Is this deep bruising or necrosis? I had lip filler done two days ago with Juvederm. (Photos)

Question

Hi there! I had lip filler done two days ago with Juvederm. Upon injection my upper lip blanched and turned blue. My doctor immediately recognized it as a vascular occlusion and within 40 minutes he used two vials of hyaluronidase to remove the occlusion. I am not in severe pain however, the corner of my upper lip is tingly and numb. I can’t tell if this is severe bruising or the start of necrosis. I booked in with him for this afternoon to check but I want more opinions. Thank you.

Jason Emer, MD · Answer

I recommend following up with your injector for a formal evaluation. Additional hyaluronidase may be needed and you should be treated with topical vasodilators (nitropaste) as prevention. Best, Dr. Emer

Jonathan Kulbersh, MD · Answer

Since you had an occlusion, I recommend following up with your injector. Additional hyaluronidase may be needed to fully dissolve the filler.

Renee Burke, MD · Answer

Thank you for your question. It is difficult to advise based upon your photos, however, I would advise that you continue to follow up with the provider who did your injection, or a board certified plastic surgeon in your area to assess whether further hylauronidase is required to treat the area.

Monika Soni, MD · Answer

Thank you for your question. It is difficult to give you advice on your photos. However, I would continue following up with your injector if he/she was worried about necrosis as additional treatment of hyaluronidase may be required. I hope this helps!

Quenby Erickson, DO, FAAD, FACMS · Answer

It is difficult to tell from your photos if this is necrosis vs bruising. It is best to follow up with the doctor who injected you when there is a concern of necrosis. if there is significant pain that is worsening with time rather than resolving, that is a sign of necrosis rather than bruising.

Is this deep bruising or necrosis? I had lip filler done two days ago with Juvederm. (Photos)

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