Would you proceed to do a lip lift less than 24h after injecting 300u of hyaluronidase in the philtrum and upper lip area?

Question

Would you proceed to do a lip lift less than 24h after injecting 300u of hyaluronidase in the philtrum and upper lip area? In your post op protocol, how long before the operation you suggest your patient to dissolve fillers, when needed and why? Thanks

Ritu Chopra, MD · Answer

Hi, I like to make sure the filler is dissolved at least two weeks in advance. This allows for some of the swelling to be relieved, and will have a much more accurate anatomical vision of what your lip looks like. If this is not doable a weeks time maybe adequate

Anna Chacon, MD, FAAD · Answer

I would generally be very cautious about performing a lip lift less than 24 hours after injecting 300 units of hyaluronidase into the philtrum and upper-lip area. In most cases, I would prefer to allow the tissue to settle before performing surgery, particularly when a relatively large amount of filler-dissolving enzyme has been used in the exact area that will be operated on.

Hyaluronidase breaks down hyaluronic acid filler, but after an injection there can also be temporary swelling, inflammation, bruising, and changes in the tissue's appearance. Those factors can make it more difficult to accurately assess the anatomy and can potentially affect surgical planning.

There is also an important distinction between dissolving filler for an urgent medical reason and dissolving it in preparation for elective surgery. If there is no urgency, I would rather operate on tissue that has had adequate time to settle.

For elective lip-lift surgery, I generally prefer the filler to be dissolved well in advance rather than immediately before the procedure. The exact interval depends on the amount and location of filler, how much hyaluronidase was used, the patient's response, and the type of procedure being performed. Giving the area at least several days—and often longer when the anatomy needs to be reassessed—allows swelling and inflammation to resolve and makes it easier to determine what the natural tissue actually looks like.

Another reason I like to wait is that a lip lift is a procedure where millimeters matter. The position of the upper lip, philtrum, columella, and nasal base all need to be evaluated carefully before deciding how much tissue to remove. I would not want temporary swelling or post-injection changes to influence those measurements.

So, if I had the option, I would not rush into an elective lip lift the next day after 300 units of hyaluronidase. I would allow the tissues to settle, reassess the area, and then plan the surgery based on the patient's true anatomy. That approach gives us a much better opportunity to achieve a natural and balanced result.

Gary M. Horndeski, MD · Answer

No, I would not recommend doing a lip lift within 24 hours of lip injection.  I would suggest to wait 3-6 months before doing a lip lift.

Best Wishes,

Gary Horndeski, M.D.

Would you proceed to do a lip lift less than 24h after injecting 300u of hyaluronidase in the philtrum and upper lip area?

Answers (3)

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