Uneven lumpy lips after 1ml Juvederm - visible when I smile or stretch lips. Is it permanent or just swelling? (photo)

Sorry to hear that you have lumps in your lips.  Typically, if during the injection lips look fine and and don't feel lumpy, then this is how things will revert to afterwards.  It is common for the lips to swell and this can definitely be asymmetric.  If the lumpiness persists, then I would revisit with your plastic surgeon who can assess whether any hyaluronidase is needed to break down the product to help you achieve your goals. From your picture, it does appear like you have a small bruises and this could definitely result in the lumpy sensation.

You could still have swelling at this point.  You should give it more time, if you still feel that you have lumps after 7-10 days be sure to see your surgeon. 

It is much too early to determine the outcome of your treatment. Juvederm injections into the lips often cause swelling. Massaging and cold compresses might be of some benefit. Wait 1 week before considering dissolving with Hyaluronidase. 

You still have swelling in your lips since it has only been 4 days since your treatment. It is difficult to evaluate your final result until the swelling has resolved. Sometimes small lumps of filler can be massaged and flattened if the lumps do not resolve on their own. I would wait about 10 days to assess your final result and then return to your physician if you still have concerns. Best wishes.

ONLY 4 days!!!! Allow at least 10 day than decide if you need a dissolver injected (costs $500).......

Too early at this point to get excited. I does appear that your upper lip is larger than the lower, which is not normal. The lower lip should be bigger by the ratio of 1:1.61. See my link. I use Restylane Silk for lips exclusively now.

since you are 4 days you can massage and this may be swelling and may go away.Also juvaderm in time will dissipate so it is not permanent and your plastic surgeon can inject it to remove it as well.

I would wait until you are 7-10 days post injection so that the swelling subsides.  You might be able to massage small areas and smooth them out.  Your best course of action would be to return to the physician who injected you if you are still having issues 7-10 days out.

Swelling after Juvederm injections can take up to 2 weeks to subside and during this time you may feel small lumps of the product, especially on the inside of your mouth.  Give the product 2-3 weeks to settle and allow swelling to subside.  If you still feel lumps after this time, check back in with your doctor who did the treatment. We also recommend using Arnica gel to our patients to help with swelling and bruising.