Juvederm injections have left me with an uneven smile and crooked lips. How do I fix a botched lip injection?

Question

Got Juvederm injections in Sep 2017. Waited approx 4 weeks after initial injection to have doc fix unevenness. Doc injected hyaluronidase and then more Juvederm a week later to fix. 6+ months later lips still not even, smile is crooked. I’m self conscious wearing lipstick or smiling in photos. Not sure how to fix. Doc refuses to completely dissolve says hyaluronidase is risky and I’m too picky - thinks lips are fine. Help! Suggestions for a fix are needed.

Michael A. Zadeh, MD, FACS · Answer

Hi Sara. Thanks for your questions and your pics which are a big help. I see what you are saying, and I'm sorry that your doc isn't doing much to remedy the situation. At this point I would recommend fully dissolving the filler with Hyaluronidase. This may take a few sessions, but I would want you back to your baseline and then start over to gradually get you to your goal lips. You may want to consider finding a more experienced physician injector this time. Hope this helps answer your question.

Harold J. Kaplan, MD · Answer

Hi Sara.  Yes, it does appear that you have more filler in the left side of the lower lip than anywhere else.  This is easily remedied with Hyaluronidase injections.  Although it's easy to inject Vitrase (Hyaluronidase), it's harder to get the exact amount to even the lips out completely.  Be prepared that if you decide to use Hyaluronidase that you may need to start your project over again.  Best of luck.

Jason Emer, MD · Answer

If you're unhappy with your final results, you can have it reversed with hyaluronidase and try a different technique next time. See an expert. Best, Dr. Emer

Jonathan Kulbersh, MD · Answer

If you're unhappy with your results, the Juvederm can be reversed with hyaluronidase. It may take a series of treatments. Hope this helps.

Monika Soni, MD · Answer

Thank you for your question! There can be some swelling and/or bumps after lip injections which can last 1-2 weeks. You can apply firm pressure between two fingers on the lips for a few days, for 5 mins a time, in order to help decrease swelling and even out the lumps. If you're unhappy with your final results you can have it reversed with hyaluronidase and try a different technique next time. Best of luck!

Marek Kacki, MD · Answer

Yes, your lips are visibly uneven. No, you are not too picky!  Pure arrogance on the part of your injector, something that is not uncommon, unfortunately. The major problem is your relationship with your doctor and I am not sure it is a good idea to go to the same place. My  assessment is based only on your description of the events. Aside of your particular case, it is clear your filler was placed incorrectly and hyaluronidase did not result in expected improvement. This is not your fault and the full correction (dissolving and re-injecting) should be done free of charge. Since re-inecting your lips by the same injector could potentially lead to the same problems I would consider looking for someone else. The best method is through the word of mouth...ask your friends, co-workers, read comments and, above all, try to learn about lips as much as you can. You will be surprised how much you will  know!Good luck!

Pacific Plastic Surgery Group - San Francisco · Answer

Thank you for your question, and we are sorry to hear about your unfortunate experience and results.  In our experience, sometimes, and probably in your case, hyaluronidase can be used serially to get a more desired look or potentially back to as close to your baseline as possible if there continues to be dramatic asymmetry/overfilling.   We recommend going back to the injector to discuss additional enzymatic correction or making a consultation in the office of a Board Certified Plastic Surgeon to help correct this issue if possible.  You may have developed some post-injection scarring/nodules that may be contributing to added bulk and asymmetry in the lips which need time to fade.

Allure Aesthetics - Boca Raton · Answer

It looks like you'd benefit from additional treatments of hyaluronidase to further even out your lips. It is sometimes necessary to dissolve asymmetrical filler more than once to get desired results. Assuming your after pictures were taken after swelling had resolved, your left side seems to have more volume and may have developed some post-injection nodules. I recommend following up with your injector and treating with hyaluronidase before adding more filler.

George Commons, MD (retired) · Answer

You will do well with selected treatment with hyaluronidase znd then very targeted treatment with Vobella.   My Best, Dr Commons

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