Second time having Juvederm in the lips, but this time terrible swelling, should I be concerned? (Photo)

It is very common to have swelling after filler injections to the lip. The amount of swelling can vary from person to person, and as in your case even with the same person depending on numerous factors such as the amount of filler place, the type of filler place, the technique used, etc. The good news is, the swelling will go down, and the only volume remaining in your lip will be that provided by the filler itself. This process may take several days, to expedite you may ice the area, I prefer not to use steroids unless it has become very very  bothersome. To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.

This is normal.  If it is there after 10-14 days consider reversing the filler with an enzyme called hyaluronidase.  Best, Dr. Emer.

Swelling after lip fillers is very common and often dramatic.  Swelling can be related to filler used, amount injected, technique, and patient factors.  It is often the case that immediately post-treatment, lips are a desirable volume and shape.  Usually within a few hours, swelling increases, during the first 24-48 hours it is extremely important to apply cold compresses and to apply topical emollients to the lips. When considering lip filler injections, planning the best time for injections usually revolves around this potential swelling.