Necrosis Lip Filler Advice - what kind of doctor can help me? (Photo)

Question

What kind of Dr. can help me w botched lips? I went to correct the size of the right side of my bottom lip. The lady injected me w novocaine to numb the area, waited 5 minutes & injected filler 2 times. When I looked in mirror, I noticed my lip was growing & expanding in real time & the area turned white. It looked like puss or like my lip had died. It is bruised now & swollen. I fear rotting. She wants to give me antibiotics & viagra. Is this correct? HELP!

Thomas Wright, MD · Answer

The best person to handle any filler complications in the physician who performed the procedure. One the principles of medicine is you should not do a procedure if you are not able to manage the complications.  Injections of filler are part of the practice of medicine and can have complications.  There  are some doctors who delegate filler injection to nurses in the US and they should be on hand to handle any complications

Zoran Potparic, MD · Answer

Based on these photos, it does not look like you will have tissue necrossis and loss. It may take few weeks before swelling goes away. If you have doubts you should seek a consult with a board certified plastic surgeon ASAP. Good luck.

Kenneth D. Steinsapir, MD · Answer

What you are demonstrating here is a bruise which is relatively common. I am sorry you have had this complication. Necrosis is associated with severe pain, grey, dark skin. What you are showing us in the photographs is a bruise with swelling. You need to work with an injector who knows the difference between necrosis and bruising. The treatment for impending necrosis is not viagra! The treatment is to flood the involved area with hyaluronidase. This needs to be done within 24 hours of service. I recommend seeing a board certified dermatologists, facial plastic surgeon, or generally plastic surgeons who offers filler service for a professional assessment if this area is getting worse rather than better. Avoid injectors who do not know what they are doing.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! Sorry that you're having trouble with your lip. It sounds like a hematoma occurred which is when blood collects rapidly underneath the surface of the skin. But, it's always important to rule out something like vascular occlusion which can lead to necrosis. I would seek consultation immediately with a facial plastic surgeon who can provide you the proper protocol to treat the lip. Necrosis can be a devastating outcome if not addressed. Please seek help to make sure you stay safe. Good luck!

Camille Cash, MD · Answer

The photos that you posted show bruising and swelling.  Viagra would not be a prescribed medication to treat a bruise or necrosis.  I encourage you to return to your injector to discuss your concerns, or if you are uncomfortable, you can seek an evaluation by a board certified plastic surgeon.

Mats Hagstrom, MD (license on probation) · Answer

Most providers use local anesthesia with Epinephrine. That medication causes tissues to vasoconstrict and on lips they often turn white for about an hour immediately after the procedure.
It sounds like you’re a provider hit a blood vessel passing a hematoma most likely the labial artery.
By going to providers that have sufficient skill and experience including medical training they should be familiar where the blood supply of the lips and avoid injecting in the vicinity of the labial artery. 
Lips are highly vascular and developing lip necrosis from fillers would be highly unusual.
At this point there is no need for intervention other than wait and see.
There’s no evidence that you have an infection so antibiotics should not be indicated.
Best,
Mats Hagstrom MD

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