I had Juvederm injected into my nasolabial folds approx. 15 months ago (July 9th 2012) and two hard lumps formed as a result (one above both corners of my mouth). I thought I could wait for my body to dissolve it naturally but that hasn't happened. I am reluctant to try the Hyaluronidase injection due to my Juvederm injection experience. So, is it possible to have it removed surgically? If yes, would there be any visible scarring?
Can Juvederm That's Been Injected into the Nasolabial Folds Be Surgically Removed?
Doctor Answers (9)
Find out what the bumps are first
If the lumps are caused by Juvederm, hyaluronidase can dissolve it. You should see an experienced injector who can assess and treat the lumps. Surgical removal will leave scars.
I’d recommend giving the hyaluronidase a shot prior to surgical extraction. It’s remarkably safe and won’t leave a scar. Best of all, hyaluronidase has been shown to not affect nascent (your own) tissue, only the injected material. Yes, hyaluronic acid (Juvederm) can be surgically extracted as well, but anytime you cut the skin’s surface, there’s always a risk of scar tissue forming.
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Juvederm and folds
Eventhough it has been 15 months, it may still be filler, but it can be a granuloma. You might want to try hyaluronidase first.
Juvederm Nasolabial Folds - correction (hyaluronidase vs surgical excision)
It's only natural for you to be hesitant to have any further injections into that area after what you experienced with the Juvederm. However, hyaluronidase is fantastic and works within a matter of days to break down the Juvederm (which is hyaluronic acid). It is safe. I take "baby steps" in terms of correction when I'm fixing misplaced or "lumpy"-appearing filler (not like this is a usual occurrence for me, but, I do see quite a few less than ideal results on patients who come into my clinic requesting for me to fix them). Specifically, I inject a relatively small number of units of hyaluronidase (a.k.a. Vitrase) into the problem areas and then have the patient return for reevaluation in 4 or more days (once it's had a chance to kick in). Then, if the problem is fixed. . . fantastic. However, some patients need a bit more hyauronidase for an optimal result, so I can inject a few more units if necessary at that time.
Surgical removal of a hyaluronic acid filler - like Juvederm - is not a good idea because hyaluronidase injections work SO well. . . and surgical excision leaves visible scars. Also, any surgical procedure that you have done can be associated with unanticipated complications (like infection). So, the last thing you'd want would be a new problem.
Hope this helps!
Monika G. Kiripolsky, MD, FAAD
Fellowship-Trained Cosmetic & Laser Surgeon
Can you remove Juvederm surgically
Do not be reluctant to try hyaluronidase. It's easy and fast when performed by a trained physician. A surgical removal is possible but will absolutely leave some kind of scar behind, or infection or bumpiness or many other issues. Hyaluronidase won't. Get a small amount of hyaluronidase.
"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."
Surgical removal of fillers will leave a depression and a scar. If the filler is juvederm and has left a lump which did nor resolve in reasonable time then one can attempt more time, puncture aspiration, antibiotics, Hyaluronidase. consult a Board certified Plastic Surgeon (American Board of Plastic Surgery) to explore the various options.
To remove Juvederm that is causing a problem, use hyaluronidase, not surgery
Hyaluronidase is a very safe and effective treatment to dissolve HA fillers like Juvederm, Restylane, Perlane, and Belotero. Usually it works within minutes to hours. Sometimes a 2nd treatment is needed. To remove surgically, there are risks of scarring, infection, nerve injury and need for more surgery which makes it a long second choice for your problem. Steve Weiner, MD, Destin and Panama City Beach, FL.
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