Thank you for your question.
You stated in your question that you had Juvederm about three weeks ago.
And that recently you developed a bump in your upper lip.
And that you're concerned about it but you want – you're afraid of using hyaluronidase
because you're afraid you'll might make things worse.
Well, certainly I can give you some guidance as to how these types of situations are managed
in my practice.
I’m a board certified cosmetic surgeon and a fellowship trained oculofacial plastic surgeon.
And I’m practicing in Manhattan and Long Island for over 20 years.
Lip enhancement is a big part of what we do with fillers such as Juvederm and certainly
this concern is not uncommon.
So I would suggest that first of all, you would want to communicate with the doctor
who performed the procedure.
You know, a lot of times, it is best to go back to the original doctor who did the procedure
because a lot of times they have their own individual style with how to approach this
type of issue.
Although the principles are still constant, but sometimes, the approaches can have some
variability.
So to begin with, I would say that – you know, the fact that the collection occurred,
the bump occurred relatively recently; but it’s still just about three weeks out.
You may have an opportunity to be able to massage this area down.
A lot of times with hyaluronic acid fillers and – of course, hyaluronic acid fillers
have different viscosities.
And a lot of times with thicker fillers such as Juvederm are chosen for their longevity.
But because their viscosity when they, kind of, collect, they’re – they’ll become
kind of hard.
In your situation, it may be amendable to just the movement of the mouth as you’re
speaking and talking.
There’s often this small movement, it could be described as kind of like the tide polishing
a stone.
Like an area that this elevated can kind of soften up with the action of muscles working
over and over this area.
Now if this still is relatively problematic or it feels like a hard ball, then going back
to your doctor, your doctor may be able to manipulate and massage the area to try to
even out a little bit better.
It’s a little bit hard at three weeks.
Usually when we do the sculpting part of this procedure, we see the patient, we do the – we
do it at the time of the procedure.
But the thing about lips is lips can also swell fairly quickly.
And sometimes it’s not always easy to tell if the material is distributed in the desired
way.
Now as far as hyaluronidase is concerned, certainly if it’s – if an area looks unusual
or it doesn’t look right, then I think hyaluronidase is a good option.
Hyaluronidase can be delivered in a very small amount and you can really reduce the material
to a level that would be hopefully appropriate.
Certainly your fear is well-founded that hyaluronidase can also dissolve more than you want and dissolve
some of the filler that you want to have around.
But as unfortunate, there sometimes the balance that you have to accept when you start doing
procedures like this.
It is part of the reality that if you want to have a certain augmentation and if the
tissue – and if the material does collect in an undesirable way, then if the massage
doesn’t work and the material doesn’t kind of even out, it still creates a bump,
then hyaluronidase is the way to go.
I think you should get – go back to your doctor and let your doctor feel it.
And a lot of times when we – when we actually examine the patient, you can feel how hard
it is.
You can – you can get a sense of what is going on as to what you can potentially do
to improve the situation.
And sometimes a little bit of hyaluronidase can go a long way.
So I hope that was helpful.
I wish you the best of luck.
Thank you for your question.