Delayed swelling to Juvederm Volbella. What can I do and can I ever get fillers again? Please help!

Question

I have Juvederm Volbella injections in my cheeks for 3 years now and roughly 5 visits for it during that period. I find that I have swelled up a few times randomly months after the injections; however, right now I am more swollen than ever on one side of my upper cheek. I recently switched injectors and had more injected just into the centre of my cheek area & do not appear to have swelling there. Is it possible I can not get Juvederm or HA filler injections ever again? Am I allergic?

Michael A. Zadeh, MD, FACS · Answer

This is impossible to answer without an in-person examination or at least some pictures. You need to be evaluated by an expert physician who has experience in dealing with filler complications. I don't think the answer is adding more filler until it is clear what is going on. Best wishes.

Juan Carlos Fuentes, MD · Answer

After getting fillers injected in the face it is normal to have some ligth swelling, but if the swelling occurs weeks or months after the injections, it may be from a biofilm in the area of the injection. You need an evaluation in person to check if you just have some chronic swelling from water retention in the area, or if you have a subclinical infection, this will require antibiotics and hylauronidase. Check with your physician.

Jason Emer, MD · Answer

fillers ALWAYS respond to hyaluronidase.  IF there is still swelling after that then RF treatments are needed to improve the lymphatic flow of that area and antibiotics are needed to decrease internal inflammation.  Eventually this will burn out unless its a true infection. But if this is just a post-inflammatory reaction or swelling once the filler is gone and you start treatments such as LED, RF treatments like Venus legacy, and antibiotics and/or steroid injections + 5FU this will then resolve.  And its often not a consequence of the technique used or the physician its just an internal reaction to the filler from that individual person and can't be predicted who this will happen to.

Monika Soni, MD · Answer

Thank you for your question! Nodules or delayed inflammatory reactions after treatment with the Juvederm products Voluma, Volbella and Vollure have been reported. These reactions have been reported weeks to months after injection and sometimes have been associated with recent dental work. Some people have felt that they are related to the development of a biofilm in the area of injection. They generally are best treated with a course of antibiotics such as doxycycline or minocycline. They generally take 6-8 weeks to resolve. Dissolving this type of hyaluronic acid can be challenging. I would suggest following up with a trusted provider and considering a course of antibiotics for 6-8 weeks. Best of luck!

Emil A. Tanghetti, MD · Answer

Nodules or delayed inflammatory reactions after treatment with the Juvederm products Voluma, Volbella and Vollure have been reported. These reactions have been reported weeks to months after injection and sometimes have been associated with recent dental work. Some people have felt that they are related to the development of a biofilm in the area of injection. They generally are best treated with a course of antibiotics such as doxycycline or minocycline. They generally take 6-8 weeks to resolve. Dissolving this type of hyaluronic acid can be challenging. I would suggest following up with a trusted provider and considering a course of antibiotics for 6-8 weeks.

Leonard Grossman, MD · Answer

You do not have filler allergy. I think you need to be evaluated by a plastic surgeon to make sure that there's nothing else going on with your face. if everything else is ruled out, there is a small chance that the filler maybe infected. If that is the case you need to be treated with antibiotics and possibly have the filler dissolved. Good luck from New York City

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