Thank you for your question. I understand you had Juvederm 3 weeks ago, and you recently developed a bump on your upper lip that concerns you. You’re worried about using hyaluronidase because you feel it might make things worse.I can certainly give you some guidance as lip enhancement is a fairly large part of what we do with fillers, so this is not uncommon. I’m a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic surgeon, practicing in Manhattan and Long Island for over 20 years.Now, because the bump occurred quite recently since the procedure was performed, you may have an opportunity to massage this area down. The thing with hyaluronic acid fillers is they have different viscosities, and most of the time, thicker fillers such as Juvederm are favoured because of their longevity. However, because they are of a thicker viscosity, they do tend to collect and become kind of hard.In your case, wherein a bump has formed on the lip, it may be remedied simply by the movement of the mouth as you’re speaking and talking. It can be compared to the way the tide polishes a stone — because of the repeated action of muscles working over and over this area, an area that this elevated can eventually soften up.If the area still feels problematic or feels like a hard ball, then I would suggest for you to go back to the doctor who did your procedure. Your doctor may find a way to manipulate and massage the area to try to even it out a little better. Usually when we do the sculpting part of this procedure, we do it at the same time as the procedure, so it may be a bit more difficult to do this at three weeks. In addition, the lips tend to swell quite fast, so it’s not always easy to tell if the material is distributed in the desired way. Now, if an area really doesn’t look right, then hyaluronidase is a good option. It can be delivered in a very small amount which can really reduce the material to a level that is hopefully more appropriate and satisfactory. I understand your fear of hyaluronidase dissolving more filler than you want. It is part of the reality of lip augmentation that if the material does collect in an undesirable way, and massage doesn’t work, then hyaluronidase is the way to go.I suggest that you meet and discuss this with the doctor who performed the procedure so you can get a sense of what is going on, and what you can potentially do to improve the situation. Keep in mind that it would be best to go back to the original doctor who did the procedure, because most of the time, doctors have their own individual styles of approaching this type of issue. The principles of treatment are constant, but sometimes, the approaches can have some variability.I hope that was helpful and I wish you the best of luck!
