Ellansé & AestheFill Nose Nodules: Why They Don’t Dissolve, and How to Remove Them

You feel a hard lump inside your nose, it barely moves when you push it, and then you find out what you had injected wasn’t hyaluronic acid — it was Ellansé, or AestheFill.

The next question is almost always the same: “Can we just dissolve it?”

Let me get one idea straight first, otherwise you’ll waste time going the long way round: neither Ellansé nor AestheFill is hyaluronic acid, and the dissolving injection has almost nothing to grip. Here’s why.

They’re Collagen Stimulators, Not Hyaluronic Acid

Let’s line up the names and ingredients first. Ellansé is PCL (polycaprolactone); AestheFill is PDLLA. The nicknames differ, but they belong to the same family — collagen stimulators. That means they aren’t there to “fill” by themselves. Once injected, they prompt your own tissue to grow collagen, and it’s that new collagen that holds the shape up.

That’s the biggest difference from hyaluronic acid. HA takes up volume itself, so when you inject hyaluronidase to break the HA down, the volume goes away. Ellansé and AestheFill don’t work that way — a big part of the nodule is collagen your own body grew, not the original material.

So here’s the catch: the dissolving injection only recognizes hyaluronic acid. It does nothing to PCL or PDLLA, and nothing to that mass of collagen you grew either. In other words, there’s no ready, widely available antidote like hyaluronidase that can melt an Ellansé or AestheFill nodule with a single shot.

Key point: A hyaluronic acid lump can be “dissolved”; an Ellansé or AestheFill lump basically has to be “removed.” Get the material wrong at the start — assuming one dissolving shot will fix it — and the whole plan after it goes sideways.

So Is There “No Way to Dissolve It at All”? Honestly, There’s One Experimental Approach

Here I have to add a fair note, so I don’t overstate things.

People are in fact researching a route to “dissolve” these nodules. A 2025 paper in the Journal of Cosmetic Dermatology (Wu L, PMID 40296530) proposes a method called iCare: not with hyaluronidase, but with collagenase (an enzyme that specifically breaks down collagen). The logic is clever — since the nodule is mostly held up by collagen, you break down that collagen rather than the PCL itself. In the lab it dissolved the nodule in about five minutes, and it was tried clinically with no adverse reactions.

It sounds promising, but let me flag its weight clearly so you don’t pin the wrong hopes on it.

This is a preliminary study — lab data plus a small clinical report of just 3 patients and 10 nodules. And the sites treated were the forehead, temples, cheeks, and chin — not the nose. Collagenase for filler nodules also isn’t in common clinical use yet; it isn’t something you can walk into a general clinic and get.

The same paper also notes the background: the incidence of Ellansé nodules is cited at around 0.023%, which is low; when things do go wrong it’s mostly tied to too much volume, the wrong depth, or injecting into a mobile area. And the historical standard treatments — corticosteroid (triamcinolone), methotrexate, surgery — resolved only about 9% of nodules, which frankly isn’t a pretty record.

So the conclusion is this: it isn’t that dissolving is “absolutely impossible,” it’s that there’s “no ready, widely available method that’s been validated on the nose.” For a nodule that has already formed and sits in the nose, the practical route is usually physical removal.

The Practical Route: Ultrasound-Guided Minimal-Incision Removal

Since it can’t be dissolved and the new method isn’t mature enough for the nose, what’s left for reliably dealing with it is taking it out.

Here’s a real observation from our practice. Among the nasal filler-revision cases that reach us, Ellansé (PCL) actually shows up fairly often and is one of the most stubborn materials. Does that contradict the “very low incidence” in the literature? No — the denominators are different. The literature counts everyone who was ever injected; we see the small group who were referred over with a problem. Low incidence means “few people who get it run into trouble,” and “this material is hard to deal with among those who do” is a separate thing — both can be true at once.

