Juvaderm in nasolabial folds was not injected deep enough and is also uneven

Swelling and bruising can occur after Juvederm placement, as it typically takes 10-14 days to see optimal results. After two weeks if you are unhappy I suggest reversing with hyaluronidase. I suggest only receiving treatment from a board certified dermatologist who specializes in facial sculpting. Best, Dr. Emer

Thank you for your question. Unfortunately without a series of photographs it is difficult to offer definite advice, but it is wise to allow your results to mature for at least two weeks after injection so that they have an opportunity to soften and appear more natural.  If still asymmetrical you may need additional treatment on your left side or dissolving of excess filler on the right. I would certainly make an appointment to discuss your results with your injector so that an open dialogue can be had. 

The short answer to your basic question is that if you are concerned about your result, you should contact the injector and s/he should advise you whether you need simple watchful waiting for any post-treatment swelling to go away, or whether additional treatment is required to achieve symmetry or even whether the bump needs to be dissolved with hyaluronidase before retreatment is undertaken. I personally feel, and it is my office policy, that such touch ups, or retreatments, etc. should be considered part of the original treatment fee and there should not be a charge for this, unless the possible need for additional treatments at additional expense had been discussed in advance.Your question, however,  raises a lot of very important issues worth discussing. The first being that you are contacting this forum to ask your question and express your concerns, rather than feeling comfortable enough to query or rely upon the injector directly. This suggests an issue of confidence in the treating provider that goes beyond the lack of trust that is apparent over the current outcome of treatment.And then there is the issue of the expertise of the injector. As a rule, I would suggest trusting your face to consultation with a board certified, core aesthetic physician with expertise and experience in the use of these products. I would also suggest additional vetting by requesting to see his/her before and after photos before agreeing to proceed.There is also the question of whether simple Juvederm, which is best reserved for treating superficial lines and wrinkles, was even the appropriate agent of choice. Nowadays, we seldom "chase" after deep wrinkles and folds, like the smile lines, by injecting directly into them as we routinely did two decades or more ago.  Experienced injectors understand that typically these folds result from loss of volume in adjacent and superior areas of the cheeks and that replacing volume in those areas can achieve not only more natural looking cheeks but secondary improvement in the smile lines without even directly treating them at all. And to achieve this kind of improvement, we would rely upon volumizing fillers, such as Voluma XC, Radiesse Plus, or Restylane Lyft, or even a combination of these, if deemed necessary.And an experienced physician injector would be able to tell you beforehand, which material(s) and how much of them would be needed to get the job done, so that there would not be any surprises, rather than the more novice way of charging by the syringe. By analogy, you would expect a surgeon about to perform a gall bladder operation, based upon his/her expertise, to be able to quote you a fee for the total surgery in advance, rather than charge you for each and every package of gauze or suture material used during the operation. Going forward, it might be wise to give serious thought to the lessons that can be learned from this encounter.