Hylenex and Hyaluronidase is not working on Volbella, what are my next steps? (Photos)

Unfortunately, those lumps may not be the result of filler and may not go away with hyaluronidase. I've had some patients develop granulomas in the lips with the use of volbella even many months after the procedure. The best treatment I have found is massaging the lumps and using warm compresses with small doses of kenalog injections (steroid) injections by your doctor. This will typically hasten the resolution of the lumps and bumps.

Thank you for submitting your question. 
Hyaluronidase is fantastics but it works to break down hyaluronic acid fillers (juvederm, restylane) while volbella has vycross technology. It may require several sessions to break down this product. That being said, if your wedding is in May and the objections were in October; most of the filler should have dissolved by that time and you should be close to your baseline!
Thank you for your question and congratulations on your upcoming nuptials!

Dear strawberryshortcake13,For an HA filler the primary method for reversal is Hyaluronidase. Another way is time, just waiting it out for the filler to absorb. If after 6-12 months the filler still persists you may need surgical removal although HA filler should not stay in the lip - surgical removal is usually only necessary for silicone injections. Good luck,Nirmal R. Nathan, M.D.
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgeons

Hylenex and Hyaluronidase work very well to dissolve filler, if you feel you are not back at your baseline yet, it is most likely that the quantity injected just needs to be higher. Most patients when dissolving may need multiple treatments to ensure the filler is completely gone. There are some studies that also show that Vitrase may work better on Vycross dermal fillers (such as Volbella, Vollure, and Voluma) – so seeking out an experienced injection specialist who carries this type of dissolving agent may also be helpful. We wish you the very best and hope you are able to feel your best for the big day.

Hyaluronidase (Vitrase, Hylenex) is an enzyme used to dissolve hyaluronic acid based fillers. With Vycross technology found in Voluma, Volbella, and Vollure, it may take several sessions to reverse the filler completely. I recommend you followup with an experienced aesthetic physician to discuss what can be done in person. 

Thank you for your question. It's been 4 months since your injection. I highly doubt there is a lot of filler left. Also,  Volbella is the thinnest filler on the market and it will not add any significant volume to any lips, not even possible to cause a bump like that, unless you had an amateur inject  the entire syringe into one spot.   Vitrase should have done the job, maybe you needed another session to complete it s sometimes it takes more than one treatment.  I suggest you see your injector and discuss further options with them. You have a choice to wait longer as time will break it down more  or to dissolve more.  I suggest to see an expert to help you get this thing resolved and get you wedding ready. Hope this helps.  Best, Dr.Avaliani

Since it appears that you have lumps are from the fillers I would try Vitrase to dissolve it since your wedding is coming up.  Sometimes it takes more than one treatment and I would also try some Prednisone to help accelerate the healing.  Best, Dr. Green

Hi strawberryshortcake13,
I'm sorry to hear that you had a poor experience with Volbella. In addition to time, movement also tends to increase the speed at which hyaluronic acid fillers break down in the body. Volbella usually lasts 6-9 months, so the majority of it should be gone by the time your wedding comes around.

All the best,
David Nguyen, MD
Heavenly Plastic Surgery