Too Many Risks! (thumbs up for Hyaluronidase) San Francisco, CA

I'm a 38 yr old mother of 4 and I went in about 11...

I'm a 38 yr old mother of 4 and I went in about 11 days ago to try Juvederm in my naso-labial folds (which are not that bad, but certainly starting to appear on their "way down"). I went to the place where I've been getting my facials/dermasweep for over a year. It is a "laser and skin" center- managed by an MD, with a nurse who is certified in injections and lasers and then several aestheticians who do the other bits.

Anyway, I've been eyeing the dermal fillers for several years and but had never had it done. I was ready to just try it b/c I'd spent about 2 years thinking about it and was tired of constantly mulling it over. I've done botox about 4 times in the past 5 years (by a Plastic Surgeon) and I'd been pleased with that, so I wasn't completely new to a needle in my face. The injection nurse used 1 vial of what turns out to be Juvederm Ultra Plus. She said of course she would go for a "natural look".

However-- I've been a mess the past week and 1/2. The first day or so I wasn't worried. B/c I had quite a bit of swelling, so you really just couldn't possibly make out final results. I did have some minor spot bruising on both sides of my mouth/ in folds at injection site. Not a big deal. But by the 5th day I was looking worse and worse. The huge large puffiness was gone, but what remained where large swaths of skin on either side of the folds that puffed out-- spreading into the corners of my mouth and into the cheeks. It's like you could visibly see the areas affected by juvederm. It's made the naso folds themselves appear deeper b/c of the swelling on either side.

Additionally, it appeared in certain light like the puffy skin was also red. Almost like an allergic reaction. I've been in full-out panic mode. It has been incredibly stressful to think I not only have messed with a perfectly fine face, but that I've paid almost $600 to do so. As many of these reviews say... UGH, to only be able to turn back the clock!! I should have left well enough alone and feel utterly foolish. I've stayed up late into the night the past few nights researching everything I can about hyaluronidase, how to deal with bad juvederm results, etc. Nothing has helped. I even went to see my botox Plastic Surgeon this morning for her advice-- of course I should have gone there in the first place... hindsight :( But she will not dissolve with hyaluronidase b/c a) she can't be sure where exactly the juvederm was placed and is afraid she will not address the filler and only my own tissue and b) she doesn't have much experience with injecting it and doesn't want to make things worse. She is of the mind that it's better I wait it out and let it dissolve naturally.

The woman who injected me was not a Plastic Surgeon/ MD, but I do have to say that I still believe sometimes it can be the more experienced injector nurse or PA that has better technique b/c they do them almost exclusively, unlike an MD. But in any case, that is not the case here with me, so again-- I feel foolish. I think it ultimately depends on the experience level of either. I went with a well-reviewed legitimately certified injectables nurse, not some shady spa, but still ended up with bad results.

The current state of my face is that I continue to have grayish/blue stains on the left fold-line near the corner of my mouth. PS this morning said it was not Tyndall effect... looked like broken capillaries from bruising. She said they may fade. I also still have swelling in both upper sides of my lip which make me look like a chipmunk. It HAS gone down some in the past 3 days. Not a lot. I'm continuing to do gentle massage (have done so for a week) and hoping and praying it will decrease more. The corners of my mouth are drooping down more than they were to begin-- due to the swelling above it. Which, in all honesty, is unfortunately most likely the product, not just swelling anymore.

I'm forced now to either doctor-shop for someone who will try to rectify another person's mistake, or just live with this for multiple months. Not sure what I'll end up doing. I certainly don't feel comfortable going back to the person who did it in the first place to fix it... something quite un-logical about that and I hate when I read doctors always saying, "I encourage you to go back to your doctor and have them know what you are unsatisfied with and have them fix it." Um, no thanks.

Bottom line: I do NOT look better. Actually look worse. I'm not a horror story like some the things you read, but I feel much worse about myself. Puffy lip-sides, drooping mouth corners and broken capillary stains that may or may not go away.

NOT WORTH it. Our faces are better off left alone. I'm not saying some people don't get amazing results and boosted self-esteem from fillers. I do believe it happens for sure. But the RISK is just not worth it. No one can guarantee what your results will look like. Who wants to be the person who has unsatisfactory results? You go in wanting to feel better about yourself-- in that position the last thing you need is to feel worse. Absolutely not worth the risk.

