How safe is it to remove granulomas from lip filler Juvederm Volbella by a doctor popping it with a needle and squeezing it out?

Question

For three months now I have dealt with formed granulomas from my lip filler. My doc told me to wait it out to dissolve on its own and this can take up to a year. It is very embarrassing, wearing lipstick makes it show up even more. I saw another doctor also specializing in Plastic surgery and he wanted to poke it with a needle tip and then squeeze it out. The other surgeon said not to. Is it safe to do this and have it popped out or will this cause massive scarring and possible infection? SOS

Monika Soni, MD · Answer

Thank you for your question! this is a very interesting topic as some reports are suggesting we see this more often with volbella. Management can include drainage and you don’t necessarily need to go to a plastic surgeon to have this done as a dermatologist should also know how to do this. These can be disfiguring and your doctor should discuss your options with you.

Deborah Kessler Hudak, MD, MHA · Answer

The most popular lip fillers are hyaluronic acids, such as Juvederm and Restylane.  They uncommonly have associated "granulomas," since (by pathology definition) granulomas have "giant cells" that try to ingest the foreign material.  If the lip area is properly cleaned with antiseptic and sterile technique is used, the granulomatous bump can be extruded after needling it.  Alternatively, a small amount of hyaluronidase (an enzyme that breaks down hyaluronic acids) can be injected.  In either case, I recommend you have an expert physician injector care for it.  Risks of infection or improper treatment are too high to trust anyone else.
I hope that is helpful information to you.

Sagar Patel, MD · Answer

this is a very interesting topic as some reports are suggesting we see this more often with volbella. Management can include drainage and you don’t necessarily need to go to a plastic surgeon to have this done as a dermatologist should also know how to do this. These can be disfiguring and your doctor should discuss your options with you. Good luck!

Sagar Patel MD

How safe is it to remove granulomas from lip filler Juvederm Volbella by a doctor popping it with a needle and squeezing it out?

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How safe is it to remove granulomas from lip filler Juvederm Volbella by a doctor popping it with a needle and squeezing it out?

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