White Bumps Around my Lips After Juvederm Augmentation?

Question

I had Juvederm in my lips, and see little white "pimples" under the  skin on my lips.  I never had those before.  You can't feel them, but  up close you can see them.  What is this?

Anil R. Shah, MD · Answer

Lip filler bumps is fairly common after filler.  The bumps can occur early on and many settle down.  Although massage after filler is considered a mainstay, beware that massage can drive the filler into another location if done too early.  
Reasons for bumps after filler:
Technique- Filler may have been used too superficially or wrong type of filler
Mouth movements- In some patients their movements can promote the accumulation of bumps and an alternative technique can be advocated.
Treating lip filler bumps:
Observation +/- massage-  Should be done for almost all lip filler bumps for 2 weeks.  For our patients we usually advocated massage after 48-72 hours to let the filler settle into place.
Reversal- A reversal agent can be used such as Vitrase to dissolve the filler if there is a large obvious persistent bump
Additional filler- An expert filler injector can used improved technique to mask the lip bumps.
The application of lip filler is very technical and should be done by an expert injector.

Richard J. Bruneteau, MD · Answer

Lumps and bumps of the lips following Juvederm injections
are always a source of anxiety for patients who have undergone this procedure.
In the vast majority of patients white bumps following Juvederm injections are
related to permanent sebaceous glands which are more noticeable because of lip
projection. These bumps don’t require
treatment and tend to improve as lip fullness subsides.Occasionally
lip bumps are related to small collections of Juvederm. Under these
circumstances the bumps have a clear blueish coloration. This can be extracted
with small needle punctures or reversed with hyaluronidase.If you
have concerns about lip bumps, consultation with your surgeon is
appropriate. Your surgeon should be able
to make an appropriate recommendation to address your concerns.

Monika Soni, MD · Answer

Thank you for your question. From your photo this looks like superficial placed filler. You can gently massage the area and they should go away with time. However, you can also have this dissolved with hyaluronidase. I recommend having this evaluated by your injector to determine the best treatment plan. Best of Luck!

Hardik Soni, MD · Answer

Thank you for your
question. What you are describing is normal and unrelated to your lip filler.
These are called Fordyce spots, which is normal sebaceous glands of the lips.
They are visible because the skin of the lips is thin. You have probably had
them for years, but noticing them now because you have had filler. I hope this
helps!

Michele S. Green, MD · Answer

Without a photo it is difficult to say what the white bumps or pimples are.  The differential diagnosis includes anything from a viral reaction to a benign reaction to the injection to too much product injected superficially.  Please return to your treating physician for examination and let me know.

William Portuese, MD · Answer

The white bumps you are experiencing after the injection is usually related to a small portion of the injection material expressed through the needle superficially along the skin. Massaging this area should help alleviate this issue

Martie Gidon, MD, FRCPC, FAAD · Answer

These whitish-yellow bumps are normal sebaceous glands called Fordyce spots. Your Juvederm filler has made them more obvious. There is no treatment for these glands. Some days they may seem more apparent than others, but they are normal.

Edward E. Dickerson, IV, MD · Answer

Its most likely your sebaceous glands "oil glands" that are more visible now or it could be an unrelated skin condition. If the bumps are painful or causing you to feel self-conscience the physician that preformed the augmentation can affirm what the is the reason for the bumps.  If a small about of the product is to superficial to the skin that it can be corrected quickly by your provider.

	"Dr.D"

Scott W. Mosser, MD · Answer

We all have sebaceous glands in our lips. It is a natural occurrence and they are there for a reason. They may look a little yellow to white in color and be smooth to the touch. Although this is most likely just the natural texture of your lips being pushed to the surface by the filler, it is always wise to discuss your result with the physician or nurse who initially injected you.
They can then decide if the bumps are normal or if it is something that needs to be addressed. If the spots are bumpy to the touch, and clear or blue in color, this may be caused by the filler and can be fixed by your doctor by smoothing or draining them. Always see your doctor if you have questions or concerns.

Shawn Allen, MD · Answer

What you describe is likely part of your normal anatomy, called Fordyce spots ( sebaceous glands) in the lip. They are not blocked they are just just pushed closer to the surface by underlying filler. They should look a little yellow to white and should not be bumpy in feel, they are smooth . The filler simple pushed them closer to the surface so you see them now. If the spots are bumpy / clear or blue in color then they are from the injection and can be smoothed out with pressure or a small nick to drain them. Inform your doctor of your concern they will see you and decide whether this is normal or needs to be addressed. By the way, I do not recommend that you try to have sebacous glands in the lip removed by TCA or other procedures, this will likely result in scarring or not work and they are there in your body for a reason! We all have them! Good luck

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