Evening after hyaluronidase

Here are 2 pics I just took. I don't have any "before shots" that don't have my whole face and I can't be fully identifiable :) I thought I was seeing more immediate affects, but now in this light it doesn't seem to be very much difference. Maybe wishful thinking? I don't know. Perhaps it needs overnight to work. He didn't put much in at all, so I guess it's better to go back and get more than get too much.

I need to post this as a question for docs-- I still have that weird stain on my left lip. No sign of it being affected by the HD unfortunately. The dr said today he at first thought it was some Tyndall, but then thought differently after feeling around and looking more closely. Thinks it could be hyper pigmentation post-injection or that it was already there before (was not... I'm for sure on that one b/c I scrutinized that wrinkle!) It's the weird apostrophe-like shaped outline on my lip there in the one image. No idea what that is (?)

Russian Roulette

So I went in again today for a second round of hyaluronidase from the same doctor as last week. I think I saw a teeny tiny bit of improvement from the first round, but not enough. He did the same amount as last week today (very very small. I think he said .1 hyaluronidase to .1 saline). I'm noticing a bit more improvement tonight. If it takes me 3 weeks to get back to normal, that's fine. Would rather do it conservatively and save my skin from shriveling.

The main issue I have is that the dark spots haven't gone yet (worse on left, but also on right side). I've read sometimes they fade as the body absorbs the hyaluronidase, but I don't know. Not convinced. I'm pretty sure these dark spots from nearby the injection sites are going to be permanent. A darn shame. I'd say tonight I'm almost back to where I was before this mess.... But unfortunately even after all the Juv wears off in a year, I'm left with dark spots. Upsetting to have gone into this to feel better about oneself and get out of it with permanent new things to be self-conscious about.

But honestly, after one has experienced the pain of how it felt the past 3 weeks to look like that, the relief of getting back to where you at least resemble your old self is enough to make me not think about that too much. I've added a bunch more photos to hopefully show some more details and the progression. For the most part the left side of my face has taken the worst beating.
injectables nurse

Would not go back. She meant well, but did not do a satisfactory job. Is not "an artist"

