Should I get my lips dissolved and start over? (Photo)

Question

I got Juvederm Ultra Plus for a few years now. My lips looked pretty great up until the past year where I seem to be looking like a fish/duck from the profile view. Do I have to get it all dissolved or partially dissolved? What are my options? I waited 8 months for my last treatment to go down then got it again and am over 2 weeks out and still looking like a duck.

Raffy Karamanoukian, MD, FACS · Answer

Longterm filler problems include migration, edema, and nodularity. 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

yes these lips are terrible and need to be reversed. you can get much better injection technique and product.

lip fillers and lift will not help the corners of your mouth, that needs botox, threads or a lip corner lift.  sometimes an early face/neck lift helps. accutite can be a non invasive alternative. I would use daily hydration and plumping (lip essentials kit emeragecosmetics).  everyone can do a little filler when done well really gives nice hydration and plumping.  Best, Dr. Emer.

Anteneh Roba, MD · Answer

I would wait a little longer before considering to have it dissolved . If swelling persists then it should be no problem getting it dissolved. 
Juvaderm ultra plus is not the choice product for lip enhancement.

Robinson Facial Plastic Surgery - Alpharetta · Answer

Hello!Whether or not to dissolve lip filler can be a difficult decision. In your case, I would recommend dissolving before spending more money to continue filling. Over time, filler can migrate out of the lip and into the surrounding spaces, causing a less than desirable look. Juvederm can tend to do this more easily than some other fillers due to the nature of the product. Without dissolving, the filler will likely remain there for a long time with subsequent treatments causing a more ducky/fish look. Please see a provider who is highly skilled with Hyaluronidase treatments for your dissolving session. Good luck!

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