How long do I have to wait until dissolving lip filler with hyaluronidase after injections? (photos)

Question

I got lip fillers three days ago and look absolutely horrendous. My lips are uneven, look completely fake and just terrible. I want to cry. I can't go outside like this or meet friends. How long do I have to wait until I can get the filler dissolved?

Nelson Castillo, MD · Answer

Thank you for your question and I am sorry that your lip augmentation results are not what you anticipated.  Due to the thin nature of the tissues of the lip they are predisposed to significant swelling.  You did not mention how much filler material you had placed but I would allow your results at least 2 and up to 4 weeks to fully mature before electing to pursue hyaluronidase.  Best wishes!

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

Anil R. Shah, MD · Answer

Best to wait about 2 weeks to see if filler will settle in. Early on can be due to edema.  Use hyaluronidase conservatively by an experienced injector.  Best Dr. Anil Shah

Donn R. Chatham, MD · Answer

Unfortunately in spite of attempts to achieve beautiful meticulous results using injectable fillers, sometimes excessive or uneven responses occur. Many fillers create unwanted swelling (big lips for example) and usually this settles down within a week. Sometimes a second week will be necessary. When excessive fullness, or ‘bluish color’ or uneven results persist and an “HA” filler has been used, this can be reversed using a dissolving enzyme such as hyaluronidase. This may require more than one session. One then starts from the beginning since the filler is now gone.

Jason Emer, MD · Answer

If you would like to reverse the fillers I suggest waiting 2-3 weeks to do so, swelling takes that long to resolve.  Best, Dr. Emer.

Millicent Odunze Geers, MD, MPH · Answer

It's been two weeks, so hopefully things have improved. If you have not already taken action, you may consider waiting it out another 1-2 weeks before having hyaluronidase injected. Hyaluronidase injection(s) will dissolve the filler if it's a hyaluronic acid filler (Juvederm, Restylane, Perlane, etc.), so be prepared for everything to go back to your baseline look.

Christian N. Ford, MD · Answer

Thank you for your question and for sharing your photographs.  Sorry to hear that you are having some concerns about your postprocedure appearance.  Please keep in mind that it will take 2 weeks to see your final result.  Swelling and bruising after filler injection is normal, especially in the lips.  Icing can help for up to 48 hours postprocedure.  Arnica can also help to minimize postprocedure swelling and bruising.  I would suggest giving it a full 2 weeks to allow for normal postprocedure swelling and bruising to resolve and to see your final result.  At that point, if you continue to have any concerns, please see your injector for an in-person reevaluation in order to best address your concerns and to determine the best course of action.  In general, any unwanted filler can be easily removed with hyaluronidase.  Best wishes!

Michele S. Green, MD · Answer

I would wait two weeks from the injection to let the product settle in.  If after two weeks you are still unhappy I would dissolve with Vitrase.  Best, Dr. Green

Justin Harper, MD - Account Suspended · Answer

Hi gettingthere2016,The lip swelling can be due to your body's reaction, the type of filler used and the injection technique. Swelling will be at its worst 1-2 weeks post-op. I suggest having the hyaluronidase only after all the swelling has subsided. This may take more than two sessions. It will also cause some swelling which will resolve in a few days.All the best,Justin Harper, M.D.

How long do I have to wait until dissolving lip filler with hyaluronidase after injections? (photos)

Answers (9)

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