What is the Best Filler for Thin Skin? I Am Always Left With Lumpiness.

I have received injections in the fine lines around my mouth (smile lines) with Restylane and/or Juvaderm from different doctors (either board certified plastic surgeons or dermatologists)..while it gives a subtle improvement to the lines, it always results in lumpiness under my skin which to me, is more unattractive than the original smile lines. Are there any other fillers that are better suited to fill fine lines/wrinkles on a thin-skinned person and less likely to result in lumpiness?

Doctor Answers 9

Restylane and lines around the mouth

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It is very difficult to answer your question without seeing you in person, however, most dermal fillers, when injected expertly should help diminish fine lines around the mouth. It's best to follow up with your provider for smoothing and/or correction of lumps or bumps.

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

What is the Best Filler for Thin Skin?

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It’s really difficult to tell without either evaluating you in person, or seeing close-up photos of you.  Some fine lines can at times be softened and/or eradicated with the use of laser resurfacing or certain chemical peels.  Autologous fat grafting is also used in some lines and wrinkles.  In patients with very thin skin, I am even more cautious and I would suspect that the physicians you’re going to are also. 

Jonathan Ross Berman, M.D. , F.A.C.S.

Jonathan Berman, MD
Boca Raton Plastic Surgeon
4.7 out of 5 stars 19 reviews

Lumpiness after Fillers

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Lumpiness after fillers from bruising and/or swelling is normal and may last up to 2 weeks.

Beyond 2-4 weeks, continued lumpiness may represent lumpiness of the filler material related to filler choice and injection technique.  Diluted Restylane or Juvederm is a good option.

"Lumpy" Restylane or Juvederm can be dissolved with injectable hyaluronidase, if needed.

Robert Strimling, MD
Las Vegas Dermatologist
4.3 out of 5 stars 9 reviews

When injecting Restylane, technique matters

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Fine lines around the mouth can be treated successfully with either Restylane or Juvederm.  If your injector strictly fills the lines by injecting vertically, lumpiness is common.  The filler will make the concave lines appear temporarily as convex lines.  A better idea is to inject horizontally along the vermilion border of the lip (red-white junction), as this will leave a smoother result while eliminating or significantly diminishing fine lines.

Ronald Friedman, MD
Plano Plastic Surgeon

Fillers for lip lines

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I would suggest diluting the HA filler with lidocaine prior to injection which makes lumpiness much less likely.  This is considered off-label but done routinely to make fillers flow better and give smoother results.  The filler can be diluted with different amounts of lidocaine, up to a 1:1 ratio of filler to lidocaine.  The thinner product also can be injected through a tiny 32 gauge needle. 

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 28 reviews

Fillers in fine lines

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Fine lines may be best treated with LaViv although this is off-label.  The HA's for the most part may be ok but they can create a Tyndall effect if inejcted too superficially.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Lumpy fillers

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Lumps are not the result of the filler but the result of the way it is injected. Poor choice of filler for an area can also result in "lumps" but an experienced doctor should be able  to choose correctly. Restylane can be diluted top use in cutaneous lip(skin above pink part) and gives a smooth look. 

Jo Herzog, MD
Birmingham Dermatologist
4.8 out of 5 stars 20 reviews

Fillers for fine lines...

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Belotero is the newest HA filler on the market from Mertz Aesthetics and is working beautifully in my office for these particular types of wrinkles.  Always be sure you go to a reputable injector for these types of treatments.

Hope this helps.  Good luck.

Dr. Grant Stevens 

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 reviews

Good results are more dependent on the physician injector than on the specific filler

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Injecting fillers is an art as much as it is a science. Because of this, the effectiveness of your treatment depends on your physician’s ability to visualize the desired changes and to select and skillfully administer the best treatments alone or in combination. Albert Einstein is quoted as saying, “The only source of knowledge is experience”. Since every face is different, the experience and technique of your physician injector is the most critical part to your achieving a beautiful, natural result. Always ask to see before and after pictures of patients they have personally injected. If possible, look for someone who is on the medical education faculty for one of the facial fillers. If they have been selected to train other physicians how to treat the aging face they are likely to be good, experienced injectors. 

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.