My Juvederm fillers have become swollen and tender throughout my face after a vomiting bug. What caused this to happen? (Photo)

Question

I've had a 24 hour vomiting bug. During the last six hours of the 24 hours, i noticed the Hyaluronic filler on the left side of my chin had become hard and tender. This has now extended to the left side of my chin and through the fillers in my cheek bones. All my fillers are tender to touch. The swelling and soreness is similar to when i first had fillers put in. My chin was done 8 months ago, my cheeks have been filled for 2 years. Will this subside, has it been caused by retching?

Mitesh Kapadia, MD, PhD · Answer

This is a late immune response to the fillers. This type of reaction is an uncommon problem, but one which I have seen several times. It seems to get triggered by dehydrating events such as an illness or heavy drinking. In my opinion, the best treatment would be to start on a course of oral prednisone right away to reduce the severity of the reaction. If the reaction keeps coming back as the prednisone is tapered, the filler may need to be dissolved. You need to see an experienced doctor in your area to take care of this.

Tim Neavin, MD · Answer

Thank you for your question. The swelling should subside in 48 hours. If not, I would recommend you to follow up with your injector.

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question and I am sorry to hear of your illness side effects.  Unfortunately there can be delayed reactions to previously placed filler with illness but which tend to resolve spontaneously with little issue.  Should the area of firmness and swelling persist you can try a course of oral steroids or lastly dissolve the filler.  See your injector for an in-person examination if this does not completely resolve in the next day or two.

John Paul Tutela, MD · Answer

Thanks so much for reaching out. You’re having a very rare reaction to your filler. The best course of action would be to go back to your provider. Likely what you will need to do is start a short course of antibiotics and a steroid. You may need to have the filler dissolved. I hope this helps :)

Jonathan Kulbersh, MD · Answer

This is not typical with fillers. If it persists, I recommend following up with your physician for treatment. I hope this helps!

Melda A. Isaac, MD · Answer

Unfortunately more cases of delayed reactions to fillers are being reported, even without a history of having a prior bug or illness. Therefore it is impossible to say with 100% certainty that your vomiting spell triggered this reaction. Although rare, we don’t completely understand the mechanism of action as to why this happens. I can reassure you that all cases reported have resolved without serious side effects. I urge you to see your injector.  If he or she isn’t familiar with this rare side effect, you should see a physician who is experienced with treating this reaction. The resolution of this side effect is expedited with the treatment of hyaluronidase to dissolve the filler and antibiotics coupled with intralesional and/or oral steroids depending on the severity of the reaction. Good luck.

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