1.5 syringes of Juvederm Ultra Plus and 3 months later my lips shrunk down and now I have skin rash around my mouth (Photo)

Question

Pic 1 shows my lips before injection. First injection 1 full syringe. 3 days later you can see lips are uneven. 1 week later doctor injects .5 (half) syringe to fix upper lip where filler was lacking. He over did it before now that side was larger than the other and they are lumpy. 3 months later my lower lip looks exactly as before injection and upper lip is only tad larger. WHERE did 1.5 syringes go??? I have a terrible rash in corners of my mouth for the last 2 months. Nothing helps.

Matthew Elias, DO, FAAD · Answer

Thank you for your question.  Since the volume aspect has been covered at length below, I'd like to comment on your rash.  From the pics it look like you have perleche (angular cheilitis) - there are many known causes of perleche it is most often due to an infection either final or bacterial and secondary to either distortion of anatomy, nutritional deficiencies, lip licking, immune suppression, etc.  Typically we use a combination treatment to treat and resolve this disease.  I am a fan of using the iodiquinol/cortisone combos for perleche as iodiquinol has both antibacterial and anti fungal/anti yeast properties.  I advise you to follow up with your Board Certified Dermatologist for proper evaluation and management as well in the future have your lips done by the Dermatologist so if you run into issues like this it is easily treated.  Regards, Dr. Matt Elias

Julio Clavijo-Alvarez, MD, MPH, FACS · Answer

I am sorry that you are having concerns about your procedure
and thanks for sharing your question. I can appreciate your
concern.

The longevity of the fillers can be
related to various reasons. The most prevalent one is that the filler that was
used is the short lasting one 4 months vs the 8 month ones depending on the
brands that were used. Another reason is that your body might have more active
enzymes that dissolve the filler faster. The irritation, could be either
topical reaction to the filler (very rare) or superficial infection of the
filler (also very rare).

My advice is to let all the fillers dissolve
and restart the process from scratch. Now you are chasing correcting issues
that need to settle before you undergo more injections.

Finally, make sure that you have a consultation
with a board certified plastic surgeon.

Wishing you the best in your journey

Karen S. Harkaway, MD · Answer

I do think that your lips look fuller now. You already had fairly decent sized lips, and now I would say that they are at the upper limit of normal appearing, meaning that they look very full but still fairly natural.  Much fuller they would certainly look strange.  As for the rash, probably due to the increased fullness of the lips, and the slight change in the corners of the mouth, alive may be gathering there at night, causing an irritation dermatitis. Put a blob of Vaseline in each corner before bedtime and see if that helps.Best regards,Dr Harkaway

Brian Windle, MD (retired) · Answer

Thanks for supplying your photos.  That is helpful on answering your questions.  Let me talk about your injection first.  1.5cc of Juvederm is actually not that much
when it comes to volume and I have added a video for you that demonstrates that.  Your lips actually do look bigger than they
were before your injection so the Juvederm is working.  Unfortunately, it is not working to the
extent that you would like.  Many women
like the look of their injection for the first couple of weeks, thinking that
all the volume they have is due to the injection but in reality, the volume is
swelling form the injury of the injection, especially if a needle was used
rather than a cannula.  The effects of
trauma from an injection can last 3 weeks.

The rash you have is likely not related to the your Juvederm
injection at all.  You should see your primary
care physician for this.  Without seeing
the rash in person it is hard to tell exactly what it is but by the pictures it
could be a problem such as impetigo, perioral dermatitis or even a yeast
infection.  These conditions and the rash
you have are not known adverse events for Juvederm and other injectables.

I hope that helps.

Best regards.,

1.5 syringes of Juvederm Ultra Plus and 3 months later my lips shrunk down and now I have skin rash around my mouth (Photo)

Answers (4)

Answer: Juvederm Injection Problems

Answer: Juvederm Injection Problems

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Everything you need to know about Juvederm

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

1.5 syringes of Juvederm Ultra Plus and 3 months later my lips shrunk down and now I have skin rash around my mouth (Photo)

Answers (4)

Answer: Juvederm Injection Problems

Answer: Juvederm Injection Problems

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Recommended reading

Everything you need to know about Juvederm

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