Pimple developed after lip filler has returned after surgical removal, please help (Photos)

Question

About a year ago, I dissolved hyaluronic acid injectetion on my lips. everything was fine, but after 2-3 months, I decided to get a refill. After the injection, I developed a white pimple on the inside of my bottom lip. My doctor suggested that it might be due to too much gel .three different doctors attempted to treat the pimple with laser treatment,and used needles to pierce the area but with no success. Two months ago, I opted for surgical removal of the pimple. but the problem has returned.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. I'm so sorry to hear this. It sounds like you’ve had a challenging experience with persistent issues following your lip filler treatment. Given the history of the white pimple on the inside of your bottom lip and the subsequent treatments you’ve tried, there are a few possibilities to consider:

Hyaluronic Acid Granulomas: The pimple might be a granuloma, which is a type of inflammatory reaction that can occur when hyaluronic acid is not fully absorbed or if there was a reaction to the filler material. Granulomas can sometimes be difficult to treat and may require specific approaches to address them effectively.

Incomplete Resolution: If the problem reappeared after surgical removal, it could be due to incomplete removal of the granuloma or a recurring issue related to the original filler material or the body's reaction to it.

Other Conditions: The white pimple might not be directly related to the filler but could be a different condition, such as a mucous cyst or a different type of inflammation. Proper diagnosis is crucial for determining the correct treatment approach. I recommend seeking out a dermatologist or an oral and maxillofacial specialist with expertise in dealing with complications from cosmetic treatments. They can offer a detailed evaluation and provide insights into why the issue persists. I hope this helps and best of luck!

Anna Chacon, MD, FAAD · Answer

Hello,
I'm sorry to hear about your ongoing issues following your lip filler treatment. Persistent pimples or nodules after filler injections can be quite frustrating. Here are a few considerations and steps you might take to address the problem:

Infection: Even though you've had the area treated multiple times, it's important to rule out any underlying infection. Sometimes, infections can be subtle and may require a course of antibiotics or other treatments to fully resolve.

Filler Material: Since you've had multiple treatments with hyaluronic acid fillers, it's possible that remnants of the filler material are causing a reaction. An ultrasound examination can sometimes help visualize any remaining filler material or other abnormalities.

Granuloma Formation: Sometimes, the body can form granulomas, which are small areas of inflammation, in response to the filler. These can be persistent and may require treatment with corticosteroids or other medications.

Second Opinion: Given that you've already seen multiple doctors, it might be beneficial to seek a consultation with a specialist who has extensive experience in treating complications from dermal fillers. They might offer new insights or advanced treatment options.

Biopsy: If not already done, a biopsy of the area might be helpful to definitively diagnose the nature of the pimple. This can provide valuable information for guiding further treatment.

Alternative Treatments: Depending on the diagnosis, other treatments such as hyaluronidase (to dissolve any remaining filler), corticosteroid injections, or even different laser treatments might be considered.

It's crucial to consult with a board-certified dermatologist or plastic surgeon who can evaluate your specific situation in detail. They can provide a personalized treatment plan to address the issue effectively.

Best wishes for a quick and complete resolution to your problem.

Mats Hagstrom, MD (license on probation) · Answer

Your second picture looks different than the first one.
In the second picture, it looks like you have a hypopigmented scar.
It’s difficult to make a good assessment based on pictures.
I suggest you rely on in person consultations.
Sometimes keeping things as small procedures at the cost of not having long-term success is not a good strategy.
Both patients and providers may be apprehensive in turning something small into a bigger procedure, but that may be a better option if it gives a better outcome. Doing partial lip, wedge resections sometimes doesn’t turn out as well as doing a bigger cut.
It’s really hard to say what the right approach is based on limited information.
Best,
Mats Hagstrom MD

Pimple developed after lip filler has returned after surgical removal, please help (Photos)

Answers (3)

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