Our approach is this: at consultation we use ultrasound first to see which layer the nodule is in, how deep it sits, and how it relates to nearby vessels, then go in through a small pinhole and take the nodule out — along with the fibrosed tissue around it — piece by piece. This is what Liusmed has always done: precise removal in reverse, not opening the nose up with a large incision to go looking. It’s done under local anesthesia, with gentle pain relief added when needed.

But I won’t give you the pretty version. Old Ellansé or AestheFill nodules that have bound to the tissue can usually be removed at around 80 to 90 percent, not 100. Some tiny bits hide deep in fibrous tissue or sit against an important structure, and forcing every last piece out would risk the surroundings. How much can come out depends on how much accumulated and how tightly it’s bound — that varies from person to person, and it takes a consultation to know.

Key point: The goal of removal is to safely clear the lump that bothers you and let the nose look natural again — not to chase down every last grain. Telling you honestly how much can come out matters more than thumping my chest with a guarantee.

Why the Nose Calls for More Care

The way blood vessels run in the nose makes it a high-risk area for injection complications to begin with. By the same logic, removal there has to be more careful.

Unlike Radiesse, which is calcium and shows up plainly on X-ray, Ellansé and AestheFill don’t — which makes “see clearly before acting” all the more important. I use ultrasound first to confirm three things: where the nodule actually is, whether it’s against a vessel, and how stretched or fibrosed the surrounding tissue has become. Only after seeing that do I decide whether to remove, how, and how much. In a place like the nose, knowing where to stop matters as much as knowing how to remove.

If you want to compare it with another material that “also won’t dissolve and can only be removed,” see the sister article on Radiesse nose lumps; for a deeper look at whether Ellansé can be removed and how, see can Ellansé be removed. If you’re thinking about redoing a rhinoplasty and there’s still old filler in the nose, the sequence is a separate question — I cover it in clearing old filler before rhinoplasty. For the full “dissolve vs remove” comparison across materials, the clearest place to start is the nasal filler residue & lumps hub.

Frequently Asked Questions

Can Ellansé or AestheFill be dissolved with an injection like hyaluronic acid?

Almost never. The dissolving injection (hyaluronidase) only recognizes hyaluronic acid. It does nothing to Ellansé (PCL) or AestheFill (PDLLA), and nothing to the collagen your own body grew around them. They are collagen stimulators, not HA, and the management is completely different.

I heard there's a new method that uses collagenase to dissolve nodules — can I have that?

Not something to bank on yet. A 2025 study did propose using collagenase to break down the collagen inside a nodule, and it looks promising on paper — but that was lab data plus a small report of only 3 patients, the cases treated were on the face rather than the nose, and it isn't in common clinical use. For a nodule already stuck in the nose, the practical route is usually removal.

Is removing Ellansé or AestheFill from the nose dangerous?

Because of how blood vessels run in the nose, it's an area that calls for care to begin with. We use ultrasound first to map the nodule's position, depth, and the vessels around it before deciding how to enter. Every nose differs, so how much can be removed is judged at consultation.

Will my nose go back to how it looked before?

It depends on how much accumulated and how stretched or fibrosed the tissue became. Most people look more natural after removal than they did with the lump, but whether it fully returns to the pre-injection state varies — I won't promise 100%.

Wrapping Up

If the lump you feel in your nose comes from Ellansé or AestheFill, hold onto a few things:

First, they’re collagen stimulators, not hyaluronic acid, so the dissolving injection has almost nothing to grip. Second, that new collagenase method is still preliminary, small in sample, and unvalidated on the nose — don’t treat it as a dependable fix. Third, the practical route is usually ultrasound-guided minimal-incision removal, and you should go in expecting around 80 to 90 percent out, not all of it.

Ellansé and AestheFill aren’t bad products. In the right area and the right hands they’re useful materials. The trouble usually comes from too much volume, the wrong depth, or placing them in a mobile nose. To deal with it, get the material identified correctly first, then take it one step at a time. For filler revision more broadly, see filler revision specialty; how it’s actually handled still depends on assessing your nose in person.