Can I get hyaluronidase to dissolve my Juvederm lip filler 72 hours after the procedure?

Question

I got my lips filled with .6ml of Juvederm Ultra yesterday for the first time and I swelled at first but it’s going down now. I also have a large lump in my upper left side of my lip and it’s bruised. Above my lips also bruised, which I find to be unusual, but my med spa has told me it’s normal. I don’t want to have lip filler anymore. I just want to go back to the way I was before ASAP. Definitely regretting it now. Do you think another doctor would dissolve it after only 4 days having passed?

Nima Shemirani, MD · Answer

Hi @katt14! You are able to dissolve hyaluronic acid filler at any point. In my opinion, I would wait 2 weeks to see if you notice any improvement. Swelling and bruising the first week after lip filler is common. Best of luck to you!

Raffy Karamanoukian, MD, FACS · Answer

Hylauronidase has many advantages and should be considered in patients who are unhappy with their results or in acute cases of overfilling or occlusion. Its often better to reverse filler and restart then to deal with long term edema. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

There can be some swelling and/or lumps after lip injections which can last 1 to 2 weeks. You can apply firm pressure between two fingers on the lips for a few days, for 5 minutes at a time, in order to help decrease swelling and even out the lumps. If you're unhappy with your final results, you can have the filler dissolved with hyaluronidase and try a different technique next time. Best, Dr. Emer

Robert Kearney, MD, FACS · Answer

Yes you can dissolve it  immediately but you run the risk of more bruising. The asymmetry you have is more from bleeding than from filler put in incorrectly. I would apply topical arnica and wait a week or so.  It will most likely settle down. If it does not I would get it dissolved then.

Julie Thomson, MD · Answer

Hyaluronidase can dissolve filler at any time.  However, I agree with the comments below.  Lip filler can cause considerable swelling and/or bruising in some patients in the first 48 hours.  The swelling can be multifactorial.  It can be from bruising,  an exaggerated histamine reaction to injection or from the product absorbing water. Small lumps and bumps are common and usually resolve over a period of 10 days to two weeks.  I ask my patients to follow up in two weeks to ensure swelling and bumps have resolved to their satisfaction.   Arnica gel is helpful to decrease bruising in the lip area which may help you. Antihistamines are also helpful in the first 24-48 hrs in some patients to decrease swelling.
If after two weeks you are still unhappy with your results you do have the option to correct/liquify the filler.

Thomas Copperman, MD · Answer

You can always dissolve HA filler at any time.. 
That being said the lumps and bumps you are experiencing may be due to bruising rather than the filler itself. There is also a period of swelling a few days after injections due to water being pulled into the filler product. You could give it 1-2 weeks to see if things improve, then if not you can return to request dissolving. 
Best of luck

Alix J. Charles, MD · Answer

Thanks for your question. I always tell my lip filler patients that it might take a couple of weeks for the bruising to resolve and for the filler to "settle".  So I typically would not do anything until more time passes, and then I would visually re-evaluate my patient and guide their decision making process.  Even the best injector can have their patients develop lumps or bruising when dealing with the lips.  Always make sure you research and find an experienced and well trained physician injector who can deliver the results you seek and anticipate (and deal with) any potential side effects. Best of luck to you.

Shaun Patel, MD · Answer

I would wait 2 weeks to let the bruising and swelling resolve before judging your results and before proceeding with the hyaluronidase injection. Both swelling and bruising can occur when treating the lips, even in the best of hands.

Liliana Marcu Awan, MD, FAAFP - Account Suspended · Answer

Very common question Yes please give yourself 2 weeks for the lumps and bumps to resolve before using HA I am confident you wold change your mindBest of luck Ft Lauderdale

Can I get hyaluronidase to dissolve my Juvederm lip filler 72 hours after the procedure?

Answers (9)

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