Volbella delayed swelling 8 months later, hyaluronidase did not work first attemp. Will this be a permanent problem? (Photos)

Thank you for your question and your pictures.It would be important to know the products as hyalurodinase will likely not work on a non-hyaluronic acid products (yet sometimes it helps).Volbella can trigger a granuloma reaction (chronic inflammation) with hardness, tenderness and swelling.  It is rare but possible.  And all the VYCROSS Juvederm are harder to melt and hence, patients like the fact they last longer.I would suggest additional dose of hyalurodinase, serially, perhaps with a stronger concentration (some are 150 IU/ml, some are 1500 IU/ml, etc.)Occasionally a steroid injection can be considered.If it is Volbella, it will melt over time and your issues will stop.I do like the Juvederm Volbella, Volift and Voluma but I make sure I apply "surgical principles" when using it with sterile face prep and sterile glove.  It is also ALWAYS performed in a medical clinic - I am saying this because I hear more and more of Botox and injectables being done in spas and hair salons, not to mention condos, by non-professionals.And I like to use the cannula technique too, being careful not to contaminate the cannula.Make sure you see a board-certified plastic surgeon for this issue.Hope this helps!Kind regards,Dr. Marc DuPere, aesthetic plastic surgeon

Your symptoms may not be due to Volbella especially this long after your injection. Their episodic nature and your photographs suggest cheilitis granulomatosa (Miescher's cheilitis) or angioedema. You should follow up with your primary care physician or an allergist. 
Good luck.
Best regards,
Lillian Overman, MD

Thank you for sharing your question and photographs and I can see your areas of concern.  Unfortunately more information is needed to offer the best advice.  Firstly I would be absolutely sure that Volbella was injected as this swelling would be very unusual 8 months after treatment.  If it is Vobella try more hyaluronidase and perhaps a different formulation to dissolve the product and antibiotics to take care of any possible infection.  If your injector is not an ASPS board certified plastic surgeon, seek one out for a second opinion.  Hope this helps.

Volbella can cause swelling immediately after injections but it would be most unusual to cause swelling 8 months later.  You may be having an allergic reaction that needs a complete work up and I would consult a board certified dermatologist to do a proper work up.  You may need oral steroids or anti-histamines to help alleviate your problem.  Best, Dr. Green

volbella is more resistant to hyaluronidase than juvederm and restylane. You need much higher doses ...5 times more ....and injections need to be repeated. It will work, eventually.