Best way to massage large lumps of Juvederm Ultra + in the lips?

Sorry to hear about your lip situation.  If you feel like the swelling and lumpiness is getting better with every couple days, then it is worth waiting until things stabilize.  If it is fairly stable, then you can seek out an injector who has experience with hyaluronidase to help dissolve a portion of this.  As far as massage, I tend to the the massage myself and ask my patients not to massage after I use Juvederm (or Voluma, Radiesse, Perlane, Restylane, Restylane Silk).  The only product where I ask the patients to massage is Sculptra.

By ten days out, you may not be able to massage them down.  You may need hyaluronidase to dissolve the product.  See your injector.

There is typically no need to massage or manipulate hyaluronic acid fillers such as Juvederm Ultra Plus. “Lumps” or areas that feel slightly hardened are normal, and will generally resolve on its own within a week of treatment. In your case, because 10 days have already passed with no improvement, it is likely that these “lumps” require additional treatment. No amount of massage will dissolve these “lumps,” however rest assured that this is a simple fix!You will need to return to your doctor and request he inject hyaluronidase into the “lumps.” Hyaluronidase is an enzyme that breaks down hyaluronic acid; it starts working immediately but can take up to three days for the full effect. It will only dissolve filler where injected, and will have no effect on your own tissue. If you feel uncomfortable returning to the physician who injected the Juvederm, be sure to seek out the care of a board certified Dermatologist and experienced injector. Best of luck.

If you ask 2 doctors you'll probably get 3 different answers on the correct way to massage.  Fillers are usually injected at the junction of the white and red part of the lip.  If this is where yours was placed, I'd recommend using one finger on the white and one on the red and push gently squeezing the fingers together.  This will help direct the filler to the correct area.  If the Juvederm was injected into the body of the lip then again using two fingers you should gently massage with one finger out of the mouth and one finger in the mouth.  I would avoid pushing very hard as this can lead to a bruise or even a broken blood vessel which can worsen the swelling.  If the area remains lumpy and you are not pleased with your result, there is a material that can be injected into the area where filler was placed to remove it.  This would unfortunately remove all of the Juvederm you had injected making your initial treatment a complete waste of money but is an option.  Any physician who injects fillers should have the material available to inject to remove this one if you did not want to see your previous physician.  However, your previous physician would likely not charge you for the solution to remove it whereas another physician likely would. 

At this point massaging is probably not going to help very much. However, hyluronidase can remove the filler. You need to contact someone who has experience with both fillers and hyluronidase. If you are uncertain where to look, start with the Clinic. Dermatology and Plastic Surgery work together there in their "Institute".          jlr

Greetings, thanks for your question. First it is important to note that the lumps you are experiencing may not be juvederm, they may be hematomas or bruises in the lip muscle. It is impossible to know without an actual evaluation. You can massage the lips after injections to help smooth the product out, but this only effective for the first 24-48 hours at most; for your purposes the technique is not critical, just literally try and smooth out the nodules with your fingers. Most nodules/lumps do resolve on their own with time.  I would consult either your surgeon or another provider to assess you lips and potentially help you through the process. Hope this helps.