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Hardness Under Skin After Juvederm

I had Juvederm done on Friday for my nasolabial lines and marionette lines. I expected swelling (which I had, and is reducing) but didn't expect hardness under the skin. It feels like two hard lines running down the nasolabial lines. Is this normal? And if so, how long will it last?

Doctor Answers 13

Some irregularities are normal...

It’s not unusual for patients to have contour irregularities of the facial skin following Juvederm injections. In the vast majority of patients this is usually related to swelling and may take several weeks to resolve.
Unfortunately, in some cases these lumps, bumps and areas of hardness may be related to uneven injection of Juvederm or superficial injection of Juvederm. The hard lines you describe following treatment of nasolabial folds and marionette lines probably fall into this category. Juvederm tends to absorb water which can accentuate this problem as well.
When this situation arises, it’s important to contact your physician. In some cases gentle massage will address the problem. In other cases removal of the Juvederm will be necessary. This can be accomplished by either perforating the skin and extracting the material or using the enzyme hyaluronidase to dissolve the material.

Omaha Plastic Surgeon
5.0 out of 5 stars 142 reviews

8900 West Dodge Road
Omaha, NE 68114

Hardness under the skin from Juvederm

Juvederm is a great injection especially for the nasolabial and marionette lines.  Do the injections LOOK abnormal or do you just FEEL hardness? Without photos it is impossible to assess what is going on.  Many patients who have injections in this area, especially for the first time, are not used to having something injected.  It may also be that too much product was injected in the nasolabial area.  For the best cosmetic results please consult a board certified dermatologist with experience with Juvederm injections.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 43 reviews

156 East 79th Street
New York, NY 10075


Juvederm is used to plump up the wrinkles and with doing so it may draw fluid into the injected areas. The hardness feeling you are describing may be totally normal and seen a few days after you have the Juvederm done. Within usually a week or so the feeling will subside and around week 2 you should be loving its effects. If by chance the region does not become softer than it can be dissolved with Hyaluronidase, an excellent and fast dissolver of Juvederm.


Yael Halaas, MD
Manhattan Facial Plastic Surgeon
4.5 out of 5 stars 29 reviews

120 East 56th Street
New York, NY 10022

Juvederm Hardness

Their are many causes of hardness after Juvederm:

  • Improper injection plane
  • Improper techinque
  • Aggregation of material (more common in Radiesse)
  • Rare (nodule)
  • Microhematoma

Followup with your injector per your concern level.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 96 reviews

845 N Michigan Avenue
Chicago, IL 60611

Lumps and Ridges after Juvederm

Being that the swelling has progressively reduced, the firmness may also likely soften within the first two weeks.  We teach our patients not to be overly concerned of what they can only feel versus seeing.  Our patients are invited to return in two weeks so that we may address any questions, concerns, and make certain that our mutual treatment goals were achieved.  With that said, I would encourage you to contact your practitioner.  He or she may not want you massaging the area. 

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

23211 Hawthorne Blvd.
Torrance, CA 90505

Hardness understand after Juvederm injection

Juvederm is an excellent hyaluronic acid based injectable that can be used effectively for facial contouring.

It may be possible to feel this dermal filler under the skin shortly after the injection. Your best bet is to place a cold compress on to this area and to gently massage this filler. If you continue to feel this palpable threat or if it becomes visible, return to your doctor as they may choose to remove some of the filler or help melt the filler with the injection of another medication.

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 67 reviews

848 Brickell Avenue
Miami, FL 33131

Hardness or lumps are rare, but treatable

Juvederm Injections on lip area can sometimes couse some temporary reactions such as swelling, tenderness, brusing, redness, and also as some patients report, the feeling of uneven hard lumps. Usually, condition like these should resolve on its own within days. You could try to massage gently the injection site. It is always recommended to contact your physician to make sure he is aware of your concerns. A quick check up is always a good idea. In rare cases, the lump should be treated with an enzyme called Hyaluronidase that can dissolve the Juvederm.

Gregory Turowski, MD, PhD, FACS
Chicago Plastic Surgeon
4.5 out of 5 stars 35 reviews

9843 Gross Point Rd
Skokie, IL 60076

This is common, but talk to your doctor

Hyaluronic acid fillers like Juvederm and Restylane create some of their beneficial effect by drawing water into the area, expanding the material, and creating the plump and full appearance you desire. Depending on your skin type, the amount of filler injected, and the technique, this can sometimes cause the thick feeling you describe. Usually it abates in a few days, but I would discuss it with my plastic surgeon or dermatologist.

Armando Soto, MD, FACS
Orlando Plastic Surgeon
5.0 out of 5 stars 147 reviews

7009 Dr. Phillips Blvd.
Orlando, FL 32819

See your doctor right away.

Even after several days, Juvederm can be massaged into a better shape. But don't try this yourself!

The most important thing is how you look. If you have gotten improvement, and these "hard lines" are not visible, you should consider leaving them alone.

In about 2 weeks, you will see the result that will last you for several months. If then you really don't like the result, it can be reversed with injections of hyaluronidase, but this would be very unusual.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

875 Park Ave at 78th Street
New York, NY 10075

Usually this is ok

It is not uncommon to feel some firmness under the skin after filler injection. I tell patients that they can mold it as well for a few days if it appears irregular.  If this should persist, you should probably see your doctor.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

1049 Fifth Ave
New York, NY 10028

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.