Hardness Under Skin After Juvederm

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.

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.

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. 

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.

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.