Lumpy and Uneven Lips After Juvederm. Is This Normal? (photo)

I just had Juvederm injections in my lips yesterday afternoon for the first time (at this point it hasn't been 24 hours yet). I have been icing alot but they are very lumpy, uneven and one side of corner of the upper lip is bigger than the other. Is this normal or is it all due to swelling? When should the lumps go away? Did the doctor who did the filler not do a good job?

Doctor Answers 9

Swelling after Juvederm in the lips

Thank you for your question. It is very common for the lips to look over corrected, lumpy or fake the next day. I often tell my patients that this is the "oh my gosh" day. This is due to all the swelling that ensues. It may last a few days with every day showing a decrease in swelling. The more you ice the first day or two, the less swelling you will have. I would wait a few days to a week and then return to your injector if you still have concerns after that. If you like the look of the lips at some point during the swelling reduction, then take a picture. This way you know what volume you like in the lips for the future.

Houston Plastic Surgeon
4.8 out of 5 stars 38 reviews

Uneven Lips After Juvéderm Treatment Are Related to Uneven Injections.

Swelling after lip enhancement is common and this will subside over several days. Occasionally this swelling may appear slightly uneven, despite the fact that the final result is symmetric. Cool compresses can be helpful for the first 48 hours in helping to reduce bruising and swelling.

Your pictures show what appears to be a relatively symmetric and even result with your lips closed. However, with your lips open, the inner vermillion and mucosa of the upper lip is uneven. I suspect that this is related to an uneven injection and not just swelling.

You could gently massage these areas that you are concerned about – gently rolling the lip between your thumb and forefinger while working back and forth over the area that is uneven. You should be able to disperse and mold the Juvéderm to provide improvement.

Lip enhancement procedures are individualized, but it is not uncommon to inject both the vermillion border and the body of the vermillion. Injecting the vermillion border provides definition and can smooth fine lines in this area. Injecting the body of the vermillion can provide additional lip volume and enhance vermilion show. If done by an experienced injector, both of these techniques are safe. Deep injections of the lip muscle should be avoided. Asymmetric injections in any area will lead to an uneven appearance of the lips.

If you still have concerns after several days, contact the physician who performed your treatment, and he/she should be able to provide more guidance.

Best wishes, Kenneth Dembny

Kenneth Dembny, II, MD
Milwaukee Plastic Surgeon
4.9 out of 5 stars 34 reviews

Uneven lips

The lips are very vascular and are prone to bruising and swelling.  That could be the reason your lips look lumpy. Give your lips a week to settle down and if they are still lumpy see your physician to even out your lips.

David Stoker, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 54 reviews

Swelling After Lip Filler

Thank you for your question. It is not uncommon to experience swelling after filler injections, however this should resolve in the next 2 weeks. I always advise my patients to ice the treated area to help resolve swelling. You can also gently massage the swollen area to help smooth it out. Please consult your injector if this persists after two weeks. All the best! 

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 45 reviews

Swelling after lip injection is common

Swelling and unevenness are common side effects after lip injections, especially within the first 24 to 48 hours, and they will subside. Icing the lips is a great to reduce swelling. Elevated sleeping the first night or two is also recommended to reduce any swelling in the face and lips. As for the lumps, the lip has been injected with foreign molecules, so the body’s natural response causes the area to swell and feel harder. The lumps will slowly subside within 2 to 3 weeks as the body regulates itself around the molecules injected inside the lip. 

The lips take about 2 weeks to settle with the new product in them. Be patient with your results, because the rate at which people heal and recover varies.

Cory Torgerson, MD, PhD, FRCSC
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 150 reviews

Lumpy lips

Your lips can be lumpy for a few reasons

Give it a few days to see if they improve

If they do not improve go back to your physician who may be able to smooth the lumps

Paul Carniol, MD
Summit Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Lumpy and Uneven Lips After Juvederm. Is This Normal?

The lips are lumpy and uneven beacause the Juvederm appears that it may have been injected into the body of the lips instead of along the vermillion border (red outer portion of the lips).  Injecting the vermillion border is the only recognized use of lip fillers despite some MD's use within the lip itself.  This is for safety reasons to prevent injury to the lip vein(s) that can and has caused tissue death of the central portion of the lip.  Do a quick internet search on lip necrosis or slough from lip injections.

For this reason, I will only use fillers along the vermillion border, of the lips and if further lip augmentation is required in the body of the lip, I prefer lip implants of Alloderm.  You can always contact the MD that diod the lip Juvederm and ask about lip massage techniques to smooth out the lumps of injected material.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Injections of filler in lips...Be patient.

Sometimes it takes some time for the lip injections to improve.  Massage is a great tool that we use for our patients and this usually works.  Be patient.  If you are still not sure about the appearance go and see the practitioner that helped you.  Personally I would stick with board certified plastic surgeons that do injections routinely.  There are some nurses that are great with injections too, but best to get a personal referral.

Kimberly A. Henry, MD
Greenbrae Plastic Surgeon
4.6 out of 5 stars 36 reviews

Lip enhancement results

It would be best if you book a follow up appointment with your injector in 1-2 weeks, and he/she can massage any residual lumps or bumps at that time. You are still recovering from the treatment and have some swelling as well which tends to subside in a week or two. 

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.