Volbella Swelling is uneven. (photos)

Thank you for sharing your question and photographs.  Asymmetrical swelling after lip injections is not uncommon, especially if your injector was attempting to correct an underlying difference in lip size.  I would allow your results time to mature over 2-3 weeks.  In the meantime, try reducing the swelling by using cold compresses to your lips and elevating your head at night with a couple of extra pillows behind your back.  You may want to also consider using Arnica Montana and bromelain as supplements.  Hang in there!

You can have asymmetrical swelling after your lip injections and it will resolve in 1-2 weeks. You can ice if necessary or take prednisone. If you're unhappy with your final results, you can have it reversed with hyaluronidase and try a different technique next time. Best, Dr. Emer

Thank you for your question and photos. Your lips are still swollen and it is too early to judge the final results of your injection.  After injection of any lip filler, swelling and lumpiness is normal and gradually subsides in the next two weeks. Most people are delighted with their final results and if you have gone to a competent injector, then I encourage you to trust the process. I send all my patients home with verbal as well as written post treatment instructions that include all the dos and don’t.  I text and email all my filler patients 24 and 48 hour after their filler injection. This gives my patients the opportunity to send me their selfie if they have any concerns. I also see all my patients in two weeks to make any final corrections and create amazing results. These are all the added value touch points that my patients receive which enhances their experience.
I would avoid rubbing your lips because you can move the product and you can introduce bacteria from you hand to the lips.  Icing your lips will help to speed up your recover. Do not take any prescription medications unless it is a direct recommendation from your provider. If you are not happy with your final result or how your injector handled your post treatment recovery period, there are expert physicians with superior competence who have also mastered the art of an elegant experience.

Wishing you success on your aesthetic journey,

Dr. Bonakdar

I would recommend to wait at least two weeks before attempting any treatments or massage. Your body needs this time to heal itself. The shape of the lip may also change as well once the swelling goes down.  After two weeks if the lips are still uneven schedule a follow up with your injector to discuss where to go from there. 
At that time it will be determined if more product is needed or or some may need to be dissolved with hyaluronidase. Best of luck!

Thank you for your question. Swelling after lip enhancement is common and this will subside over several days. Occasionally this swelling may appear slightly uneven, despite the fact that the final result is symmetric. Cool compresses can be helpful for the first 48 hours in helping to reduce bruising and swelling. You could also gently massage these areas that you are concerned about, gently rolling the lip between your thumb and forefinger while working back and forth over the area that is uneven. You should be able to disperse and mold the Juvéderm to provide improvement. 

It is really normal to have post injection swelling, particularly on the lips which are sensitive, and for that swelling to be asymmetric or uneven. This will resolve with time but it may take a couple of weeks. Be patient. Things will improve. 

Thank you for
your question sylviaelaine. I understand your concern. Volbella
is a hyaluronic acid filler designed to enhance the lips. Swelling is normal for 2 weeks after a treatment. Swelling can be asymmetric. We have patients return after 2 weeks to assess the results. At that point more product can be used if further enhancement is desired. Please
consult with a doctor for specific recommendations. Good luck!

The lips are particularly prone to swelling, especially if hypodermic needles are used to inject Volbella instead of the newest technique using the Microcannula, which is like a blunt-tipped needle with a tiny extrusion port near the tip.  The Microcannula is less likely to tear tissue and blood vessels, which causes the swelling and bruising.  Of course, if there is too much swelling on one side, it becomes more difficult to balance the symmetry of your lips so they are even.  I recommend against having my patients massage their own lips, particularly immediately after injection, because repeated compression tends to cause even more swelling.  Instead, I recommend the use of ice for an hour--applied intermittently--to minimize swelling, though occasionally I offer mild steroid pills like Medrol Dosepak to accelerate the process.  I do offer to massage lips a week or two later as needed, to smooth the appearance after all the swelling, or water, has been absorbed.  It is common to have more swelling on one side immediately after injection, especially if more injection has been needed on one side.  Excessive Juvederm or Restylane can be dissolved using the enzyme, Hylenex, in an off-label use.  I like Juvederm Volbella for those who want smoother lips without adding much fullness, which is due to a decrease in the affinity to absorb water--as seen in our patient's lips in the January 2017 issue of MedEsthetics Magazine.  When I teach physicians for Allergan or Galderma, the lips are the second most difficult area to inject because even a slight variation in symmetry will be readily apparent.  Ideally, I suggest you have cosmetic filler injections done by someone with expertise in using Microcannulas instead of hypodermic needles.  As always, I recommend you seek the care of a physician whose primary practice and experience is the procedure you are seeking--instead of going to someone who just has general cosmetic medicine credentials--but rarely does what you seek...Best Wishes, Garry R. Lee, MD

Thank you for your question and for submitting your photos.  The lips are a very sensitive area, and are particularly prone to swelling and bruising after filler injections.  It's also not uncommon to feel small, firm lumps or nodules of filler shortly after injection - as the Volbella absorbs water, it should soften and blend in.  Swelling and bruising can last up to 2 weeks after lip filler injections.  I would recommend against massage for now - I find that sometimes patients massage their filler so firmly that they actually increase irritation and swelling, and in some cases they even displace the filler!  For now, I would recommend gently icing your lips or applying cool compresses.  If you still notice any swelling or bumps in 2 weeks, please follow-up with your injector - they may be able to gently massage out any remaining nodules at that time, or dissolve them with a medication called hyaluronidase.  Best of luck!

I really don't understand why practitioners recommend massaging. Most patients are excessive with this and end up squeezing the filler and moving it around. Keep your hands away. Ice if needed. And you can take Prednisone if you have it. For lip fillers I often give patients Prednisone. It helps tremendously. In my opinion, stop massaging. "This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."