How do I know if it’s lip filler or scar tissue? 13 months after lips injection (Photo)

That suggests that you got this service outside of the United States or your injector obtained this filler outside of conventional supply channels. Hyaluronic acid fillers are broken down by hyaluronidase. Products that do not respond to hyaluronidase are likely not hyaluronic acid based filler.  It suggests that you may have received a product that was not actually a hyaluronic acid filler.  There is a big business in bootlegged products. The risk of receiving such a product increases when products are obtained outside normal channels.  Injectors are motivated to lower their costs and bootlegged products are cheap.  The most common products that end up in these syringes include products like silicone oil or polyalkylimide gel.  I caution you about using steroid injections that can damage your natural lip fat.  It is not possible to help you without a detailed assessment. Medical records are helpful. I would recommend very high dose hylauronidase. If that does not make a change, then it is likely you received something other than hyaluronic acid filler.  Caution is advised at that point. 

This needs an in-person evaluation. 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 to determine if this is filler or scar tissue. Best, Dr. Emer

Thank you for your question! At this time frame there should be no filler in the lip and scar tissue is not really very likely.  see a board certified dermatologist or plastic surgeon to see if something can be worked out. Best of luck!

Hi.  Sorry to read of you story. Steroids can cause permanent changes. It may be worth trying that with a local expert.  I think for other readers, the lesson here is to make sure you know what filler you are getting and what experience your injector has.  I have cared for patients told they are getting restylane... then they get silicone!   The last step in persistent lip asymmetry after filler is to surgically remove filler/scar tissue... which can be done! Anyways, good luck - hope you get resolution.. 

Hello olioli1,An in person evaluation is really the best way to evaluate what is going on in the lips.  Scar tissue tends to feel more firm than filler.  If filler is injected into the lips as opposed to more superficially, it can last longer and be more difficult for the hyaluronidase to remove.  Depending on how much hyaluronidase was injected you may simply  need more injected and in different levels of the lip.  I'd recommend you consult with a facial plastic surgeon to learn more about your options.I hope this helps and good luck.