How do I know if I have scar tissue build up in my lips from Voluma lip injections? (photos)

Question

- December '14: injected w/ Voluma in lips - July '15: lips almost back to normal, got Juvederm by new doctor, still felt like upper lip was "top heavy." Stopped lip fillers altogether - June '16: injections of the dissolvent (went down a bit) - May '17: Still feel like I have filler left or scar tissue.Could voluma still be in lips? If it is scar tissue, will it get worse? Went to a facial plastic surgeon, felt my lips & said it didnt feel like scar tissue, but how can you tell from feeling it?

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  In the majority of cases dermal fillers like Voluma do not result in the formation of thickened scar tissue, rather the hyaluronic acid becomes incorporated into the tissues to leave a soft, natural quality to the skin.  Voluma placed into the lips may last for several years so I would advocate for continued dissolving of the product.  Hope this helps.

Kouros Azar, MD · Answer

Without examining you, it is literally impossible to say whether or not you have scar tissue. It is improbable, however. If you don't trust the surgeon who has seen you in person, you could always get a second opinion. I am sorry that you've had such a bad experience. In general, I don't like to use Voluma in the lips. There are other fillers that I prefer such as Volbella or Vollure.

Sean Doherty, MD, FACS · Answer

It is impossible to say if you have scar tissue without examining you in person. I would say that the chances are very slim especially since the surgeon who examined you in person agrees. Best of luck.

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question sm1214. I am sorry to hear about your situation. Voluma is a
filler used to enhance the appearance of the face. It is difficult to make an assessment without an in-office exam. Please
follow up with your doctor for specific recommendations.  Good luck!

Sameer Bashey, MD · Answer

It would be highly unusual to see scar tissue formation after filler injection. Rarely, sometimes the body forms a wall made of cells around the filler (granuloma) but this is rare. I usually prefer not to inject voluma into the lips but that is personal preference. Best.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question, and for sharing your concerns.  Products like Juvederm and Voluma are specifically formulated so that they do not trigger an immune or inflammatory response in the vast majority of patients.  While there is always a very small possibility of immune reactions and scar tissue or granuloma formation after injection, this is exceptionally rare.  It's difficult to make exact recommendations without assessing you in-person.  That said, generally speaking, scar tissue and granulomas would feel very firm and hard under the skin, and would feel very different from residual filler.  Also, Voluma is often quite difficult to dissolve with hyaluronidase, and usually requires multiple sessions with higher doses of hyaluronidase than typically used to dissolve other fillers.  A single session of hyaluronidase probably would not be sufficient to dissolve Voluma.  Did your plastic surgeon think you could benefit from additional hyaluronidase?  It would be best to follow-up with him/her to see what the best treatment options would be.  Best of luck!

How do I know if I have scar tissue build up in my lips from Voluma lip injections? (photos)

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