Dear Dalal.Aldhafeeri, From your clinical history, it appears that eight years ago some type of soft tissue and dermal filler was injected into your lips. At this point in time, eight years later, if there is still some palpable remnant of the product or biologic reaction to the product, you would need to carefully weigh the options on whether removing the product will cause excessive scarring or deformation of the lips. It would be important to seek out the original physician to find out the exact name of the product by getting a copy of your chart. Some products, such as Artecoll®, Radiesse® and Sculptra®, elicit a biologic host response in production of your own collagen around the product. If the product has dissipated, you may be left with excessive collagen response and this may be treatable without surgery with simple injections. Conversely, you may have a long-term product that did not fade or dissipate and the actual product itself may need to be extracted. However, many products can be extracted with needle techniques rather than surgery, but in the final analysis, you may require surgical reduction of the product if it has left you with a lumpy, irregular and unattractive lip. This is clearly a difficult situation and you’ll want to visit with a plastic surgeon with extensive experience with soft tissue fillers and, importantly, removing permanent or long-term fillers or the consequences of those fillers. The good news is, done expertly and with great care and attention to detail, the aesthetic impact upon your lips themselves can be greatly minimized and, postoperatively, soft tissue fillers can often be deployed to restore contour, volume and shape safely and effectively. I hope this information has been of some assistance and best of luck. Sincerely, R. Stephen Mulholland, MD Certified Plastic Surgeon Yorkville, Toronto