I understand the frustration with your result; however, in your case, the solution is one of two paths: more filler or more invasive procedures. I sincerely hope that the injecting physician you had your filler with counseled you on surgery and resurfacing procedures. You are a classic case where you can feesibly spend MORE money trying to achieve a non-surgical result (which won't last long and will need to be repeated) rather than undergoing a surgical procedure. If surgery and/ or resurfacing wasn't even discussed, please consider seeking the consultation of a facial plastic surgeon or plastic surgeon. Good luck!
The HA fillers like Juvederm can be an excellent option for the marionette lines and nasolabial folds. It is possible to achieve the result you are hoping for, you simply need more filler. As far as the lumpiness that you are feeling, that could be related to your injection and massages directed by your injector should help. As far as the perioral lines, those can be improved with filler but also resurfacing like chemical peels and lasers. I would recommend you follow up with your injector to express your concerns and see what options you have to help you get to the goal you want. If your injector was not a core aesthetic physician injector (facial plastic surgeon, plastic surgeon, dermatologist) then for your next injection that is who I would recommend.
I hope this helps and good luck.
Sometimes, patients need more filler material to get a full correction. You may also need a facelift. As for lumps, often massage can help if it is done soon after treatment, but I would discuss this with your injector first.
First, make sure you express your concerns to your injector. Juvederm can help improve the appearance of skin folds, but it cannot take the place of a facelift or skin tightening from a laser. Jowling is best treated with a facelift and will help improve the appearance of marionette lines beyond what Juvederm can do. Before and after photos (taken with your face in the same position and the same lighting in each photo) can help you see when/if a difference has occurred so that pertinent adjustments can be made to your treatment plan. It my be as simple as you may need more Juvederm or you may need something more invasive (laser, facelift, etc.). Feel free to discuss these options with your injector.
Thank you for your question. You have deep etched in lines that are best treated with a combination treatment of botox, fillers and laser resurfacing. A face lift will do nothing to address these, unless paired with an aggressive laser or deep chemical peel.
When treating the peri-oral lines one must address multiple issues such a over all volume loss in and around the lips to "frame" and "reset" the lips, relax excessive movement and puckering with botox injections, and filling of the individual lines with fillers that are meant for fine line treatment such as restylane silk. Often when lines are deep, filler alone is not sufficient, and a resurfacing laser such as erbium in need not only to soften the lines, but also improve skin quality and thickness that causes lines in the first place. Best of luck!
There are many factors that may influence one's results. We don't know how many syringes were used. When injecting multiple areas there is usually a need to use more than one syringe. The placement of the product is important.
Lumps and bumps will lessen in weeks.
Before you consider more Juvederm ask about any other procedure that may benefit you, including facelifting and skin resurfacing.
I always recommend returning back to your doctor.
Thank you for your question and for sharing your photographs. I am very sorry that you are having some concerns about your postprocedure appearance. Beautiful natural results can be achieved with Juvederm. Please keep in mind that it will take 2 weeks to see your final result. Some swelling and possibly bruising after filler injection is normal. Icing can help for up to 48 hours postprocedure. Arnica can also help to minimize postprocedure swelling and bruising. Gentle massage may be beneficial. My best advice would be to give it a full 2 weeks to allow for normal postprocedure swelling and bruising to resolve and to see your final result. At that point, if you continue to have any concerns, please see your injector for an in-person reevaluation in order to fully address your concerns, review your before and after photographs, discuss your goals and expectations, and determine the best course of action. Additional product will likely be required in order to achieve your desired goals. Regarding your additional concern about your perioral area, vertical upper and lower lip lines are very challenging to treat. I find that a combination of Botox and dermal fillers works best in this area. Best wishes!
Juvederm typically takes 10-14 days to see optimal results. If you are unhappy with the results I suggest reversing with hyaluronidase and seeking treatment from an experienced cosmetic dermatologist. There are other options including layering with fat and combination of fillers, or lifting which may need implants or surgery. Please consult with an expert. Best, Dr. Emer
2 issues: #1 Undertreated with amounts that would be needed to effect an apparent visual result. Like 4 syringes at least, but than the expensive would be $$$...#2 Might need facial peels, surgery before trying fillers?
Thank you for your questions and photographs and I am sorry that your current results have not met your expectations. At 10 days your results may still improve as the filler material matures and softens but if you feel large lumps I would revisit your injector for an in-person evaluation. They may ultimately need to dissolve the material if it does not clear on its own.
As far as your results, one consideration you did not mention was how much filler material was used. These two areas often require more filler volume than people expect and can be supported by filler placement into the cheeks for further improvmeent. As far as your vertical lip wrinkles you may see better benefit from the use of chemical peels, Botox, and a thin filler such as restylane silk or belotero. See a board certified plastic surgeon for an in-person evaluation and discussion of treatment options.