Lumpy lip filler fixes? Should I do more hyaluronidase and then try more filler?

Facial fillers using Hyaluronic acid can cause immediate swelling and uneven contour. The swelling usually subsides with time. I recommend applying Plato's Bruise Balm twice daily for a few days after injecting my patients. If the filler lumps do not resolve, then a small injection of Hylenex usually can correct an HA filler that is overdone. If Hylenex does not work, combination injections with verapamil or corticosteroid IIT may help. 
In some cases, Venus Viva RF can help tighten skin thereafter. 
Best 
Dr. Karamanoukian
Realself100 Surgeon

Hi and thank you for your question! At this time since you seem to like the results right after the 2nd round of injection (when swelling was still active), it would make more sense to try to replicate that effect by careful injection of filler to add some volume and smooth out the lump. It should be done conservatively to avoid over filling, but the good thing about hyaluronic acid fillers is that they are quite forgiving and any excess can be dissolved later on if needed. I suggest taking a conservative approach and doing it in small steps if possible to make sure you can achieve the look you want before undergoing more rounds of filler followed by enzyme. I hope it helps and good luck! 

If you're unhappy with your final results, you can have it reversed with hyaluronidase and try a different technique next time. It can take a series of treatments with hyaluronidase. See an expert. Best, Dr. Emer

Hi,Thank you for your question, hopefully I can help clarify!
Is there any way you can provide us with the timeline of these events as well as some photos?
Thanks again for the question!

The most cost effective option would be to wait a few months for the filler to dissolve on it's own and then start again. If you don't want to wait, you can either dissolve all the filler with hyaluronidase, which can take several sessions and then start again. Or try to fill in the uneven areas now with filler, which is a little harder to do as you have already discovered. Good luck!

It is difficult to advise you since it would be necessary to do an exam and decide what is the best way to proceed.  Certainly dissolving the all the product and starting over is one approach.  It might be possible to just inject the area where the lump is to smooth it out.  Oftentimes it takes several treatments of hyaluronidase to dissolve the filler. Adding more filler is also an option. Again, several treatments may be needed to give you the results you want. You should discuss this with your provider who can advise you.

Sorry to hear about your experience. I would highly suggest to return to your providers and discuss your options. You can either wait for the product to get absorbed over time, usually about 4-6 months or have them dissolve it partially or completely and have your lips reinjected with a different technique. Hope this helps. Best, Dr.Avaliani

I suggest returning to the plastic surgeons office and seeing the physician who can explain the result and suggest possible solutions.  It can take a couple of weeks for filler to "equilibrate" and sometimes we want a "bump" to enhance or highlight a particular area on the lips, like the lower lip "pillows."  All the best to you, Alexis Parker MD