How can I remove lip filler and lump? I tried hyaluronidase but the result weren't satisfying. May I need another dose? (photo)

Question

i had upper lip augmentation surgery (no filler added just stitches), 10 years ago. Two years ago i did upper lip filler but one upper side had more filler and made a lump on one side, and blood clot in the internal side of the lip, the lump did not go, and the blood clot now is still and brown in color. Same doctor injected hyaluronidase last week and the filler didnt dissolve completely. My filler is not the permenant one. Do i need more huyaluronidase dose? Will the lump and filler ever dissolve?

Joelle Rogal, MD · Answer

It is very possible that you need another treatment with hyaluronidase.  It can often take multiple injections with hyaluronidase to dissolve the filler completely.

Raffy Karamanoukian, MD, FACS · Answer

Longterm filler problems include migration, edema, and nodularity. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jonathan Kulbersh, MD · Answer

Yes, it can take a series of treatments with hyaluronidase. I recommend following up with your injector. Hope this helps.

Theresa M. Jarmuz, MD · Answer

Not all hyaluronidase is the same. If you have had one treatment and weren't satisfied with the results you can try Hylenex. This hyaluronidase seems to dissolve better than most. 
Good luck!

Harold J. Kaplan, MD · Answer

Hi Ayla.  Yes, we would advise another attempt at Vitrase (hyaluronidase) before taking further steps.  If the lump is dense and hard, it's possible you have a granuloma.  This type of lump would normally be injected with a steroid like Kenalog.  Best of luck.

How can I remove lip filler and lump? I tried hyaluronidase but the result weren't satisfying. May I need another dose? (photo)

Answers (8)

Answer: Try Hylenex

Answer: Try Hylenex

Answer: How to Dissolve Lip Filler

Answer: How to Dissolve Lip Filler

Recommended reading

Everything you need to know about Hyaluronidase

Our mission is to create a world where every investment in modern beauty is Worth It.

How can I remove lip filler and lump? I tried hyaluronidase but the result weren't satisfying. May I need another dose? (photo)

Answers (8)

Answer: Try Hylenex

Answer: Try Hylenex

Answer: How to Dissolve Lip Filler

Answer: How to Dissolve Lip Filler

Browse related questions

Recommended reading

Everything you need to know about Hyaluronidase

Our mission is to create a world where every investment in modern beauty is Worth It.