Why is my lip filler not dissolving after 6 treatment? Should I continue? (photos)

Question

There are certain parts of my top lip that appear as if I still have filler but my dr advise that it appears like that because I have lost a lot of my own collagen. I have gotten 6 treatments of Hyaluronidase. Should I continue with the treatments?

Raffy Karamanoukian, MD, FACS · Answer

Hylauronidase has many advantages and should be considered in patients who are unhappy with their results or in acute cases of overfilling or occlusion. Its often better to reverse filler and restart then to deal with long term edema. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Shaun Patel, MD · Answer

Based on the photos, it looks as though a most of the filler has been dissolved using hyaluronidase. I would look at your pretreatment (before the lip filler) for comparison to see if your lips have returned to their original shape.

F. Victor Rueckl, MD (in memoriam) · Answer

Remember that removing filler is just as much an art as putting it in to begin with. So while the photos appear to have the majority of the filler dissolved, maybe you should seek another opinion. Six rounds is a lot. But in patients with excess filler placed in bad spots (much like your photos), I've done it up to 8 times to get rid of all the filler. I like to use much smaller amounts than some other injectors and really focus on the specific areas, not try to "flush" the area. So it's not necessarily about the number of visits, but the amount injected and where it's placed. 
"This answer has been solicited without seeing this patient and 
cannot be held as true medical advice, but only opinion. Seek in-person 
treatment with a trained medical professional for appropriate care."

Why is my lip filler not dissolving after 6 treatment? Should I continue? (photos)

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Why is my lip filler not dissolving after 6 treatment? Should I continue? (photos)

Answers (3)

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Everything you need to know about Hyaluronidase

Our mission is to create a world where every investment in modern beauty is Worth It.