Lip Injections Are Lumpy when I Smile, Will this Even Out? (photo)

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.

I'm sorry to hear about your experience. Swelling may be obscuring your results especially since it's been just a day after your treatment. Massage can help, but I recommend you talk to your injector first before massaging your lips as you don't want to displace the filler. Lumps will dissolve on their own as well. If the lumps haven't disappeared within a couple of weeks, please see your injector. Hyaluronidase may be injected to dissolve them.

Thank you for your question. I recommend waiting another week and then having follow up visit with your injector for an evaluation. By two weeks all swelling should be resolved and the filler would have enough time to settle. If you require any touch ups this is appropriate time to have it done. Best of Luck!

Lumps in the lips following Juvederm injections can be caused by trauma, bleeding or too superficial of an injection.    Injecting the lips is technically challenging.  The goal is an aesthetically pleasing lip and not just a fat or sausage lip.  I usually inject in the white roll of the lip, this is the junction between the skin and the mucosal portion of the lip.  I usually do not inject in to the body of the lip as this can form lumps. Small lumps may just be from the needle trauma.  Vitrase or Wydase can be injected into these areas and will melt the Juvederm lumps in a day or so.

Being that you are only one day out and have lumps, you should  talk to your doctor. I usually have patients massage out the lumps if they get one.

It is possible to have areas of fullness 1 day after a lip filler injection. Normally, your doctor will massage these until they are smooth and frequently lip movements will help to even this out over a week or so. You can return to your doctor to see if they can manipulate this to be a bit more smooth.  Fortunately, time will remedy most of your issues, but a gentle massage (best done by your physician) will help to remedy your issues.

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon

It is always advisable to wait at least one and preferably two weeks for all of the swelling to resolve before assessing the results of lip filler injections. Massaging early on is not a good idea as you can make the swelling worse. Because this is an art as much as it is a science, it is especially important to remember that the experience and technique of your physician injector is the most critical part to your achieving a beautiful, natural result. You should return to your injecting physician if the lumpiness persists.