Debra Atkinson, MD

So good question. The reality is that your exercise routine shouldn’t affect your filler outcome. If you have bruising/swelling the first few weeks then minimizing extreme physical exertion is good idea but after that, no worries. Some studies suggest that if Botox is given in areas around where filler  is given (if appropriate and safe) that it may slow slightly the breakdown of filler.

I understand your frustration - we all want results immediately as we get so excited to finally get filler. Even though Volbella is a great filler for this area as it is very soft and doesn't swell as much as other fillers, there is still some swelling that occur in the first few weeks. It doesn't look like you have significant bruising so it is more likely something that you just need to give time. The other possibility is that the irregularity could be due to movement of the underlying perioral muscles, so sometimes adding a small amount of Botox safely around the upper lip can relax the muscle improving the appearance of the vertical lines. So I would suggest follow up with your provider in approximately 2 weeks to have a reassessment of the area. Wish you  the best!

Radiesse does come in prefilled syringes and is the color white, whereas most other fillers are clear. That is not good or bad, just different.

In the dental literature showing Botox was effective in helping with masseter hypertrophy and teeth clenching, most studies looked at 10-20 units per side, but my opinion has always been to start slow, as you can always add more but you can't take it away until it resolves. In my practice I typically start with 6-8 units per side, but it is very individualized as everyone's muscle is different in size and shape, and that is where getting it done by an experienced provider is the most important. Good luck!

Most people will develop more obvious asymmetry of their face as they age, often due to genetics, side of face they sleep on, or uneven sun exposure (such as through driving window in car). Botox could be very effect if helping to even out the asymmetry but performing an eyebrow lift on the lower side, and possibly relaxing the forehead slightly on the side that is raised, to give a more even result. It would take a good in-person consultation to determine the best course. Wish you luck!

It does look like some filler was injected superficially or closer to the inner lip than appropriate. Over extended time it should decrease but if unhappy with it, would return as there is medication that can be injected to dissolve and decrease the fullness.