4 days after Juvederm and uneven bumpy lips, is this swelling or final result? (Photo)

Thank you for the photos.  Sometimes there may be some contour irregularities after injection.  This can be due to the product placement, bruising, or other issues.  You are very early in your post procedure course.  In our office, we usually wait 10 to 14 days before seeing a patient back as we know there will be swelling.  Swelling can be present for a while, even longer if there was any bruising.  Often contour irregularities can be smoothed out.  Please let your well trained, experienced injector know about your concerns.

Thank you for your question. I understand you had one syringe of Juvederm injected into your lips four days ago. You noticed some bumpiness and unevenness in the upper lip, and you’re worried about whether this is due to the swelling, if a small scar in your upper lip affected it, or if this is the final result.

I can certainly help you with your concern. To give you a bit of information about myself — I am a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. Facial rejuvenation is certainly at the core of my practice, so I work with injectable fillers frequently.

It’s very important to understand that it is normal to see variability when it comes to the lips. In my practice, I always try to explain to my patients who want lip enhancement that there is a spectrum of controllability and a degree of swelling with the lips. For example, someone who wants to augment the border of the lips will have a different degree of swelling compared to someone who wants to augment the border and the actual pink part of their lips. Essentially, the more places you inject, the more likely you will experience variability and swelling.

It’s also important to know the lips swell very easily, and the smallest bit of trauma can result in significant swelling. This is especially apparent in patients for whom this is a new experience, and they often become surprised at the way the body responds to the trauma of the injection and the integration of the filler into the soft tissue of the lips.

After lip augmentation, I usually tell my patients to come see me again after two weeks. I find that the two-week mark is an ideal window for me to see if there is need for additional modifications or enhancement. I also tell my patients that we always have an open door policy, and that they can always reach me if they have any concerns, so certainly they can also choose to come and see me even before the two-week mark. I think that as long as the line of communication between you and your doctor is open, then you should be able to see them to have this concern taken care of.

In terms of what you can do for now, I’ve observed that a little bit of massage can help get you through the next couple of weeks. In addition, since the material is integrated into the tissue of your lips, even the act of talking, smiling, and just the natural dynamic nature of the lips can also help shape the material.  You can attempt to massage your lips a little, but this is dependent on what your doctor recommends.

I think it’s important to keep in mind that if you’re going to have lip augmentation done, you need to allow an adequate amount of time for the material to settle and for the swelling to resolve. You don’t want to do injectables before a very important presentation the next day. You’ll want to allow two weeks for things to resolve and then see your doctor about issues concerning asymmetry and irregularities.

There is certainly an art to doing injectables in the lips. In many ways, it is comparable to doing other types of surgeries, wherein you like how things look in the operating room, but then a significant amount of swelling will occur after the surgery, which can change the way things look from what it was in the operating room. Experienced physicians will be confident in knowing that what they did in the operating room will eventually be the final result once all the swelling and healing are completed.

I suggest that you get in touch with your doctor so they can examine your situation and give you proper assurance. I can understand how patients can feel very concerned after trying injectables for the first time, and this is why having an open door policy is very important for me in my practice. Most of the time, however, the two-week mark is ideal for a follow-up evaluation.

I hope that was helpful and I wish you the best of luck!

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Thank you for your question and photographs.  I would anticipate some continued improvement in your lip appearance as the remaining swelling resolves and the filler material begins to soften and appear more natural.  Allow your results a full two weeks to mature. If not happy with your lip appearance then, speak to your injector about an adjustment injection.  Hope this helps.