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

Question

Does this look normal? I had lips done 12 hours ago. My lady said I had a heamatoma and filler hit an artery and the blood supply was stopping to right side lip up to nose.next 30 mins she used dissolver in all that area,around 50 Injections in total of filler and dissolver.very scary. It is now very swollen(pics don't show the swelling well)and inside is a deep dark red. Is this necrosis?Where the blood had stopped for a while,will it die or did she save it with the dissolver?What do I do now?

Matthew Bridges, MD, FACS · Answer

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.

Kenneth D. Steinsapir, MD · Answer

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.

Jason Emer, MD · Answer

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

Robert M. Tornambe, MD · Answer

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.

Jonathan Kulbersh, MD · Answer

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.

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

Answers (9)

Answer: Lip Augmentation Complication

Answer: Lip Augmentation Complication

Answer: Is this necrosis? Hyaluronidase to dissolve filler

Answer: Is this necrosis? Hyaluronidase to dissolve filler

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

Answers (9)

Answer: Lip Augmentation Complication

Answer: Lip Augmentation Complication

Answer: Is this necrosis? Hyaluronidase to dissolve filler

Answer: Is this necrosis? Hyaluronidase to dissolve filler

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Recommended reading

Everything you need to know about Lip Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.