Is this a vascular occlusion after Juvederm fillers on lips? (Photo)

Question

I’ve had JUVÉDERM injected before and yesterday I went to a different doctor to get my sec syringe JUVÉDERM but I’ve being having sever pain, bruising and even my gums are purple and swollen and I’m very concerned and freaking out, the first time I wasn’t in any pain and barely had any bruising. I can’t move my upper lip or touch it with out being in so much pain, I’m very swollen purple black, even on top near my nose, I’ve being icing and using arnica, should I go to my doctor

Jonathan Kulbersh, MD · Answer

Yes, I recommend you follow up with your Doctor as soon as possible. The filler can be reversed with hyaluronidase. Hope this helps.

Camille Cash, MD · Answer

I recommend returning to your doctor for an evaluation.  The symptoms you describe seem severe and warrant a visit.

Munir Somji, BSc, MBBS · Answer

Hi there. I would be concerned about the possibility of vascular occlusion. Please go see your injector immediately to assess and treat the area. Time is of the essence. Treatment within 48 hours is generally the golden period any longer and you have risk of permanent side effects.

Jason Emer, MD · Answer

I suggest you see your physician right away.  This can be reversed with hyaluronidase and should be treated with topical vasodilators (nitropaste) as prevention. See an expert. Best, Dr. Emer

Monika Soni, MD · Answer

I would be concerned about the possibility of vascular occlusion. Please go see your injector immediately to assess and treat the area. Time is of the essence. Treatment within 48 hours is generally the golden period any longer and you have risk of permanent side effects.

Marek Kacki, MD · Answer

It appears to be exactly what you are concerned about! You must see your injector as soon as you can to have your lip "flooded" with hyaluronidase. Meantime be very gentle with your lip and apply heat. The hyaluronidase is the only hope to restore the circulation, at least partially. Good luck!

Aaron Capuano, MD, FACS · Answer

Thank you for your question, and sorry to hear you are experiencing these symptoms. . Based on your photographs and your severe discomfort I feel that it is imperative that you contact your injecting surgeon or present to a local emergency department if you cannot reach him or her so that you can be evaluated and treated immediately.  The longer you wait the higher the potential for permanent injury.  The white color change in your right upper and lower lips in your photograph are suggestive of ischemia and possible injection into or compression of an artery within the lips.  A hematoma can also be seen.  Treatment may include immediate hyaluronidase injection, including attempts to cannulate the vessel with ultrasound guidance, heparin Injection subcutaneously, aspirin as well as Nitropaste and warm compresses.  An in person examination by a board Certified plastic surgeon is essential as soon as possible.

Timothy W. Chang, MD, FAAD · Answer

Yes this is a vascular occlusion and an emergency! You need to go back to the person who injected you immediately and have hyaluronidase infiltrated to the area to dissolve the filler.

Renee Moran, DO · Answer

Yes, if you are having that kind of pain with the bruising as shown, I would go back to your doctor ASAP and they can treat you for an occlusion.  Take some aspirin now and use some hot compresses.  Call them ASAP!!  They can inject Hylenex which can correct this.

Chester F. Griffiths, MD, FACS - Account Suspended · Answer

Thank you for posting your question and photo. Yes, you should follow up with your doctor immediately for evaluation. It is difficult to determine the cause of the discoloration based on your photo alone. If it is vascular occlusion, the filler needs to be dissolved immediately. Please take this seriously and follow up with your injector ASAP. 
Best,
Dr. Griffiths

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Is this a vascular occlusion after Juvederm fillers on lips? (Photo)

Answers (10)

JUVEDERM PROVIDERS NEAR YOU