Filling dent in face caused by the removal of filler? (photos)

Question

A doctor over filled the lines around my mouth that required the removal of the Juvederm. The removal created large dents on each side of my face that seem impossible to fill. I have had two doctors try to fill the area with Juvederm but the dents seem like a bottomless pit, that will not fill. Are they using the wrong product or techniques. A friend said fill under the dent to push it up but she is not a doctor, I thought it would best to post here. Thank you.

Nelson Lee Novick, MD · Answer

Without photos or still better an in-person examination, I can only comment in the most general of terms. Indentations in the face, originating from scars, traumatic wounds, or in this case apparently from the removal of a prior filler, can be treated by the appropriate injection of a volumizing filler with a robust lifting capacity immediately beneath the depressions. It might also entail the prior use of Subcision.In my Upper East Side Manhattan practice, my choice of volumizers would include Radiesse, Voluma XC, or Perlane L. (In my Israel satellite facility, where a far greater number of regulatory agency approved volumizers and fillers are available, these would likely be Tyosyal Ultra Deep, Emervel Volume and Restylane SQ). In order to determine how best to proceed, it would be wise to seek consultation with a board certified aesthetic physician.

Steven Wallach, MD · Answer

Without seeing photos or better yet in person, it is difficult to say. Best of luck with your issues.

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

Your friend may be right, but it's hard to know without seeing a photo. In general Juvederm tends to be a thinner filler and actually it can have a translucent color if filled too shallow in the skin. So using a thicker HA filler like Restylane, or Perlane, or perhaps even Voluma might be better choices. If you can post photos we may be able to offer more advice. "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."

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