One side of lip is plumper than the other. It’s only slight but I see it. My Dr. said to wait, I wanted a second opinion (photo)

Question

First time I had my lips done 5 week ago injector jabbed me by accident with needle had massive purple bruise inside and outside lip took week&half for bruise to clear since then had x 2 0.5mls previous bruise side continues to be smaller than other side. When I feel it it feels like the filler has avoided the part of my lip that bruised is this due to the trauma? Is this what will happen every time I have filler in? Or does it need time to heal?

Douglas Wu, MD · Answer

Thank you for your question. Five weeks after your injections, you are seeing the full results of your procedure. While there is some asymmetry in your lips, it is difficult to assess the cause without seeing a before photo. It is possible you had asymmetry before and your injector did not compensate for that during your treatment. It may also be that the two sides were injected differently. I recommend you schedule a follow-up with your injector to determine whether some additional filler is needed to even out the result. Always make sure you work with a board-certified dermatologist who is also an expert injector for your lip augmentation procedures to ensure a consistent outcome.

Eric M. Joseph, MD · Answer

Based on your photo, you appear to have large lips. The slight asymmetry by the red arrow may not be noticeable by most, so without examining you, my suggestion would be not to add more filler. Hope this helps. Dr Joseph

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question and picture. It appears that your left upper lip would continue to benefit from a small amount of filler into the white roll just above the lip for improved symmetry.  It can take a fair amount of product to correct natural asymmetries and I do not think the bruise has prevented that area from accepting the filler.  Hope this helps.

Deborah M. Longwill, DO · Answer

Hi userr1679,
Thank you for your question. It may take two weeks for the 
swelling to dissolve from the HA filler. If after the two weeks it is 
still asymmetrical, I recommend to dissolve the filler and start again. 
Dissolving the filler will bring you back to your natural beauty. I 
suggest to see an expert injector around your area to tailor a treatment
 best for you. Best of luck!
Dr. Deborah Longwill

Robert W. Sheffield, MD · Answer

After five weeks, the swelling and bruises are entirely gone, so this is the final result in which you can see that there is a slight asymmetry on the upper lip which can be easily treated by adding a little bit more filler in that area so the lack of volume can be fulfilled and make both sides more symmetrical or dissolving all the filler and start all over again. My advice for you is to make a follow-up appointment with your injector to solve this issue. Bruise and swelling could are common side effects of this type of treatment and can even happen under the best hands, so it´s better to do it with a Board Certified doctor with experience in fillers and lip augmentation

Glenn Murray, MBBS · Answer

Five weeks should be sufficient time to assess your true result. You may just require a small top up to the left upper side to even them out. Your injector should perform this for you if there is an obvious asymmetry. There are always some bruising even with an experienced injector.

Warm Regards,
Dr Glenn Murray, Absolute Cosmetic Medicine

Warm Regards,
Dr Glenn Murray, Absolute Cosmetic Medicine

Jerry Tan, MD, FRCPC · Answer

Lip symmetry is an achievable result at this time.
The swelling and bruising should have resolved after 5 weeks and the slight asymmetry at this point can be corrected by:
1. small amount of filler at left upper lip for symmetry; OR
2. small amount of hyaluronidase (presuming you had a hyaluronic acid filler) to the right upper lip to reduce volume. This is more difficult to precisely control as too little or too much filler can be dissolved.
Hope this is helpful.

Mark Kearns, MBChB, BSc, FRACGP · Answer

Hey there thanks for the question! There is slight asymmetry and this is usually caused by bruise swelling, underlying previous asymmetry of the lips which is more apparent after filler is injected, or filler placed in unequal amounts in the lips - all can be corrected later by adding a smaller amount filler to the smaller side at a later date (which must be after all the original swelling has settled).
Good luck!

Bhavlene Panesar, MD · Answer

Thank you for your question and your picture.  
At 5 weeks post filler the swelling and bruising should be completely resolved.  
It does appear that you have a slight asymmetry on the upper left side.  While it is not likely that the bruising "pushed away" the filler it may have made it difficult for your injector to judge how much filler went in to that area when he was injecting.  A small amount of filler injected to that area should be enough to correct the asymmetry. 
Good luck!

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Hi thereAfter 5 weeks there should be no more swelling.  Of course there is always the risk of swelling and bruising every time.  Looks like you just need a little touch up and that should do it.  They look great!

One side of lip is plumper than the other. It’s only slight but I see it. My Dr. said to wait, I wanted a second opinion (photo)

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