1ml of Juvederm Ultra Plus in my lips and now they look so big. What can I do to bring it down? (Photo)

Thank you for your question. I understand that you’ve had 1ml of Juvederm placed in your lips, but a day after the procedure, you feel your upper lip is too large and looks too duck-like. You’re concerned about your results and wondering if it can be undone.I can certainly help you with this question as we do use a lot of fillers in our practice, and lip aesthetic improvement is one of the most sought-after procedures that we provide. I am also a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic surgeon who has been in practice in Manhattan and Long Island for over 20 years.Over the years, I have learned and observed that lips are extremely sensitive and can swell quite significantly. When we perform lip augmentation in our practice, I administer the injection, and I have my assistants on standby so they can share their opinions and give me feedback with regard to areas to further augment, and which areas to leave alone. After the procedure is done, I give the patient a mirror and make it a point to let them see what their lips look like immediately after. This is because there is a very small window wherein the patient can see what their lips look like with the filler, before 2 types of swelling occur.There are two types of swelling associated with lip enhancement: reactive swelling which is a natural reaction to trauma, much in the same way your eye area swells if you bump it against something; the second type of swelling is the swelling of the material itself, or the filler. The material absorbs water and if often responsible for a certain percentage of the swelling. To minimize the swelling, we give our patient a cold compress or a bit of ice, especially if they need to return to work soon.Lip aesthetics are more challenging. Following the proper lip ratios, whether it is the Golden Ratio of 1.6:1 for the lower and upper lip, or 1/3:2/3 for the upper and lower lip. These ratios are extremely important and can spell the difference between beautiful, full lips and duck lips. Keep in mind that the swelling can make people feel like their lips are excessively big and duck-like, so I always encourage my patients to apply as much ice as they can tolerate for the first couple of hours.There are some people who do not swell at all, which mostly depends on the individual, how they react to the procedure, and how much manipulation was done during the procedure. This is especially important for those who are getting lip fillers for the very first time—1mL of filler for both the upper and lower lip is not big amount, but it will ultimately depend on how you respond to the procedure. I always advise first-timers to give themselves a day or two to get the swelling down before going out. Ideally, they could have the procedure done on a Friday, and have the weekend to heal.If you find that you are still unhappy with your results, you can opt for hyaluronidase, which is an enzyme that is used to dissolve any excess, unwanted cosmetic fillers. I would suggest to give it bit more time. In fact, in our practice, I always have my patients come back 2 weeks after any type of injectable procedure, just so I can assess their progress and see if there’s any need to further enhance or augment anything. Interestingly, during the days when we still used fat as a lip filler, patients would be very apprehensive of their results for the first two weeks, and then a few months later. they’d ask to have more material put in. Just keep in mind that it is mostly the reactive swelling that is making your lips look larger than you would like.Again, manage the swelling with some cold compresses for the first 24-48 hours, and if need be, contact your doctor and ask about maybe getting some anti-inflammatories. Most importantly, just keep in mind that it take about 1-2 weeks for the swelling to settle and for you to see what it’ll look like in the long run, depending on your metabolism and how you respond to the procedure.I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

Hi there!
Thank you for your question! Swelling is very normal so soon after treatment and should subside within 7-10 days. To help your symptoms you can use a cold compress to help reduce swelling. If you are still feeling concerned after this time period you should contact your practitioner for a review. If you are really unhappy with results, Juvederm can also be dissolved using hyalase injections.
Hope this helps!
Dr Rupert

Thank you for the question. You do not need to be overly concerned. Fortunately, excessive swelling in your lips will likely subside within a few days. Cold compresses might help diminish the swelling. If you still are unhappy in a week, Hyaluronidase can be injected to dissolve the Juvederm. Good luck.