3 months post op Juvederm Volbella injected into my lips. I developed hard, painful nodules. Should I get Hyaluronidase or Wait?

Hello, About 3 months ago, I had half a syringe of Juvederm Volbella injected into my lips. Last week, I developed several very hard, painful nodules, thickening of the corner of my lip, and severe swelling that fluctuates over the course of a day. This is has not resolved at all. I am trying to decide if it is worth having hyaluronidase injected, or if I am better off waiting it out for a bit now. I am very upset with the current state of my lips and just hoping for a solution. Thank you.

Doctor Answers 6

Vobella lip nodules

This is not that uncommon, about 4% from what I'm told. It is product related. It requires hyaluronidase, but at higher doses than other HA products. It is starting to be sold in the US now and I expect this to become more of a problem on Realself in the future.

Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

See your

This is not a normal reaction. There maybe several reasons for this, including biofilm infection, granulomatous inflammation (either due to the filler or the start of granulomatous chelitis), plus other medical conditions. 

The very first step is to obtain a diagnosis before treatment. 

All the best

Dr Davin S. Lim
Laser and aesthetic dermatologist
BRISBANE, Australia. 

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 75 reviews

The majority of swelling if not all should have subsided at this point.

The majority of swelling if not all should have subsided at this point. Schedule an appointment with your injector to discuss your options. If you are unhappy, having the product dissolved may be your best option. It is common for lips to have a slight increase / decrease in water retention. 

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 457 reviews

See your injector

Please see your injector for a physical examination of your lips. Hyaluronidase may help, but this could be caused by something else. 

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

3months post filler

Thank you for your question. Since it has been 3  months already, I would suggest seeing your provider for further evaluation. Good Luck.

George T. Boris, MD, FRCS, FACS
Los Angeles Facial Plastic Surgeon
3.7 out of 5 stars 18 reviews

Dissolve filler or wait

While Volbella is not currently an FDA approved filler in the U.S., it is still a hyaluronic acid filler which can be dissolved. Since the nodules are new and have not been there all along, it would be best to see your injector for an in-person evaluation to determine what has caused the nodules - the filler itself, some type of reaction or infection?, or something else.

"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."

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.