Monique Mazzuca, MD, CCFP

Although there is no clear contraindication between the procedures I would advise to book teeth whitening first at least 48 hours piror to your lip filler appointment This is to enable enough healing process (2 weeks) for your lip filler post treatment.

Natural results depend mainly on technique, however, the appropriate type of filler is also important. For a soft, mild volumizing and enhancing result it is important to use a filler with a low G prime and high cohesivity. These terms relate to the cross-linking technology i.e. compressibility and spread. For lips it is best to use something soft and spreadable. Hyaluronic acid HA, a naturally occurring substance found in the connective tissues that cushions and lubricates. Because HAs are hydrophilic, they attract water from surrounding tissues, further augmenting soft tissue volume beyond what is expected from product implantation alone. For this reason, HA fillers are often excellent choices for enhancing lip volume. My favourites include Kiss, Saypha soft and Stylage S for the most natural results.

For tear trough or undereye filler, I prefer platelet rich plasma or an HA that does not pull as much water to prevent swelling. It has to haave the right balance of stiffness, cohesivity, duration of effect (about a year under the eyes), and relatively low swelling. Most importantly, injection technique is crucial.

Even though injectable hyaluronic acid (HA)–based fillers are considered safe, rare complications, such as late-onset inflammatory reactions have been reported. Late-onset inflammatory reactions to HA fillers may be self-limiting but are easily and rapidly treatable with oral steroids, and with hyaluronidase in the case of lumps. It is likely these reactions are due to a Type IV delayed hypersensitivity response. Delayed inflammation associated with HA fillers is nonbrand specific. However, if 1 brand triggered a hypersensitivity reaction this may suggest that the technology used in the manufacturing process, and the subsequent differing products of degradation, may have an influence on potential allergic reactions to HA fillers.

This looks like a combination of technique and possible reaction to either dissolver or filler, depending on the timing. Some of the filler may still be present and has crossed the wet dry border of your lips. If there is no palpable filler this could also represent an blister due to allergy of either the filler or hyaluronidase. These cysts can develop when hyaluronic acid like Restylane or Juvederm is injected too superficially into the skin, causing these "blebs". Or the filler may have become moulded into a ball. Nodules and blebs generally look like white or skin-coloured lumps and are painless and harmless, you might need further dissolving in the correct layer. To treat these, a practitioner will either massage and warm them with a compress, then the nodule is punctured and the filler is released.
Sometimes, if these lumps, bumps, or swellings occur weeks/months later, they can be a little tricker to manage. As well as dissolving there may be a need for antibiotics or steroids to full manage the problem. On these occasions, a medical injector will assess your medical history and prescribe the correct medicine, or procedure, to fix the complication.

It is important that you are looked after by somebody who can medically manage you - having specialist knowledge of aesthetics treatments and their complications.

Prp can be done right away if it’s purely your own blood. Laser treatments on areas that you have recently tanned should be avoided.