Normal swelling from Volbella or too superficial placement of product? (Photo)

Question

I'm 26 and had volbella injected 5 days ago into a couple fine lines I was noticing around my mouth. The physician that was injecting used a little over half of the 0.66 cc syringe between 3 lines on my face. 2 of the injection areas are raised and I can clearly see where the filler was injected and the swelling hasn't seemed to change/go down much. Any thoughts on if this is normal swelling or the result of the product being placed too superficially?

Carlos Mata, MD, MBA, FACS · Answer

Hello there,Thank you for your question and I'm sorry to hear about your concern.  I tell all my patients to reserve judgement of their results for 2 weeks. The great thing is, the product is very fine and relatively easy to manipulate even after 2 weeks.  I would express your concerns at your 2-week follow up and have your provider smooth the area.  If smoothing doesn't help, you can request to have a part of it dissolved with hyaluronidase.  Hope this helps.All the best,Carlos Mata, MD, MBA, FACSBoard-Certified Plastic Surgeon

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs and I see your areas of concern.  Because of how thin a product Volbella is it is difficult to place it too superficially and I feel that additional time will likely smooth out the raised areas in your pictures.  Allow at least two weeks to pass and then reassess your results.  If nothing changes ask to have the material dissolved with hyaluronidase.  Hope this helps.

Gregory A. Buford, MD, FACS · Answer

As Dr. Emer pointed out, it can take up to 10 days for the swelling to reduce following injection of HA fillers and for the product to fully integrate into the local tissue.  Volbella is actually meant to be injected very superficially and so it is common to see the product for a bit until it is fully integrated into the local tissue. As such, I would wait for about 1-2 weeks.  If the lumpiness and visible product are still bothering you, this product can either be massaged or dissolved very easily.Check with your treating physician and make sure that they are an Expert Injector.  I hope that helps and wish you the very best!Gregory A Buford MD FACSBoard Certified Plastic Surgery and Author

Jason Emer, MD · Answer

It's too soon to tell what your final results will be. You may have swelling, which can last 1-2 weeks after your injections. If you're unhappy with your final results, you can have it reversed with hyaluronidase and try a different technique next time. See an expert. Best, Dr. Emer

Kouros Azar, MD · Answer

It takes at least 2 weeks for the swelling to fully resolve so, for now, be patient. Hopefully, this will resolve on its own.

Mark Ballentyne, MD · Answer

I find that swelling with Volbella is minimal and if you are seeing raised areas 5 days out it may be the case that these lines were over injected. Volbella is very thin and flies out of the syringe unlike other Juvederm products. It is easy to over do if the injector is not used to injecting this product. It wouldn't hurt to give it a few more days but other options would include massage of the area or even dissolving the product.

Lisa Jenks, MD · Answer

Swelling after Volbella (or any filler) can take 7-10 days to fully subside, so I would not be worried.  Volbella is supposed to be injected very superficially, and so I always tell my patients that they may be able to feel and see it for about a week after the injection.  You can certainly gently hold ice to the area a couple of times daily.  This would speed up the healing process.If, after about 10 days, you still have concerns, you should follow up with your injector.

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