I had yesterday the hydrelle injected.
Just a little in my lips.
My upper lips is swollen like a balloon now,my doktor don’t now what to do whit it.
Was suppose too fly back to europe,They would not let me on the flight,I look like a freak or worse.
What can I do???

I, too, must add another patient with an adverse outcome to this blog. I have used Hydrelle in only eight patients–eight–and found Dr. Naderi’s website precisely because one of my patients developed rapidly progressive pyogenic granulomas only three weeks after injection. They are draining well and she is coping well–but it was her first experience with HA fillers and she is horrified; I feel bad as well, and did not anticipate such an aggressive reaction.

The company, as had been reported here, has still not responded to my emergent query, though my representative indicates that he ‘has calls in to the company.’ The patient & I have had to wing it, with the help of several MD’s online posts, and I feel my patient will do OK overall. She will likely be healed in full before I receive some ‘help’ from the company! (NOT LOL).

I have always been one of those physicians who would not be the first to try out a new product on my patients; Hydrelle, as an apparent bona fide HA filler, fooled me! I will not use my remaining syringes–but hope that I may some day return them (if the FDA is able to issue a Warning, Notice, Recall, or somesuch!)

On December 28, 2009 I had one syringe of Hydrelle (1/2 each side). It was about 3 weeks later that I began noticing problems. By February 5, when I went to my Dr. I had an abscess on each side of my face. He prescribed an oral antibiotic for the weekend, and gave me a steroid injection. I felt immediate relief on my left side. On February 8 I went back to begin the process of dissolving the Hydrelle particles, and now have developed facial swelling on my left side. Although the abscess on my right side is still there, it has improved to some degree. I have another appointment on February 12 for more injections.

I understand each patient is different but would like to know about how long this whole process takes before I’ll have my face back?

Lastly, after two weeks. I’ve decided to take off the baseball cap I’ve been hiding under and share my nightmare with anyone who stares long enough. Hydrelle needs to be removed from the market immediately!

Best,
From Sugar Land, TX