Lip filler causing lips to curl in? (Photo)

Question

I had Juvederm injected in my lips, and while the doctor was careful to place it properly, and it looked amazing for the first two weeks, it's now appearing to push my lip line down, causing my natural lip line to curl under. It makes my lips appear smaller, while the tissue above my lip is now fuller and thicker. The tissue above my lip doesn't feel like the product has migrated, it's just somehow thicker, and the product has almost travelled to the inside of my mouth. What happened here?

Harold J. Kaplan, MD · Answer

Hello,As other panel members recommended, having your injector meet with you to address your concerns is the best option.  However, based upon your good description and photo, it appears that the product may be causing too much heaviness which your upper lip is having trouble fighting against.  We've seen this in our practice before with patients that are over-filled for their own shape/size of upper lip.  This oftentimes causes a flat, rolled in appearance or an elongated/flat space from the base of the nose to the upper lip line.  In addition, you would benefit from more artistry of the mouth to create a better shape of the Cupid's bow.  This would also help bring better balance to the area of concern and fight the heaviness.  Alternatively, you may consider dissolving some of the product at the heavy points before re-shaping.  We do not believe you have any swelling that is causing this outcome this far out from your treatment.

Jason Emer, MD · Answer

This is difficult to answer without before and after pictures. If you're unhappy with your final results, you can have it reversed with hyaluronidase and try a different technique next time. See an expert. Best, Dr. Emer

Payman Kosari, MD, FAAD · Answer

It certainly looks like the swelling is occurring above your lip line weighing down the upper lip and causing it to turn inward.  Fillers usually have the most swelling within the first two weeks and then it subsides.  One can also consider a delayed hypersensitivity to the filler causing the swelling.  The best approach at this point is close follow-up with your injection.  I would likely, start with a course of prednisone and reassess at that point.  In the worst case scenario, it needs to be dissolved and a different product used.  Best of luck!

Sean Doherty, MD, FACS · Answer

I am so sorry that you are experiencing this. Your best bet would be to visit your injector and be examined in person. I think you are probably going to have to have the filler dissolved but keep in mind that this take as much if not more skill than having it injected so you may want to get a second opinion from another board certified plastic surgeon in your area. Best of luck.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question dianna11. I understand your concern. Juvederm is a hyaluronic acid filler designed to enhance the
appearance of the face. It is difficult to make an assessment without before photographs. However, being a hyaluronic acid product, Juvederm can be dissolved if the desired results are not achieved. Please consult with a doctor for specific recommendations. Good luck!

Steven Swengel, MD · Answer

Hello thank you for your question and your picture. As mentioned by other doctors, this is caused when there is too much filler injected to the upper lip area and not the lip itself. Sometimes this happens when filler is injected to try to improve the lines above the lip. My suggestion is for you to go back to the provider who injected your Juveder and get an assessment. Hope this helps, Dr. S.

Kiran Polavarapu, MD · Answer

Hello and thank you for your questions. Just as all the other doctors explained, its difficult to assess your concerns without knowing what your lips looked like before and after the injections. It would also be helpful to have an exam (to palpate the area you are concerned about) and know exactly where the juvederm was injected.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question and for submitting your photo.  While it is difficult to make an exact diagnosis without assessing you in-person, based on your photos, you appear to have significant swelling above your upper lip, which is pushing your lip inwards.  It is not common to be experiencing swelling this long after your treatment, and these symptoms are concerning for a possible infection or reaction to your filler.  I would recommend following-up with your doctor to discuss your symptoms and to determine the best treatment plan.  I hope you feel better soon!

Leonard Grossman, MD · Answer

It is not easy to answer your question in a proper manner, since the photograph you provided shows your face with a slight smirk which changes the anatomy of the lips and the face considerably. If you want a good answer to your  question I would rather have you see your treating physician or provide us with your face photos at rest, before the procedure and after. Good luck from New York City

Lip filler causing lips to curl in? (Photo)

Answers (9)

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