Are lumps and bumps post Juvederm normal? (photos)

Question

I had my lips injected with 1 syringe of juvaderm. The injector claimed I needed another syringe because she “ran out of filler” to complete the left side. I waited 10 days and my lips were extremely uneven and lumpy. After much debate she agreed to fix them. I am one day post my second syringe of .5ml. The evenness is better but the lumps are back. Is this normal heeling or is this person not qualified for lip fillers? The MD claims this is normal for some bodies to “react this way”.

Thomas A. Pane, MD · Answer

Some 'bumps' are often just needle injection points that swell a bit, but that doesn't look like the situation here.  What I don't like about this story is being told you needed another syringe because the filler ran out. Almost all experienced injectors will place the filler from side-to-side so you cannot run out with one side being significantly uneven.

Monica Boen, MD · Answer

I appreciate your question and photos and I agree that the lips look uneven. Lumps and bumps often occur after Juvederm injections and typically subside on their own within a week or two. Massage and ice may help with the swelling. If you are unhappy with your results in two weeks, you can schedule a follow-up with your injector to determine whether additional treatment is needed. If the results are not satisfactory, you can dissolve this filler with hyaluronidase. Make sure you always work with a board-certified dermatologist who is also an expert injector to ensure an optimal outcome with every treatment.

Elham Jafari, MD · Answer

Hi and thank you for your question! Any painless lumps after filler injection can be swelling and during the first few days, it can be impossible to distinguish bumps due to filler from bumps due to swelling. We always advise patients to allow two weeks after filler injection for all the swelling to completely resolve and at that time if any bumps or unevenness are left, they can be fixed. I hope it helps and good luck!

Jason Emer, MD · Answer

If you're feeling pain, you should follow up with your injector / physician. Or see an experienced cosmetic dermatologist to get a formal evaluation, resolve the issue, and develop a new treatment plan to address your acne scars. Best of luck, Dr. Emer

Selena Lantry, MD · Answer

Swelling can cause some unevenness or bumps after a Juvederm injection, so it is best to wait the two weeks to ensure that all the swelling that could be affecting your lips has gone down.  That being said, if after two weeks your lips remain uneven, your provider should be able to dissolve your filler or give you touch ups to even out the overall result.  Additionally, I would make sure to do your research before selecting your provider by looking at before/after photos, reading reviews and making sure they are properly credentialed and experienced.  Your provider should not run out of filler if you had agreed on getting one syringe beforehand.

Bhavlene Panesar, MD · Answer

Thank you for your question and your pictures.
It is common to have some irregularities and bumps after lip filler.  However, these should settle after 2 weeks.  If they have not, then it could be a result of the filler being placed too close to the surface in the tissue.  Adding more filler if this is the case can make the lumps even more prominent.
If it has been placed too superficially, I would advise seeing someone who can dissolve the filler for you and start again.  
As the filler should be administered evenly to both sides I am not sure how a practitioner could "run out of filler".  In that case, I would think she should have injected more filler at the time to keep the results even and symmetric.

Nicole Hayre, MD · Answer

Hello, thank you for your question. Your downtime is going to be a bit longer due to the multiple procedures you had in a short time.  Lumps and swelling after filler injection can be normal, especially during the first two weeks after injections were done.  Juvederm fillers can take up to two weeks to settle completely.  We strongly advise patients to apply cool compresses to relieve the swelling and to avoid massaging the area where fillers have been injected.  However, if the bump is red, painful, or there is pus, you should return to your injector immediately.  Please seek a Board-Certified Dermatologist for a follow up appointment and evaluate if the lumps do not subside in two weeks.

Vilma Di Maria, MBBS · Answer

Thankyou for your question. after 10 days those lumps are due to either too superficial placement or too much in one spot. It now needs to be slightly dissolved to flatten it.Good luck

Camille Cash, MD · Answer

Some lumps are not uncommon after injections, but they typically smooth out over 14 days from injection as swelling resolves.  Gentle massage of the area is sometimes helpful.  If they are still present after two weeks it may be the product was placed too superficially and can be dissolved with hyaluronidase.  Be sure to see an experienced injector for treatment.

Stanley Kovak, MD · Answer

The most important thing is to receive your treatment by an experienced physician.  Sometimes, unevenness or "lumps" can be caused by bruising or the product.  If it is the product many times the physician can manipulate the area to smooth it out.  If necessary hyaluronidase  can be used but will dissolve the product.  I hope I was able to help and good luck.

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