Juvederm

A firm nodule that persists despite multiple rounds of hyaluronidase raises a few possibilities: a delayed inflammatory reaction or granuloma around the filler, a low-grade biofilm infection, or scar/fibrous tissue that isn't actually filler anymore and therefore won't dissolve. Hyaluronidase only breaks down hyaluronic acid, so if the lump doesn't respond after adequate dosing, it's reasonable to question whether it's truly filler causing it. An in-person exam, and often an ultrasound, can clarify what's going on and guide treatment, which may include steroid injection, antibiotics if infection is suspected, or occasionally surgical removal. It's also worth asking your original injector for your treatment record and lot number, since documentation helps rule out product issues. We're based in the Bay Area, so we can't treat you directly, but I'd recommend seeking out a board-certified plastic surgeon or dermatologist near Jacksonville who has experience managing filler complications for a hands-on evaluation.