Is this necrosis? What do I do? 1 day post lip augmentation. (photos)

This is a situation where your injector needs to be seeing you very frequently, ie daily until there is no further fear of progressive vascular occlusion. That said, you photos do not look particularly worrisome.  Nevertheless, make sure your injector checks the area to make sure there is no issue.

Let the dust settle here and find a different injector.  The injector might have done the right thing with the enzyme.  This is hard to know from your story. Getting a hematoma is not the same thing as getting a vascular occlusion from filler.  A simple hematoma is not managed with enzyme.  Generally occlusion causes severe pain, an disturbance in the circulation to the skin well outside the area where the filler is being placed.  Certainly from the picture you have posted, you should rest comfortably, that these does not appear to be any dusky, dark discoloration.

I recommend following up with your injector today. It can take a series with hyaluronidase to dissolve filler. Best, Dr. Emer

sophb123.  So sorry you have this issue. It appears that your injector appropriately recognized the issue and treated you the right way. At this time you need to heal before any further treatment or repeat Lip augmentation. If your injector is not a board-certified plastic surgeon or dermatologist, and there are any concerns whatsoever, get a second opinion. Good luck.

I'm sorry you had this outcome. I recommend following up with your injector to make sure you don't need more hyaluronidase to dissolve filler. Hope this helps.

Hi Sophie, I am sorry that you had this vascular issue with filler. It is scary for the patient and the injector when these things occur. The important thing is that it was recognized at the time and treated aggressively. From here, very close follow up with your injector should take place to assess your progress. You may need more dissolver (hyaluronidase), massage, or other treatments as deemed necessary. I wish you success with your recovery.

While it is certainly not normal, I feel confident that it is NOT necrosis.  I would like to see some closer pictures because it is difficult to determine if I'm seeing filler bumps under your lip, or is it possibly a fever blister outbreak.
While I feel that you will probably be just fine, right now you have to wait and see what progresses.  If it becomes very painful, or the lip starts looking worse, head to the emergency room immediately.
In any case, I would have a physician look at your lip at least daily for the next several days to follow its progress.
I hope this helps.

Hello and thank you for your question
common reactions after lip augmentation include bleeding, bruising, swelling and pain. Not sure what occurred in your case for the injector to immediately use dissolver, usually occurs if there is concern for vascular occlusion. I recommend early follow up with your injector. 

 Hi, I have performed many lip augmentation procedures using dermal fillers or lip implants for over 30 years. From the photos, your upper lip shows signs of significant bruising.  You should go back and be followed by the lip augmentation MD expert that did your lip injections.  The artery and vein, supplying the lips, come in from the corners of the mouth.  Knowing this and the lip anatomy is paramount in avoiding injecting filler in an area that might occlude the vein which in turn can lead to lip necrosis.  It's best to avoid injecting filler in the area of these vessels for that very reason.   Following my beauty principles, the lips should be full with the upper lip approximately 75 % the size of the lower lip for the lips to appear balanced. The lips can be augmented using a dermal filler or a Permalip implant.
Dermal fillers and lip implants offer a much more reliable volume for augmentation of the lips than permanent fillers or fat injections which are associated with increased, unwanted, side effects.
Hope this helps.