Is it possible for Juvederm to not settle or is my injector just trying to cover up for bad work? (photo)

Question

I had Juvederm injected in my upper/lower lip lines and along the lip borders. The lower part looked great but 2 months later the upper lip lines were horrible. My injector said that my body wasn't allowing it to settle and that it was sitting on top of the wrinkle. She injected more horizontally to even it out which looked great until about a month later. Now I can see where it sits horizontally. I am a small skinny woman. Is it me or should I find a different injector?

Kimberly Butterwick, MD · Answer

The Juvederm can look and feel a lumpy for about 1 - 2 weeks, but should settle down and look symmetrical then.  If you are experiencing more concerns, I would follow up with your treating provider.

Richard Parfitt, MD · Answer

Initial swelling of the peri oral area after Juvederm treatment can significantly improve the look of upper lip lines. As this swelling resolves and the Juvderm starts to break down, it is not unusual to see waves or lines of the filler.  This is an area that is very difficult to treat with filler.  It can cause an unnatural shape of the upper lip area sometimes referred to as a "monkey mouth", especially if too much filler is injected.  Another option for smoothing upper lip lines is a deep peel or dermabrasion. Finding a skilled, qualified doctor to perform either of these options is pertinent.

Steven F. Weiner, MD · Answer

Upper lip lines are hard to treat!  The easiest solution is using filler, but its not perfect and lasts for about 4-6 months.  Belotero seems to be the best filler for the lip lines, if you inject them directly.  Filling the vermillion border with filler helps and so does filling above the lip with a cannula horizontally.  I think the most recent treatment, using the Infini, seems to be very promising, with very little downtime and risk.  I've abandoned injecting Juvederm superficially because it becomes noticeable and the only filler I will inject superficially for the lines is Belotero.

F. Victor Rueckl, MD (in memoriam) · Answer

In thin-skinned areas and on people who are very thin in general, Juvederm tends to ridge. It doesn't make an even transition from a filled to an unfilled area, so people will often end up with a ridge or line, like you have. While some of this could be averted by the injector, maybe, it's more about the actual consistency of the filler and its use in thin-skinned areas. You could find a different injector if you'd like, certainly, but more than that, I'd recommend a different filler or procedure for this area. "This answer has been solicited without seeing this patient and cannot 
be held as true medical advice, but only opinion. Seek in-person 
treatment with a trained medical professional for appropriate care."

Is it possible for Juvederm to not settle or is my injector just trying to cover up for bad work? (photo)

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