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

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. 

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.

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