Upper lip crease after dissolving filler - can this be fixed? (Photos)

Question

About a year ago, I had a filler bump on my upper lip dissolved with hyaluronidase. After dissolving it, I noticed an indentation/crease in that exact spot that wasn’t there before. Since then, I’ve had more filler added to my lips, hoping it would smooth out the area, but the crease is still there. It’s more noticeable when my lips are dry or relaxed and less visible when they’re hydrated or when I smile. Could this be scar tissue or volume loss from dissolving? I’m really frustrated because I just want my upper lip to look smooth again. Any advice on how to fix this would be appreciated!

Anna Chacon, MD, FAAD · Answer

I understand how frustrating this can be, especially when you've tried adding more filler and the crease is still there. The fact that it becomes less noticeable when your lips are hydrated or when you smile is a helpful detail.

There are a few possible explanations. Hyaluronidase can dissolve hyaluronic acid filler, but it may also temporarily affect some of the body's natural hyaluronic acid. This is usually replenished over time, so a persistent indentation a year later isn't necessarily due to the dissolving enzyme itself.

The crease could be related to localized volume loss, a preexisting lip line that became more noticeable after the filler was dissolved, or changes in the surrounding tissue. Scar tissue is another possibility, particularly if there was significant inflammation or repeated injections in that area, but it cannot be confirmed from appearance alone.

Since you've already had additional filler without improvement, I'd be cautious about adding more. Sometimes, repeatedly filling the area can create more irregularity without correcting the underlying cause. A careful in-person examination would help determine whether the issue is a true indentation, tissue tethering, or a natural crease that becomes more visible when the lips are relaxed or dry.

The best next step is to identify what's causing the crease before choosing a treatment. Depending on the findings, a conservative approach may be appropriate, but not every indentation is best treated with more filler.

The good news is that a persistent crease doesn't automatically mean permanent damage. The right approach depends on the underlying tissue changes, and getting that assessment first can help avoid unnecessary additional treatments.

The Beauty Source - Plainview · Answer

Hi! Hyaluronidase is intended to dissolve hyaluronic acid filler and typically does not dissolve healthy lip tissue. Your lips may temporarily appear less full after treatment, and their appearance can change as the tissue recovers. Since there may be a small nodule underneath the area, I recommend following up with the doctor who performed your lip filler so they can examine it and determine what may be causing the change.
Zoohra Mashriqi, MDThe Beauty Source/Mashriqi Internal Medicine

Upper lip crease after dissolving filler - can this be fixed? (Photos)

Answers (2)

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