Following Juvederm for chest wrinkles yesterday, I have long, lumpy lines worse than the wrinkles themselves, is this normal?

While off-label, treating chest wrinkles and crinkles with both neuromodulators, such as Botox, Dysport, or Xeomin, and hyaluronic acid fillers, such as Juvederm Ultra XC and Restylane L, is common practice among experienced injectors. I have been doing so for nearly twenty years. In general, I prefer to treat the entire crinkly field (rather than chasing individual wrinkles) with a diluted concentration of Juvederm Ultra XC. This helps to subtly plump and smooth much of the crinkling and fine wrinkles within the field. Any remaining individual lines, i treat with a diluted concentration of Restylane L. Restylane has less of a tendency to draw water to it, so this works best when dealing directly with individual lines without leaving bumps, which is probably what is going on in this case. Next, a diluted concentration of Botox injected again in a field approach. This is done to work on the lower portion of the platysma muscle within the decollete region, which also contributes to the crinkling. Finally, when surface blotchiness and leatheriness are problems, as they often are from years of sun damage, a series of superficial peels, such as Jessner's solution is recommended along with the home use of sunscreens, retinoids and alphahydroxy acid-containing creams for maintenance. Consultation with a board certified aesthetic core physician with extensive experience and expertise in nonsurgical rejuvenation of the chest is a must.

Juvederm injections in the chest is very uncommon and "off label". The lumpy lines you are speaking of could be from swelling which will subside in 1-2 weeks. If the lumps are still there i would book a follow up with your injector to have the area assessed. 

This use of Juvederm is not typical.  The skin of the chest is very different from the skin of the face.  The lines that you feel are possibly due to swelling, but probably due to the filler.  You may apply pressure or massage to the area and soften the lines.  If this doesn't help, Juvederm can be removed from the area by using hyaluronidase.

Hi Donjule.  The chest skin is not the same as the face and you are experiencing that now.  Juvederm is a great product, but VERY off label on the chest.  Although there may be some potential benefit, it's difficult to make look good in this area and will never get rid of the wrinkles on the chest in the same way as it can on the face.If it looks worse than before, you may consider Hyaluronidase injections to reverse it.  Good luck.

Noooo, unless its just some
increased swelling. If it doesn’t go down in a few days go back to your doctor
as it can be dissolved with hyaluronidase.

Juvederm is generally safe and effective when used as recommended, and is the second most used injectable after Botox in my practice.  Use in the chest skin would be considered off label by FDA standards,  not that it is illegal but is just not approved for that use.  As Juvederm attracts water in the skin swelling is commonly seen which usually abates after 3 or 4 days.  Swelling beyond a few days although uncommon may indicate a reaction to the filler and should be seen by your physician.  Excess Hyaluronic acid injected very shallowly may cause prolonged lumpiness but may be reversed by the judicious use of hyaluronidase, an enzyme which breaks down hyaluronic acid.  I usually recommend a precise injection and massage technique which may help prevent lumpiness. 

The long lumpy lines may be the filler product. Speak with your injector. He may want you to rub them in a bit.  Good luck.

Sculptra is being used off label on the chest for wrinkles by physicians in Europe and South America for at least of couple years with very good results (seen at the latest IMCAS meeting).  I think if you were to add a skin tightening treatment like Infini, it would do better.  I have been using cannulas for this but others use needles.  It is a very comfortable procedure with cannulas.  Steve Weiner, MD, Facial PLastic Surgeon.

Chest wrinkles are most often caused by sun damage, and not necessarily loss of volume. Using fillers on the chest is off label (very much so) and so this is difficult to comment on. If the area looks worse it could be that too much was put in, or it could be swelling from the injections. Finally, Juvederm pulls a lot of water to itself right after injection so in a thin-skinned area like the chest, this could be a significant part of what you are seeing. I would suggest you contact your treating physician and have a follow-up within a week or so just to make sure everything looks like it should."This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."