3 out of 5 stars Overall rating
3 out of 5 stars Doctor's bedside manner
3 out of 5 stars Answered my questions
2 out of 5 stars After care follow-up
2 out of 5 stars Time spent with me
3 out of 5 stars Phone or email responsiveness
4 out of 5 stars Staff professionalism & courtesy
3 out of 5 stars Payment process
4 out of 5 stars Wait times
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You have a really pretty smile without wrinkles and excellent skin. Why you want any fillers, I am not sure but we all have our reasons wanting to improve. Thing is, my boyfriend who is a dr gave me some advice I will pass to you: "If you really look amazing (you do) then it is often going to ruin a masterpiece. You cannot improve on what's already great, and when you try, you sometimes are going to end up with bad results - too difficult to "improve" on the already great!"
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I'm so sorry you had a bad experience, but it looks like you're mostly better now. Do you know how much hyaluronidase was used to dissolve?
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Interesting you should ask bc I've been trying to remember how much he used for the past 4 days! I think, from researching on the web and from straining to remember what he was telling me at the time (at the time I didn't really care and just trusted him), I think he said he used .1 hlase mixed with .1 saline. And then divided that up between both lower naso folds/ upper lip corners. Then I went back a week later and I do know he used "exactly the same" again. So I guess .1 in each side ultimately. Now what exactly that means, how little or big that is if an amount is a but up in question I guess. He said it was a very small amount. From what I have picked up online it does seem to be a small amount, but fitting with what I think many doctors use I think. It's hard to know bc he was targeting the lower area of the folds (where it looks like the juv had settled and almost "pooled") so it wasn't like he was trying to flood out my whole face.
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Again like I've been telling people in differen't forums I went to Dr. Finder in S.A, TX and she told me after paying over $500 that she would not put whole syringe of juvederm in my lips because she doesn't want my lips to look to big. Well what the hell did I pay u so much money for? For u to decide what u think looks best on me???? Stupid I'm almost 60 if I want to have big lips at my age and I'm paying u for it?? What's the problem. Will never go there again.
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I also had a horrible experience with juvederm. But it was in my lips. Instead of putting it in the body, she put it in the lining. Which made me look absolutely like a duck. I was encouraged to wait several days for swelling to go down. I waited 10 days. . Hardly better at all. While waiting, I did everything you are doing. I researched....and cried a lot. I didn't want to be seen but had to work. I went back to the girl who did it and was 100% up front with her. She injected the hyaluronidase. It was absolutely the best decision I could have made. Most of the bad reviews I have read about hyaluronidase were things that had happened due to an allergic reaction to the product. I even read where a girl said to have them test a small amount on your arm. (It won't hurt u) And may save u from having a horror story about hyaluronidase. From what I understand, the hyaluronidase will not ruin your natural tissue. But will dissolve the juvederm. And it worked instantly. So I could look to tell her when it was enough. . But if course wanted all of it gone. (And most of it is).
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But unlike u..i did go to a medispa where the girl had very little experience. Don't be so hard on yourself. For every foolish thing u do, there is a much bigger fool somewhere else.
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Thank you for a story of hope! I have succeeded in completely freaking out over getting the dissolver tomorrow by reading the bad reviews! I'm still keeping my apt though. I kid you not, I scared myself in the mirror this afternoon when I walked into the bathroom! Shocking. The way my mouth droops down around the corners is unbelievable. I don't even know how she accomplished this by injecting "naso-labial" folds! I will update tomorrow.
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I was terrified also. But no way was i going to walk around looking the way I did any longer. Who is your appt with? I personally felt best about going back to the girl who messed up my lips. I know that sounds crazy. But I Figured she at least knew exactly where she put the juvederm. And it helped that she did it for free.
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Appt is with a different person-- an exclusively facial/nose plastic surgeon here. He gets fabulous reviews from RealSelf and other sites. Who knows though-- sometimes I don't feel like reviews matter! But I do think he's my best chance. Facial surgeon is going to be skilled in the face, not breasts :). He does do a good deal of hyaluronidase fixes as well, and ultimately that is the experience I'm looking for. In theory I'd love to go back to the woman who did this, but a) I'm not interested in dealing with her trying to tell me she doesn't see anything like I've heard happens often- I'd really bust a gasket. And b) bottom line is I don't really trust her. I'm trying not to think about added cost from a new person, but if I can get back safely to what I looked like 3 weeks ago it will be worth it. And I will have learned never to do this again.
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I agree. I was going to get a few other things done as well. But I think this bad experience has made me not want to do anything else now. I absolutely think the hyaluronidase was worth it, just a heads up. .It really hurt. She only used a numbing cream. So if he offers u something better for numbing then just a cream, I would absolutely take it.
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Well, I took the plunge. Had it done 30 minutes ago and already can see a difference! Oh what it would be like if this does the trick to rid me of my cotton-roll mustache... Seemed like an awesome Dr. Took 30 minutes to talk to me about it and used the tiniest amount of the HD mixed with saline. Said it's better to come back for more if needed. Holding my breath. Will update as it progresses. Not that people want to know my blow by blow, but it really seems hard to find much good info on the hyaluronidase experience.
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Oh, it he did only use a numbing cream that he only waited 5 minutes for before injecting, which panicked me as he came at me..But it barely hurt! I should find out what cream he used- good stuff. I'm sure the actusl lips hurt much worse though regardless. My injections (3) were upper white skin of lip near nose. Not as sensitive I think.
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I was injected about ten times. I refused to let her stop until the fuck lip was all gone. But it hurt so bad that I did end up telling her to stop. I had tears rolling down my face. I am so happy u decided to go for it. And you're wrong, if anyone reads this is because they want the info on it.
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*duck* that was absolutely an accident! Oh my goodness!
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Ha ha. I thought wow she is being blunt. But then thought I guess it made sense in context :)
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I'm sorry you feel worse about yourself and didn't have a good experience, that is so frustrating when you spend so much money and expect positive results.  Have you tried arnica cream to help break down the bruising and swelling?  It might help.  Let us know what you decide to do as far as having it dissolved or waiting it out. 
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Thanks for writing. Yes, have done the arnica things for 5 days now. Nothing. It's apparent that what I see is now final result. I found a PS nearby who gets good ratings (presumably) and whose assistant said that he does hyaluronidase reversals for people several times a week from other dr's botched jobs. They had a cancellation for tomorrow amazingly so I'm heading in to see what he says. Hopefully he can fix it on the spot, but I am extremely nervous. I of course read all the horror stories about hyaluronidase.
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Let us know how the appointment goes today- I hope this doctor can help you. 
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