Firm lump in lip after Volbella. Is there anything I should be doing to help it? (Photo)

On Friday, I had 0.2mL of Volbella put in my upper lip. Immediately after the injection, I could feel a lump on the left side. My surgeon massaged it and said it would sort itself out, and that I should not massage it. Now Monday, the lump is tender - a constant aching feeling. Its firm, and hasn't increased or decreased in size/shape. It is visible when I smile. Is there anything I should be doing to help it? I have an appointment this week, but thought I'd ask for other opinions. Thanks :)

Doctor Answers 6

Lump in lip after Volbella

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Lumps or nodules are not uncommon with fillers, especially in the lips and tear trough areas. The vast majority disappear on their own. Those persisting past 2-3 weeks, if bothersome, can be safely and effectively dissolved by an expert injector (e.g. dermatologist, etc) with hyaluronidase. Be patient.

Toronto Dermatologic Surgeon

Wait, then hylase if no better by 10 days

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Sometime lumps maybe due to bruising. If there is abit of pain, this suggest bruising. You definitely do not have any arterial occlusion given the pictures. Yes, I can see a lump, and like Dr Devani said, I personally would wait. I tell all my patients to ice after lip injections, and that it can take 7 or so days to settle down. If overcorrection has been made, a tiny bit of hylase can be injected to settle things down. The great thing about HA injections like Volbella is that overcorrection can easily be reversed. 

Dr Davin Lim 
Laser and Aesthetic Dermatologist
Brisbane, Australia.

Swelling/Bruising/Lumpiness (early) from Fillers

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I always tell my patients to not love their filler injections for 2 weeks. Swelling is very common and sometimes immediate. It can last 3-7 days and a good idea is to use cold compresses. Cold compresses may be used immediately after treatment to reduce swelling only if needed. This may be applied for 3 minutes, 3 times per day, for up to 3 days. This is best done with a bag of peas in a zip lock bag. Only apply light pressure to the area but gentle massage might be necessary if the bump is from the filler material itself. Get Arnica gel if you can find some and apply a few times a day as well to help treat any swelling. Avoid any blood thinners. Bruising can also last 1-2 weeks. I don't recommend hyaluronidase this early and wait a few weeks until the swelling has resolved. If it is persistent or you are worried, set up a follow up appointment with your dermatologist.

Alim R. Devani, MD, FRCPC
Calgary Dermatologist
4.9 out of 5 stars 16 reviews

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Lump after Volbella

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Lip filler bumps is fairly common after filler.  The bumps can occur early on and many settle down.  Although massage after filler is considered a mainstay, beware that massage can drive the filler into another location if done too early.  

Reasons for bumps after filler:

  • Technique- Filler may have been used too superficially or wrong type of filler
  • Mouth movements- In some patients their movements can promote the accumulation of bumps and an alternative technique can be advocated.

Treating lip filler bumps:

  • Observation +/- massage-  Should be done for almost all lip filler bumps for 2 weeks.  For our patients we usually advocated massage after 48-72 hours to let the filler settle into place.
  • Reversal- A reversal agent can be used such as Vitrase to dissolve the filler if there is a large obvious persistent bump
  • Additional filler- An expert filler injector can used improved technique to mask the lip bumps.

The application of lip filler is very technical and should be done by an expert injector.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 181 reviews

Lump after Volbella

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Thank you for your question kate2811. I understand your concern. Volbella is a hyaluronic acid filler designed to enhance the lips. Lumps are normal and usually settle on their own after 2 weeks. Patience is important.

Please consult with a doctor for specific recommendations. Good luck!

Lump after Volbella Injection

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Dear kate2811:

Looking at your photo, you need not worry.  Best advice is not to massage the lump yourself and see your physician 2 weeks after injection for further assessment and management which ranges from physician massaging of lump to dissolving it with hyaluronidase.  Best wishes.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.