Lip filler complication...
It doesn't act like a bruise because it is not one. Your doctor did the right thing in recognizing this as a blood vessel occlusion event and treating you immediately with hyaluronidase. Even though you had some skin "flaking", all that remains is alive. Your skin will be pink there for some time as new superficial vessel growth is making it appear this way. An Excel V laser can help to expedite the resolution of the pink. While blood vessel occlusion can happen with anyone, be sure you are seeing a core injector (facial plastic surgeon, plastic surgeon, or dermatologist) as we know the anatomy of the face the best. I wish you well!
Compression compromised blood flow
This is a rare, but real complication. Even the best injectors can experience this. The doctor was wise and performed the appropriate treatment. Now what you are seeing is that collateral capillaries are dilated to improve the flow of oxygen to the area that had its arterial blood flow decreased (either by direct injection, or compression of the artery by the Juvederm). You had no tissue necrosis due to the rapid action of your doctor. Now ask about Excel V 532 laser with 1064 micropulsed laser energy. IPL at lower levels can help this discoloration as well. Long term result should be excellent.
You are not exhibiting a bruise but post inflammatory erythema secondary to a vascular occlusion. It is good that your doctor was on hand with some hyaluronidase to treat the problem. I say this because many med spas that use non-physician injectors aren't equipped to deal with this problem and time is of the essence when this occurs. The condition should improve with time but you might also try a vascular laser. I would see a board-certified dermatologist about this issue. I wish you the best. Dr. Adrienne Stewart M.D. FAA D
Juvederm Side Effects -- Vascular Occlusion, SEEK AN EXPERT
It appears that you have a vascular occlusion related to Juvederm. This can be improved with hyaluronidase, corticosteroids, lasers, and hyperbaric oxygen. Please consult an expert for treatment. Best, Dr. Emer
Vascular occlusion after Juvederm
Your pictures are consistent with vascular occlusion. In a case of suspected vascular occlusion, the filler should be dissolved with hyaluronidase as soon as possible. You should stay in close touch with your doctor. Usually this type of skin reaction will improve over time. Treatment with pulsed dye laser or similar laser may be beneficial down the road to reduce redness. Another thought would be to try injecting more hyaluronidase into the area in case there is still any residual filler. Your doctor should follow you closely and guide you on what to do.Regards,Dr. Ort
Late effects of vascular occlusion
Indeed you did have occlusion. Now the areas are viable but abnormally profused. I would try further hyaluronidase. If no different, then try a vascular laser such as Excel V or VBeam. When vascular occlusion occurs, hundreds of units need to be injected to flood the area with hyaluronidase. It was good skills that the doctor recognized the problem immediately and had hyaluronidase available.