Used hyaluronidase twice to dissolve filler in over 2 weeks time but my lips are the same it did not work. Advice? (photos)

Question

Hi, I have had lip fillers April last year and it still there and now I've a small lump one side of my top lip. I went to dissolve it with Hyaluronidase the and the doctor used Hyaluronidase twice to dissolve the filler in over two weeks time but my lips are still the same the Hyaluronidase did not work whatsoever. Need help if there's anything else I can do it to go away? The doctors told me that it's not a scar tissue it might be my collagen.

Jonathan Kulbersh, MD · Answer

You may need more hyaluronidase. I recommend speaking with your injector. You may also have swelling after your hyaluronidase treatment, which will resolve in 1-2 weeks. Hope this helps.

Jason Emer, MD · Answer

It can take a series of treatments, but it's difficult to determine how many treatments of hyaluronidase is needed to dissolve filler. I recommend following up with a cosmetic dermatologist. Best, Dr. Emer

Inessa Fishman, MD · Answer

It is important to know the type of filler initially used, and the amount of hyalouronidase used to inject the bump.  Certain fillers have HA (hyaluronic acid) molecules that are tightly bound to each other; these fillers may require more than average doses of hyaluronidase to dissolve.  Beyond that, it is possible that the bump shown represents something other than filler; excessive scar tissue or inflammation may require other treatments (such as steroids, anti-scarring medications such as 5-fluorouracil, and/ or antibiotics).  Return to your treating physician to discuss your concerns; beyond this, consider seeking out another opinion with a Dermatologist, Facial Plastic Surgeon, or Plastic Surgeon.  Good luck!

Amy Miller, MD · Answer

Let me just first say, you have gorgeous full lips, lucky girl!!
So a nodule that is remaining over a year after filler injection and not responding to hyaluronidase probably is not just a simple blob of excess filler.  I suspect you may have something called a biofilm.  These occur when bacteria get into the the injected filler and basically set up camp.  The bacteria use the filler as a surface to attach to and secrete a protective matrix so the immune system can't get at them. This allows the bacteria to survive, replicate and resist antibiotic treatment.  The lip is a common area for this to happen since it is impossible to completely eliminate the bacteria from the mouth area prior to injection.
Biofilms can be hard to treat.  Many doctors recommend treatment with two different types of antibiotics for 6 weeks and repeated hyaluronidase injections to try to break up the protective coating around the bacteria.  I have an article on lip filler and complications being published next month in the Journal of Aesthetic Nursing and I talk about this.  Message me and I can send you a copy, as well as some of the articles I sited that explain treatment protocols.
Hope this is useful for you!
Amy

Used hyaluronidase twice to dissolve filler in over 2 weeks time but my lips are the same it did not work. Advice? (photos)

Answers (4)

Answer: Lump in lip

Answer: Lump in lip

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Used hyaluronidase twice to dissolve filler in over 2 weeks time but my lips are the same it did not work. Advice? (photos)

Answers (4)

Answer: Lump in lip

Answer: Lump in lip

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Recommended reading

Everything you need to know about Hyaluronidase

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