How do I get rid of scar tissue within my lip line? (Photo)

Based on your description—persistent firmness along the vermillion border after dissolving filler—it’s quite possible you have developed localized fibrosis or scar tissue, rather than residual filler. This can occur after injections and hyaluronidase use, particularly if there was inflammation or repeated treatments.

✅ Treatment Options to Consider:

Massage: Gentle, consistent massage may help soften early fibrosis. Use a bland moisturizer or arnica gel and apply pressure daily for a few minutes.

Intralesional Steroid Injections: A small amount of triamcinolone can help break down scar tissue and soften the area over several weeks. This is often the most effective first-line treatment.

Subcision: A minor procedure where a tiny needle is used to release tethered scar bands beneath the skin. This can help smooth contour irregularities.

Laser or Microneedling: Fractional lasers or microneedling can gradually remodel collagen, improving texture over time.

Surgical Excision: Rarely necessary unless the scar is extensive or causing significant asymmetry.

✅ Next Steps:
If the area has been stable for a few months and does not feel like residual filler (soft and mobile), a combination of steroid injections and massage is usually the most effective conservative approach. If needed, subcision or laser can further improve contour.

If you notice any new swelling, tenderness, or change in size, that could still be retained filler, and an ultrasound evaluation can help confirm.

Feel free to share any more details about how long this has been present or whether there’s any associated pain.

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. If you’re experiencing hardness along the vermillion border after having filler dissolved, it is possible that scar tissue or fibrous tissue has developed. This can happen as a reaction to the filler or the process of dissolving it. To address this, several approaches might be considered. One effective method is the use of massage therapy, where gentle massages are applied to the affected area to break down the hardened tissue and improve skin texture. Additionally, treatments such as laser therapy or microneedling can be beneficial, as they stimulate collagen production and help remodel the scar tissue. In some cases, corticosteroid injections may be necessary to reduce inflammation and soften the tissue. I hope this helps and best of luck!