Why did this happen after my lip filler? How can I restore them to the original shape? (Photo)

Question

I've had Juvederm to my lips years ago and they just got more and more distorted which I horribly hate. After unsuccessful enzyme dissolving I inspected my lips more thoroughly and I would like to ask for your opinion why this happened and how to restore my lips to the primary shape? Was this the product, poor skill/technique, both, something else? They're smaller on the before pic but look sooo much better than now

Kenneth D. Steinsapir, MD · Answer

The old filler is runny and migrates to many locations beyond where it was initially injected. As it ages, it holds more water contributing to an unsatisfactory look. Typically this type of change occurs after several years. I approach my filler patients recognizing this reality. I work with the least runny fillers: Restylane and Lyft. I avoid the runny fillers: Juvederm, Volume, Belotero, etc. Old filler can be encapsulated with a very thin layer of scar tissue. That means that these encapsulated deposits need to be directly injected to break them down. Bottom line, it can take very large doses of enzyme to remove these old services. Still this is an office service. Don't let well meaning individuals cut your lip up for something that can be effectively handled as an office service.

Daniel Barrett, MD · Answer

Dear klara32,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Monique Mazzuca, MD, CCFP · Answer

This looks like a combination of technique and possible reaction to either dissolver or filler, depending on the timing. Some of the filler may still be present and has crossed the wet dry border of your lips. If there is no palpable filler this could also represent an blister due to allergy of either the filler or hyaluronidase. These cysts can develop when hyaluronic acid like Restylane or Juvederm is injected too superficially into the skin, causing these "blebs". Or the filler may have become moulded into a ball. Nodules and blebs generally look like white or skin-coloured lumps and are painless and harmless, you might need further dissolving in the correct layer. To treat these, a practitioner will either massage and warm them with a compress, then the nodule is punctured and the filler is released. Sometimes, if these lumps, bumps, or swellings occur weeks/months later, they can be a little tricker to manage. As well as dissolving there may be a need for antibiotics or steroids to full manage the problem. On these occasions, a medical injector will assess your medical history and prescribe the correct medicine, or procedure, to fix the complication.
It is important that you are looked after by somebody who can medically manage you - having specialist knowledge of aesthetics treatments and their complications.

Why did this happen after my lip filler? How can I restore them to the original shape? (Photo)

Answers (3)

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