Chronic swelling upper lip a year after Revolax filler, doctors don’t know what it is (Photo)

I'm sorry to hear about the persistent swelling and complications you've experienced with your lip fillers. Chronic swelling after filler injections, despite multiple dissolution attempts, can be challenging to diagnose and manage. Here are some steps and considerations that might help you and your doctors find a solution:

1. Thorough Medical History and Examination:
- Ensure a comprehensive medical history has been taken, including any history of allergies, autoimmune diseases, or other medical conditions that might contribute to persistent swelling.
- A detailed physical examination of the affected area should be conducted.

2. Imaging Studies:
- While you've already had an ultrasound (echo), other imaging techniques such as MRI might provide additional insights into any remaining filler material or other structural abnormalities.

3. Allergic Reaction or Hypersensitivity:
- Consider the possibility of an allergic reaction or delayed hypersensitivity to the filler materials. Sometimes, fillers can trigger an immune response even after they are dissolved.
- Discuss with your doctor about the possibility of trying antihistamines or corticosteroids to reduce inflammation.

4. Infection:
- Ensure that there is no underlying infection. Chronic low-grade infections can sometimes cause persistent swelling. Blood tests and a possible biopsy of the affected area might help rule out infection.

5. Autoimmune Response:
- Some individuals can develop granulomas or other autoimmune responses to fillers. This might require specific treatments such as corticosteroids or other immunomodulatory medications.

6. Specialist Consultation:
- Seek a consultation with a specialist in dermatology or plastic surgery, particularly someone with experience in managing complications from fillers.
- An oral and maxillofacial surgeon might also offer valuable insights, especially if the swelling involves deeper structures.

7. Histopathological Examination:
- In some cases, a biopsy of the affected tissue might be necessary to understand the underlying pathology. This can help in identifying chronic inflammation, granulomas, or other tissue reactions.

8. Alternative Treatments:
- If conventional treatments are not effective, consider discussing alternative therapies such as laser treatments that might help in reducing swelling and improving tissue health.

9. Patient Support:
- Psychological support might be beneficial, as chronic swelling and cosmetic concerns can significantly impact mental health.

10. Documentation and Monitoring:
- Keep a detailed diary of any changes in swelling, new symptoms, treatments tried, and their effects. This can help your healthcare team identify patterns and potential triggers.

Given the complexity of your case, a multidisciplinary approach involving dermatologists, plastic surgeons, and possibly rheumatologists might be necessary to arrive at a definitive diagnosis and effective treatment plan.