Alexander Blinski, MD

Pretty straight forward and a common problem, you dont have to do all these, but some are easier than others.

At home skin-care regimen - Neocutis Lumiere Riche (or something like this) +/- very low dose retinol/adapalene.
In office laser treatments - aggressive or non-aggressive regimens, may take multiple sessions but worth it
In office dermal filler - must be done by someone who is skilled in this area, soft HA gel filler (this option will get you the furthest the fastest IMO)
In office neuromodulator - Botox to help decrease movement and make lines worse around the area.

I would recommend a consultation with a laser or energy based device specialist (high end medical spa / Derm / Plastics) and/or a plastic surgeon for a recommendation on surgical options.

I think that the former (energy based devices) can provide some real benefit to help tighten the skin in that area, while surgical options may provide the greatest result.

I would avoid injectable fillers anywhere near this area. Fillers will only make it worse IMO.
If you have done injectable fillers, I would consider trying a dissolving agent in that area in an attempt to see if it improves, but based on photos energy based treatment is probably best (RF micro needling, fraxel, etc.)

You must first have a proper history in order to determine the likely hood the bumps are filler or a reaction to filler. If they are HA filler (as you state), injection with Hylenex should usually resolve these issues. If the dissolver wasn't put directly into these "bumps" it wont work as well.
Furthermore, if these bumps occurred 2-3 months after injection and appear to be non swollen I would classify them as non-inflammatory DON (delayed onset nodule) which is more common in patients with autoimmune disorders. Many factors can contribute to this. In my experience; oral antibiotics, oral steroids, hylenex, and injectable steroids typically have worked for my patients in the past. Another method would be using 5-FU. I would try these before any other more invasive modality and consider biopsy.

please use a softer filler that is less likely to have this issue in the future and go slow.

Voluma is one of the longest lasting HA fillers in America and the world. I am not sure from your photo if it is filler. A proper in person physical exam can help make a better decision on the issue. Using dissolving compounds can help improve residual filler but you may never be able to 100% dissolve filler. I would imagine (based on the limited photo you sent) that there are other factors relating to the "puffiness", it may be worth a try dissolving to see if it improves.

Best

First and foremost, thank you for your photos. Without seeing a before photo it does make things a bit more difficult to assess, but I would say a few things: 1. things should soften up if a small dose of Botox was used rather fast (2-6 weeks). 2. Luckily your smile (although not your "normal" smile) looks pretty good! 3. You could always target another area, but the lower face is very sensitive to botox injections. I personally would let it return to normal as adding more has a risk of making things worse.

While this is rather common, most patience do not come in for this complaint. In the general scheme of things, there is still changes that will go on in the tissue over time. There may be some modalities like vigorous massage or steroidal injections that may break up any dense scar tissue. My recommendation would be the former and to let time heal your issue. You can always see a physician to better understand your concern with a physical exam. 

Best Dr. B 

Yes you can, I would recommend considering a very natural filler vs fillers with higher risk of migration due to over-use while playing an instrument. I would assume that you may be at a higher risk for results "going away faster" due to over-use. Either way, you should be fine to get your lips done and play the trumpet.

While subtle filler may help decrease shadowing and indentations that are drawing attention to your nasal tip and nose, I do think that a surgical approach would be best for your scenario. Please consult with a few board certified plastic surgeons before proceeding.

Thank you for your photos, I perform hundreds of non-surgical rhinos a year. I tell all my patients the same thing: 1) the gold standard for most people is a surgical correction 2) surgical and non-surgical results will never be 100% perfect 3) the frontal and 45 view (not shown here) is typically the hardest to correct/meet expectations. I think in your scenario you should at a minimum have an in-person consultation with a plastic surgeon before moving forward, so that you can better understand your options. 

Thank you for the photos with your question. 

For an optimal non-surgical result I would recommend (in this order):

1. Botox
2. Cheek Filler
3. Laser Resurfacing
4. Home Care with cosmeceuticals
5. Other modalities (RF, ultrasound, and more)

I hope this helps, 

Dr. Blinski in NYC