3 months after Restylane lip filler, lumps on lips still there. I want to get more filler added in about 1 month. Thoughts?

Question

Hi, I had Restylane injected into my lips in Feb and I developed small lumps that are noticeable only when I smile. I want to have 1 ml added by late June. Do I have to get the lumps removed( will they get filled with more filler if I add more to my lips) or can the docs add more filler without causing them to fill up more? If I do have to remove the lumps, how many days before my next lip filler treatment should I have this done?

Nima Shemirani, MD · Answer

Hi @Liana_388. I would recommend dissolving the lumps prior to adding more filler. I would dissolve 1-2 weeks prior to treatment. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck, Dr. Nima!

Jason Emer, MD · Answer

Thank you for your question, most Doctors will start with one-syringe to avoid over-filling. These fillers, (Volbella, Restylane, Juvederm) are good to create a symmetrical and full lip. PDO Nova threads can also be used to improve shape and also provide lift. Fat or implants are a permanent alternative. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question. You could either leave the bumps alone and add filler around the bumps. It will not make the bumps worse. You could also have the bumps dissolved and then immediately refill. Make sure an experienced injector perform your treatment. Good luck!

Tim Neavin, MD · Answer

Thank you for your question. It is safe to re inject after 7 months. Bumps tend to go down within a couple months.

Jonathan Kulbersh, MD · Answer

Unfortunately, it is very difficult to advise you without at least a photo or two to understand your specific concerns. I would strongly recommend you discuss these concerns with your injector or with a board-certified plastic surgeon who is also an expert injector. In some cases, the filler should be dissolved to eliminate the lumps before adding more filler. Other times, it might be okay to add the filler while the lumps are still present. If dissolving the filler is your best choice, the process usually only takes a day or two and you can get more filler injected within a week.

Camille Cash, MD · Answer

As the lumps are bothersome and noticeable to you when you smile it is best to have them dissolved a week prior to your next filler treatment.  If you do not address them they may become more visible when more product is added to the area.

Blue Medi Spa - Sherman Oaks - Account Suspended · Answer

It is difficult to address without assessing you in person. Generally it is best to dissolve the lumps especially since it's visible when you smile, allow 1 week at least then continue to fill your lips further. The reason for dissolving first is that if you fill over lumps, the lumps can become more visible while smiling or at rest. It is best to be consulted by an experienced injector.

Adam Goodwin, MBBS, FRCS(Plast) · Answer

So filling over lumps is fraught with problems. What tends to happen is the additional filler can push the lumps forward as much as disguise them and therefore is not a good idea. My advice to you would be to have the lumps dissolved. This typically takes one or two sessions of hyalase injections. Unfortunately, sometimes the lumps are scar as well as filler and can take a lot more effort to remove. Certainly my advice would not be to have additional filler. If the hyaluronic acid dissolver works, you should be able to have filler again the next week. Of course you should be aware that the same thing could easily happen again. Hope that helps. Regards, Adam Goodwin.

Michele S. Green, MD · Answer

If you have a small lumps it sounds like they are not noticeable when you smile and you can safely have more Restylane added to your lips.  If the lumps are bothering you from an aesthetic point of view then I would have them dissolved one week before your lips are re-injected.  Best, Dr. Green

Pamela Stuart, MD · Answer

Without photos of what you are describing, it is difficult to provide an answer. However if you are happy with the original lip fillers, i would not recommend having anything dissolved. If you wish to add more volume, and your injector also believes you could benefit from more filler, there should be no issue with adding more in late June. I would recommend that you speak directly with your provider and explain what it is you wish to achieve to allow them to assist you in getting the results you are hoping for.Best wishes,Pamela Stuart, MD