Bumps in the lips after fillers in the lips.

Hi, I would greatly appreciate your advice. I had filler in my top and bottom lips November 2015. The injector used Teosyal filler. After about a week I started to develop tiny little bumps all over my lips and they would burn and itch after contact with any lip products. I went back to the doctor within 2 weeks and she was not concerned even though I had irritation all over the surface of the lips and hard bumps under my lips. After about 6 months of daily irritating bumps, hives, itching, etc. I had hyalaurondaise on the top and bottom lips. It did not help. I had three further rounds of hyalaurondaise over the following 8 months. The problems still persisted. It has now been over two years since the initial filler. I still have hard bumps in my lips as well as the surface irritation which is horribly unsightly. I have seen a number of dermatologists and no one has been able to help me. I’ve tried prednisone, various topical cortisones (somewhat helpful with symptoms but doesn’t help overall) and massage. I’ve had a blood test completed to rule out HSV. I’ve tried everything I can think of and no doctor knows what to do. I would greatly appreciate your help if possible.

My heart goes out to you on this: two years can feel like a very long time. I’m guessing you are in Europe? To any readers in the U.S., the Teosyal brand of hyaluronic acid-based fillers is NOT FDA APPROVED here yet as of publishing this. It’s available in Europe and other parts of the world. It’s made by Teoxane, a company headquartered in Switzerland. But to get to the point: there are different kinds of lip bumps after fillers, and they need to be approached and treated differently. Let’s go through the potential lip bump issues, both temporary and long term (like the question-asker’s).

Temporary lip bumps after a cosmetic filler treatment:

1. Soft, temporary lip bumps caused by filler misplacement:

This is often a misunderstanding between the patient and the provider. Good doctors/nurses take some time with patients to clarify the treatment goal. If you the patient want a certain shape of lip, but that’s not technically possible, then the results might not be good if the doctor tries it anyways. Or, a mistake is made in the amount or placement of filler in the lip.

How to fix it: This is easy to correct (with experience) by un-crosslinking the material with hyaluronic acid. Further filler might then be needed to achieve the desired goal.

2. Soft, temporary bumps on lips caused by a bruise while injecting:

Bruises are just a collection of blood under the skin, and can cause temporary inflammation, which feels like a bump. They aren’t always as visible as you might think.

How to fix it: If your lips are just a little puffy, or there’s only a small to medium bruise, give it a full 10-14 days to resolve. Avoid aspirin, ibuprofen and Aleve during that time. After the first 48 hours, try a little very-gentle massage, which may help. If not gone by then, have your doctor look at it. If the bruise/bump on your lip from the cosmetic filler is very large and painful (or just odd), call your doctor right away, don’t wait. You might have a piece of filler stuck in an artery, which is serious.

Firmer lip bumps that last longer after a cosmetic filler:

1. Firmer lip bumps that last longer than 2 weeks, but less than 6 months: 

See my point #1 if it is from a hyaluronic acid based fillers. These can be caused by non hyaluronic acid fillers, too. If the lip bump is cause by a filler like Radiesse, Sculptra (which is great for other places, but not the lips), silicone, Artefill, etc, see the fix below.

How to fix it:  If your doctor isn’t sure what these are, but they are gradually going away over 6 months – great.   Maybe just wait, use a little gentle massage, and try the fix in #1.  Another possibility is a minor infection causing the bump. A two week course of antibiotic may be helpful.  Ask your doctor. Steroids are not usually helpful in this situation.

2. Firmer bumps that last longer than 6 months:

This is the situation we’re focused on for the question.

How to fix it: First, you need to know what the bump is exactly. This can only be determined by a small biopsy of the actual bump. Then the pathologist can tell your doctor if the bump is material itself, an allergic reaction plus the filler, or something else. Make sure your doctor also has the pathologist stain for bacterial, fungal, and AFBs (acid fast bacilli). Please see this link to a piece I did on biofilms. Therapy should be based on the biopsy results. If you are in Europe, write again with where you are, and I’ll try to direct you to a clinic that might be able to help you. It’s too complicated to do this by yourself.

 

Lip filler safety note to all readers: PLEASE NEVER LET ANYONE INJECT A PERMANENT OR SEMIPERMANENT FILLER IN YOUR LIPS!

Permanent or semi-permanent fillers like Radiesse, Sculptra (great other places, but not lips), silicone, and Bellafill, Artefill or similar plastic bead based fillers. These fillers often have to be surgically removed. More of my answers related to filler problems here.

Hope this helps, Dr. I

Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skincare advocate.

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