I have juvederm in my lower face; wondering if I massage the juverderm will it flatten out?

As a rule, whenever necessary, I typically massage volumizers and fillers immediately following treatment in order to mold, sculpt and smooth them. However, it has been shown that these products may still respond to massage up to a month following injection. Having said this, I just want to make the point that these days, most experienced injectors make certain that the rest of the face, particularly the cheeks and the mid-cheek regions, is properly volumized before directly treating lines, such as the marionette lines and smile lines. In fact, often these lines do not even need to be directly treated once the cheeks have been properly volumized. What's more, not uncommonly, if the marionette lines (or smile lines) are treated directly without prior treatment of the cheek regions, the look achieved may not be the desired one. In the case of smile lines, via direct injection, there is a risk of flattening them to the point of creating what is known as the "simian" facies--i.e. the smile line-less face of a chimpanzee. And in the the case of the marionette lines, there is the risk of giving rise to  linear mounds, which sounds like it might be the case here with you, or a distortion of the angles of the mouth. Finally, neither plain simple Juvederm nor ordinary Restylane would be appropriate for the volumization needed to accomplish the above. They are simple fillers, rather than volumizing agents, are best reserved for treating superficial lines and wrinkles. Make sure you are consulting and receiving treatment by a board certified aesthetic physician. Best of luck to you

Gentle massage will help smooth the treated areas and should not cause them to flatten out. Since every surgeon differs slightly on their post-injection protocol find out what exact instructions they want you to follow. 

I hope this helps,



-Dr. Angelos

Massage only can change the outcome of juvederm immediately after injection or if a lump forms.  If it has been in place for a while, massaging will not help and hyaluronidase is the only reversing.  Best, Dr. Emer.