Big Mistake: Restylane in Lips from Different Doc: Uneven Smile, Strange Lumps

Hi Sally Ann,

Sorry to hear about your misadventure in injectable land.  Unfortunately bleeding and hematomas can occur even with the best injectors.  There are some precautions that can be undertaken to help minimize bruising that an experienced injecting physician will use. 

If you are concerned about your upcoming television appearance, please email a photo, I will evaluate it, and then contact you.  It is not necessary to travel back to your original injecting physician, there are many experienced and skilled experts here in Los Angeles who have experience with actors, actresses, and those in television and film.  It is important to choose your injecting physician most carefully, choose one with artistic vision.

Good luck and be well.

Dr. P

Encino, Beverly Hills, CA

Hi Sallyanne.  You have a few options.  First you can do nothing and hope that with messaging that the unevenness will go away and with time the bruise will dissipate as well.  

If you want to be more proactive, you could of course get the injections reversed as you suggested and this will return your lips to the way they looked before. You should be able to do this where you are or at your normal injector's office.

Finally, we use pulsed dye lasers in cases that involve deep injection bruises.  If treated within 2-3 days of the initial injections, the bruises usually resolve within another 48 hours.  Good luck.

Be patient, swelling and bruising after fillers will resolve. If you truly were uneven before your treatment, and the doctor had to inject more in 1 area, that area will swell more. Bruising can also cause an area to swell more and therefore make you look uneven. I always warn my patients, during their treatment, not to judge their results during the week after their treatment, as swelling and bruising can alter appearances. As for your TV appearance, most swelling and bruising resolves by 7-10 days. If you still look uneven by 7 days after your treatment, you could have hyaluronidase injected into the plumper side, it usually takes less than 24 hours to dissolve Restylane or Juvederm Ultra.

SallyAnne

The biggest concern I have for you is the lack of a balanced treatment.  The bruising could be hidden with make-up and lipstick.  However when the upper lip is primarily treated, it will look too big relative to the lower eyelid.  This will make you look like you have had filler-it's a bad thing.  Considering you are going to be on the air in 10 days, this is a circumstance where I would recommend enzyme to take out volume and a short course of corticosteroids to reduce swelling.  The product Collagen was one that could be used the day before a red carpet event.  The Hyaluronic acid fillers are not at all like this.  If you are in Los Angeles, call my office to be assessed to see if these measures will be helpful for you.

Greetings SallyAnne~

Fortunately or unfortunately, we are very familiar with situations like this.  I really feel that the best way to go in cases like this is to dissolve the material that is there and start from scratch.  It can be quite difficult to say the least to fix someone else's mistakes and rather than chase them with more product and potentially make them worse we are better off just starting anew.  Waiting for the product to dissipate on its own may take a considerable amount of time and result in it resolving in an uneven fashion as well.  After dissolving, we usually wait a few days to reinject and the begin again with a conservative amount.

Good luck~

Dr. Grant Stevens

It is tricky to go for a "touchup" to a new doctor in a new town where you don't live. In the future I would recommend waiting to see the doctor you trust. Bruising or hematoma (collection of blood under the skin) is always a possible risk from any injectable treatment, and it will resolve, hopefully in time for your TV appearance in 10 days. People sometimes miscalculate the risk to injecting lips. There are large blood vessels running through the lips, and the lips are basically mostly made of muscle, another tissue that can bleed easily if filler is misplaced.  I recommend you do not massage the area. In this case, the lump does not sound like filler out of place, but rather bleeding, and the less trauma to the area, the faster it will be able to heal. Return to either your out-of-town injector or your original doctor for the best advice for your particular situation.

It sounds like most of what you are dealing with is bruising and swelling from the injections.  This can happen!  I recommend waiting a week and in the meantime, get yourself some Arnica homeopathic pills from the healthfood store.  These pellets are dissolved under the tongue 3 tiems a day and will help you heal more quickly.  Also get the Arnica Cream or Gel, and use that at least several times per day.  After a week you should be healed and you can better assess whether it is uneven or not. 

The main question is what do we need to do to get you camera ready.  The bruising will go away.  The Restylane can be dissolved.  New Restylane can be injected.  Makeup can be used.  You need a well thought out plan that makes sense.  A photo would be helpful.

 you probably have had some bleeding from the needle stick and need to wait until that resolves before doing anothe injection

Sorry for your issue. Any injection can cause ecchymosis. It is rarely the injector but a very inexperience or sloopy injector could be the reason. Hope things work out.