Distorted lip after injection while I had an implant? Is there ANY danger to getting filler after removal of Permalip? (photos)

5mm implant placed in upper lip. Added syringe of filler to lip with the implant in, & it made the lip distorted.Why? Is it bent? Should I get implant removed now? Might the filler dissolve & my lip go back to how it was pre-filler? Concerned for health of my lip tissue. I want to be safe, but also I want plump lip. Whats SAFEST? After removal of implant, is A LOT of filler safe? Afraid of tissue death. How long should I wait? Or would it be safest to just to put a new Permalip implant in there?

Doctor Answers 4

Distorted lip after injection while I had an implant? Is there ANY danger to getting filler after removal of Permalip?

YES remove the implant allow 3 months healing before re injection of HA fillers just to be safe...//

Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Injection of filler on top of permalip

I have a lot of experience with permalip, with and without added filler (I use Juvederm too), so I hope I can address some of your concerns.
Your first picture (after permalip, before filler) looks like the permalip implant is in the correct position, centred and symmetrical. It is unlikely that injection of the filler will have moved the implant. It is more likely that the filler has been injected unevenly.
Is the implant bent or damaged? Again, unlikely. The permalip implant is pretty robust, and it would take a lot more than the needle from the filler injection to cause significant damage. 
Tissue death is only likely to occur if filler is injected directly into a main artery (eg. the superior labial artery in the upper lip, or the nasolabial artery in the nasolabial fold), blocking off its supply to the skin. This is a rare complication that can happen with filler anywhere. Whether you've had permalip or not is irrelevant. You've had plenty of restylane injected into your lip in the past with no such problems, so you should still be ok after the permalip comes out.
What to do next? Careful examination by you and your doctor. It may be possible for you to feel yourself, and your doctor to confirm, if the permalip implant is still centred correctly. If it is, then one option is to even out the result with more filler. Another option is to dissolve the existing filler with injection of Hyaluronidase and see if the lip settles back to the way it was, with the permalip still in. Final option would be to remove the permalip implant, but I suspect the lip will still look a bit distorted, because I still believe the main culprit here to be uneven filler. If so, then your options after the permalip implant comes out are the same: even out the result with more filler, or dissolve the existing filler with Hyaluronidase.

Roy Ng, FRCS(Plast)
London Plastic Surgeon
4.8 out of 5 stars 13 reviews


If you want the permalip implant removed. It can be done fairly easily.   I would wait a few months after that before having the lip injected with filler.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Based on your concerns, an examination would be required to determine the cause of lip asymmetry following Permalip and Juvederm

At this point, you may wish to wait for all of the HA filler in your upper lip to dissolve before considering surgical removal of your Permalip. In our practice, we prefer to perform lip augmentation with Silikon-1000, an off-label filler for permanent results. We have injected Silikon-1000 in lips with Permalip without issues, but I would not suggest this till all of your HA is gone.

Hope this helps you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 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.