Did hyaluronidase cause these dents or is filler still around them? (Photo)

Question

Hello, I had my lips overfilled years ago and had them dissolved in two sessions one year ago. I’m not satisfied with the results as I believe there’s still filler on the outer sides of my top lip. I’ve read that hyaluronidase can not destroy your tissue, but these dents have been here since dissolving. Could this be damage or is there still filler AROUND the dents that needs to be dissolved. My nurse injector told me “I’m crazy” but these dents weren’t there before!!

Raffy Karamanoukian, MD, FACS · Answer

Filler migration, swelling, and granulomas can cause significant discomfort and cosmetic ramifications. Our office specializes in the use of enzymes and filler reversal techniques without hyaluronidase to help improve the results of botched cosmetic fillers, whether caused by Juvederm, Restylane, or foreign fillers. Our plastic surgery institute provides expertise in filler removal. We begin by examining the facial fillers and assessing the likelihood of fluctuance or liquid volumization. If appropriate, we use Hylenex, or other filler reversal agents to reduce swelling and filler migration. Hylenex can be targeted into the areas of concern using multiple layered injection techniques. If the filler does not completely resolve, then additional concentrations may be employed. The technique has the potential to reduce the filler and may slightly impact normal hyaluronic acid. Treatments are repeated and results can improve immediately and with time.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nilay Shah, MD · Answer

Based on your photo it seems that the dents are the areas where the filler was dissolved and the elevated areas are where it has not been dissolved. If you are not satisfied with the appearance then would suggest that you visit an expert in lip fillers to correct this minor asymmetry.

Robert T. Buchanan, MD (retired) · Answer

Since your procedures were "years ago,"what you have now is essentially permanent. Without seeing before pictures, I suspect the "dents" are where the filler was dissolved and the elevated areas are where you had filler that was not dissolved that your body then used to make its own collagen. Because the hyaluronic acid has been converted to collagen, it is essentially like your natural collagen and cannot be dissolved. Your options is to either live with what you have or see a true expert in filling lips and add a very small amount to the "dents" and to correct the very slight asymmetry.

Did hyaluronidase cause these dents or is filler still around them? (Photo)

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Did hyaluronidase cause these dents or is filler still around them? (Photo)

Answers (3)

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Everything you need to know about Hyaluronidase

Our mission is to create a world where every investment in modern beauty is Worth It.