I recently got Juvéderm from Dr. Yuan. I have never done cosmetic surgery before and was a little nervous. Dr. Yuan was a good listener and explained everything to me, in terms of how it would feel, look, and the benefits. After 5 to 10 minutes of the injection, I could see the difference. I couldn't believe that I could see results that fast! It didn't hurt much; she had placed a numbing cream on my face before the injection and that helped a lot. Afterwards, there was a little bruising on my face (where she injected the fillers) but I expected that. I was able to cover it up with a little makeup and the bruising was gone by the 12th day. My friends and family noticed that I looked better but couldn't figure out what I did. When I told them that I had Juvéderm injected in my nasal folds (the fold between the nose and the mouth area) and my lips, they were so impressed about how it turned out. Now my sister-in-law wants to do it too.
Are you planning to get your Botox injected by someone other than your rhinoplasty surgeon? Getting Botox won't necessarily preclude you from getting rhinoplasty done safely; however, you want to make sure that your surgeon has evaluated you before any Botox treatment and you also want to make sure to relay your concerns about the smiling deformity associated with the depressor nasi septi. Your rhinoplasty surgeon may include resection of the muscle as part of the surgery, which can be a more definitive treatment for your concerns. This is why it's very important for your surgeon to be fully aware of your concerns as well as any treatment you may be planning. Talk to your surgeon.
There are various techniques for lip injection and lumpiness is unfortunately an inherent risk of all techniques, but possibly more visible with this "tenting" technique. I can see the course of the needle where you were injected. Massaging immediately after injection can sometimes help to even out the filler. I personally don't do this tenting technique and prefer going transversely, parallel to the lip. I'm not sure that you as a patient can never get tenting (maybe it's an effective approach in some providers' hands) but I personally don't prefer this technique due to the risk of these findings.
You actually have a very nicely shaped upper lip, but it looks very prominent compared to your lower lip and I think it's the mismatch that may be concerning you. I would suggest augmenting your lower lip using dermal fillers. It would be safest to do this in a stepwise approach and not do too much at once. I would recommend getting a conservative amount of filler in the lower lip and then reassessing how it looks (once swelling comes down) and then buildling up the lip with more filler as needed.
