Valerie Sutherland, MD

In my assessment, your lips would show impact from increased volume.  I would use a filler with larger particle size such as Juvederm Ultra to provide actual volume, and then use Silk if fine vertical lip lines remained, although I would expect those to improve from increasing lip volume.  I think you will get more definitive, impactful results with a different filler type. 

Typically, a ratio of 1:1.6 of the upper lip to the lower lip is classically considered most desirable.  It looks to me like the ratio of your upper lip to lower lip volume is closer to 1:2. Therefore, increasing the volume of the upper lips would balance the appearance.  This would be expected to result in less inversion of the upper lip and less visibility of the incisors.  I expect that one half a syringe of Juvederm Ultra or one string of Volbella would do the trick and last 8-12 months. 

Perhaps consider the upper cheek and if that needs some treatment first. Many times there is volume loss in the upper cheek that drags down the eye troughs and the upper cheeks need to be addressed first. Your caution with Lyft is valid. 

The time course of the development of the bumps may help determine the cause.  Did you get any photos done 2 weeks after the treatment? It sounds like you did not get clinical photos. Do you have any of your own photos over Do you have any ther photos over the course of the last year since treatment? I do not know how the provider would determine they were certainly not responsive to hyaluronidase without a diagnostic trial of the treatment. It seems reasonable to try. They appear somewhat “artificial” since they are separated from friends immediate area under the eyes.

In photos 4 and 5, the lateral projection on the left side looks more pronounced than on the right, which can lead to an overall completely different look of everything below ththe cheekbone on that side. Perhaps the beauty mark being present makes it more apparent as a “landmark” and perhaps sleeping on it had something to do with it although it is hard to tell. Voluma on the right for laterally projection be used along with a good eye!