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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 12

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.

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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 28 reviews

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 85 reviews

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

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 63 reviews

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.

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.

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

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
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Can I Feel Juviderm After It Is Injected Into My Nasolabial Folds?

Hi Mum,

Immediately following injection of Juviderm, as well as other fillers, into the nasolabial folds you can feel the filler. Over a few days that should soften so as to not be bothersome at all. If you feel that there is excessive fullness or hardness after a few days then you should consult with your injecting physician to make sure that all is well. Good luck.

Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

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.