Juvederm Puffiness on Nasolabial Fold

If the Juvederm was injected but instead of being contained to the area under the smile crease, it was placed or pushed its way during the injection to the cheek side of the crease then it will lift that area making the crease look more noticeable. This can happen with Restylane, Perlane,  Radiesse or fat injections.  An advantage to using the hyaluronic acid fillers such as Juvederm, Restylane or Perlane is that your doctor can inject hyaluronidase to the elevated area to dissolve some of the Juvederm. It does not have to stay for the  year and bother you all that time.  Unfortunately, the Juvederm that is underneath the crease may also dissolve and you may need to have it repeated.

Yes, it appears that you have too much filler placed in a localized areas.  Treating nasolabial folds involves injecting under the fold but all into the cheek to help left the skin.  In your case, it appears to too much was injected just in the fold.  There is a medication which can be injected to melt away the Juvederm if that fulling that you have bothers you.  Alternatively, Juvederm is naturally metabolized over about 9 months to a year.

 

Good Luck.

Juvederm should not be able to be felt under the skin after 2 months. Also, any swelling should be gone by then. I would consider an injection of hyaluronidase to get rid of the Juvederm and start over.

Andrew Campbell, M.D.

Board Certified Facial Plastic Surgeon

If you are now two months out from you Juvederm injection and you have excess fullness at the treatment site then left untreated it will probably persist for the full 6 to 7 months. First, I recommend massaging the area with one finger  or thumb inside the mouth and the other pressing firmly on the outside to help flatten the area. I doubt that this will be effective this late post treatment. Better yet, I would return to the injecting physician's practice and discuss having them inject HYALURONIDASE into the area. This will dissolve the entire Juvederm product over several days and then you will return to your pre injection appearance. Next time you get Juvederm placed they should inject it more inferiorly to help soften the fold and not to accentuate the bulge above it.

As Dr. Smith said, this is easily reversible with hyaluronic acid. Return to your doctor and he can do this for you.

Unfortunately Juvederm injections are very technique dependent. It seems that your injections were placed too superficial and too medial. You can either wait the year for it to go away or have Vitrase injected and it will dissolve in a few days. 


 




 

Your photo seems to show fullness on either side of the nasolabial fold following your injection of Juvederm.

A full face frontal view would be useful in comparing both sides for symmetry and to determine more precisely where the Juvederm was injected. 

Depending on your goals and expectations, you may want to inject additional Juvederm deep to the nasolabial crease, or have the fullness reduced by injection of a medication that dissolves the Juvederm.

I suggest that you consult with your plastic surgeon about your concerns and expectations so that a full discussion of your treatment options can be explained.

This happens if there is too much product or it's too superficial. I recommend massage to break up the product or hyaluronidase injection.

If you feel that you have extra fullness from the injections, this will eventually resolve on its own. However, if you are bothered by it and want it removed, there is an antidote which can be injected to dissolve the Juvederm.   Only you and your dermatologist can make this decision together. Most of the time the puffiness will simply even out and generally subsides within 3 months. I would advise that it's best for you to go back to your dermatologist and to show the doctor your area of concern. As long as the treated area isn't painful, red, or hot to the touch-- you are probably O.K. & will see the fullness subside soon.

Juvederm will attract water as it breaks down.This may contribute to the swelling. Also, the product probably needed to be massaged a bit to flatten it out. At this point hyaluronidase can be used to dissolve it.