Is it normal to feel bumps in my lips 2 years after having filler?

Question

I got Juvederm lip fillers at a Dr's office, and almost 2 years later I still feel bumps in my lips. I went into a plastic surgeon's office to receive lip fillers, and it is almost 2 years since and although the filler has dissolved (and I never got fillers again). I can still feel a lump on my bottom lip that I felt initially when I first got them done. The lump has not gone away in 2 years, is this normal?

Philip S. Schoenfeld, MD, FACS · Answer

Unfortunately, this is much more common than reported.  Immediate lumps can be massaged but lumps that persist or even form months after filler injections to the lips is usually due to granuloma formation or local tissue reaction and not necessarily due to clumping of product.  I recently treated such a case from a patient who recently moved to our area.  Her injections were performed by a reputable surgeon but she formed granuloma's.  I used two rounds of hyaluronidase and steroids very judiciously in the areas with thicker tissue and no steroids and only hyaluronidase in areas with thin skin.  Reports of the use of 5-FU and other injections have been made but I have not had to use this on any patient.

Hung William Song, MD · Answer

Hi, if you received a hyaluronic acid filler in your lips, the product should have dissolved by now, however, we do find that sometimes, it can persist for years. If you have not done so already, you may want to see if it will dissolve away with hyaluronidase which is an enzyme that will dissolved the HA filler. Check with the doctor who performed the procedure to see if this is something they are experienced in doing, if not you can find someone who is.

Nima Shemirani, MD · Answer

Hi @curious010. You can dissolve the lump with a small amount of Hyaluronidase. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications.

Best of luck,

Dr. Nima!

Best of luck,

Dr. Nima!

Raffy Karamanoukian, MD, FACS · Answer

Longterm filler problems include migration, edema, and nodularity. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Robinson Facial Plastic Surgery - Alpharetta · Answer

Hello! Thank you for your question.
 No, it is not normal to still feel bumps in your lips years after filler. These bumps usually occur due to product choice or technique. If filler is injected underneath the muscle, it can cause bumps inside the lip that remain until they are dissolved. Fortunately, Juvederm is a hyaluronic acid filler that can be dissolved with an enzyme called hyaluronidase. Sometimes, multiple sessions may be needed. Please see a qualified provider who can provide treatment to remove your bump.

Leonard Grossman, MD · Answer

I see this in my practice very often when patients are simply unaware of things that are present even before the treatment. For those same reasons I carefully examine everybody's part of the body or the face before the treatment, while bringing to the patient's attention what I find and the payients are usually NOT aware of such lumps or bumps. As long as the bumps are not visible to the people around you, I would leave them alone and not have them treated. If you wish to have fuller lips you may go ahead and have them done and good luck from New York City plastic surgery

Chadi Dahabra, MD · Answer

recent studies are showing that some residuals from HA and other fillers persist way longer than what we previously believed. If the bumps you are feeling are HA then Hyaluronidase might help. It can also be a granuloma which is a known complication from fillers. Steroids,5-FU and other medications are used successfully here. 
It all depends on how much they are bothering you as well. If all fails , then a biopsy and histologic examination might be needed.
Hope this helps!

Alexander Ovchinsky, MD · Answer

Although not very common, the persistence of the lumps/nodules years after HA filler injection have been reported. This could be due to 2 possible reasons: a small portion of the filler clumped together and have never resorbed or there is a small granuloma formed due to prior filler injection.   The first problem is treated by a local injection of hyaluronidase to dissolve the filler. The second problem usually responds to local injection of steroid or 5FU.

Is it normal to feel bumps in my lips 2 years after having filler?

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