Saline flush for small bump of superficial filler on lower lip? (Photos)

That is a granuloma, most likely bound to worsen over time; once it acquires larger prominence you may need direct escision and en bloc removal of the granuloma with a wedge of overlying vermillion.

It’s understandable to feel concerned when filler appears superficially, causing visible bumps or unevenness.
If the bump is minor and superficial, gentle massage using clean fingers can often be effective in redistributing and softening filler, especially if performed shortly after injection. You can gently massage the area with slight pressure several times daily over a few days, which may help smooth the bump gradually.
Injecting saline alone typically does not effectively disperse filler. Using a needle to puncture or manually remove filler can risk further unevenness or scarring and is generally not advisable without medical supervision.
If massage alone isn’t effective, a very conservative, targeted use of hyaluronidase (hyalase) administered by an experienced injector may precisely dissolve just the superficial filler without significantly affecting surrounding filler.
Your safest next step would be a gentle massage first, followed by a consultation with a skilled injector if needed.
I hope this helps clarify your options. Consulting a specialist injector for personalized guidance is always beneficial.
— Güray Yeşiladalı, MD