Asymmetry after Juvderm injection of nasolabial folds and Doctor charging for touchup. Is this normal?

I recieved one syringe of Juvederm in my nasolabial folds. I still have more of a crease on one side. There would be a full price charge for another syringe. I told them that I felt like the doctor did not inject evenly therefore I should not have to pay for the touchup. They explained how this type of injection does not always create perfect symmetry.I thought an injector could create perfect symmetry with one syringe. Did the doctor do something wrong?

Doctor Answers 7

Juvederm and symmetry

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Juvederm is a dermal filler that can help smooth the nasolabial folds or smile lines.   The 2 sides of the face are like brothers and sister and not like twins.  There are going to be asymmetries from side to side.  Filler can help improve the symmetry, but I would not expect fillers to make perfect symmetry.  Typically, if patients require more filler, it would be reasonable to charge for the additional syringe, but that is a conversation between you and your injector.  I hope this helps  

Juvederm and Touch ups

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Thank you for your question. Juvederm is an excellent choice to smooth out the nasolabial smile lines. However each side of the face is not identical so after the first syringe has been done, you would need to wait until the swelling and stuff goes down, and yes if you were unhappy with the results then the injector would charge you for more filler. This is common practice for fillers. Please consult a professional in your area.

Asymmetry after Juvederm injection of NLF

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Thank you for sharing your question and congratulations on your dermal filler treatment.  Achieving perfect symmetry is nearly impossible with any treatment as we all start out with differences between our right and left sides.  Though dermal fillers afford the flexibility to treat areas independently it may well take more than a single syringe to achieve your desired appearance with charges commensurate with the amount of filler used.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

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Symmetry is hard to achieve

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You must look a before and afters to determine if this was pre-existing. I take detailed pictures because this is a frequent concern. In fact, most people are not symmetric and only notice the issue after scrutinizing their results after getting filler. The truth is that almost everyone is not symmetric. Most people have a small and large size. To get symmetry is impossible in most cases but to get closer to the side is what is possible. If indeed there is asymmetry caused by the filler, this should not be charged for. If this is just a matter of needing more filler, this should be charged.

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Asymmetry after Juvderm injection of nasolabial folds and Doctor charging for touchup. Is this normal?

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Because the fee included ONLY 1 syringe you need to pay again! as the common accepted practice for more HA filler used. As you were obviously under treated and needed 2 syringes. Which I assume you did not want to pay for... Some of us have 1/2 cc syringes of HA fillers available. BUT there is always additional fees when you need more HA product......

NLF filler

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Many people need more than one syringe when trying to fill an area.  I usually tell people that we can try one syringe but that it may not be enough and they may need to return for a second syringe.  We aim for symmetry, but no one is symmetric to begin with so it is hard to get perfect symmetry on anyone.  

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If you are unhappy you can use hyaluronidase to reverse the filler or other fillers to improve the contour.  Best, Dr. Emer.

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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.