Bump under wet mucusoal of my lip - how can I remove this? (Photo)

Question

I had my first lip filler treatment withi 2023. I did not notice any lump immediately after the procedure. Around a year ago, I noticed a small lump developing on the inside of my upper lip. The lump: * Is approximately pea-sized * Is on the inner (mucosal) side of the upper lip * Is skin-coloured/clear rather than red or inflamed * Feels hard/firm (previously it has sometimes felt softer) * Is fixed in place and does not move * Has remained present for about a year * Has not fully reduced despite time passing I have recently had some of my lip filler dissolved, and one side of my lip has reduced, but this particular lump remains

Anna Chacon, MD, FAAD · Answer

Based on your description, this doesn't sound like a typical temporary post-filler lump. Since it has been present for about a year, is firm, fixed in place, and did not dissolve even after hyaluronidase treatment, it's worth having it evaluated rather than assuming it's simply retained filler.

There are a few possibilities:

Residual filler encapsulated by scar tissue (fibrosis): Occasionally, the body forms a small fibrous capsule around filler. In these cases, dissolving the hyaluronic acid may not eliminate the lump because the surrounding scar tissue remains.
A mucous cyst (mucocele): Although these are usually softer and can fluctuate in size, they can sometimes feel firmer over time.
A benign salivary gland or fibrous nodule: These can develop independently of filler and may simply have become noticeable around the same time.
A delayed inflammatory nodule: While less common, delayed reactions to filler can occur months after treatment.

The fact that the lump is skin-colored, stable, not inflamed, and has not grown significantly is reassuring and makes a serious condition less likely. However, because it has persisted for such a long period, I would not expect it to disappear on its own.

If hyaluronidase did not change the lump, repeating additional dissolving treatments is unlikely to help unless imaging confirms there is still filler present.

One of the most useful next steps is high-frequency ultrasound, which can often distinguish between residual filler, scar tissue, a cyst, or another soft tissue lesion. That information helps determine the most appropriate treatment.

Treatment depends on the underlying cause:

If it's residual filler, additional hyaluronidase may still be an option if imaging confirms filler remains.
If it's scar tissue or a fibrotic nodule, conservative management, steroid treatment in selected cases, or minor surgical excision may be considered.
If it's a benign cyst or another lesion, a simple in-office excision can often remove it completely.

Because the lump is fixed, persistent, and unaffected by filler dissolution, I would recommend evaluation by a dermatologist, facial plastic surgeon, or oral and maxillofacial surgeon who is experienced with filler-related complications. They can examine the area, determine exactly what it is, and recommend the safest and most effective treatment.

The good news is that most persistent lip nodules after filler are benign and treatable once the correct diagnosis is made.

Bump under wet mucusoal of my lip - how can I remove this? (Photo)

Answers (1)

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