When do you need a second opinion for Botox/Dysport issues and other filler problems?

Dear Dr Irwin, I had 1st time Juvederm in my nasal fold and my upper lip lines. He overfilled on 1 side of my upper lip and also overfilled that side nasal fold. I bruised very badly from my treatment although I did not feel any pain as he did a dental block. I called his office about 3 times the first week to report burning, tingling, crawling, pricking sensations. His staff told me they had never had anyone have such a thing and assured me it was probably nothing. 10 days after the initial injection I requested to be seen. When I told him what I was experiencing and wanted to know what to do and also pointed out a dark blue line in the area, he said to me, "You look better than when you came in, you can manifest anything into this you want and that I have stuff in my face" with that he dismissed me and I left. Very concerned I made an apt with my dermatologists assisting nurse 2 days later because he used to do injectables. I wasn't sure if I was having a complication but really needed to find out if this was permanent with the sensations. He told me he thought it was nerve irritation, possible nerve damage and likely would heal in time. He suggested I wait it out instead of doing Hyaluronidase right away. I noticed the sensations slightly subsiding in the NLF area and was only having some bouts of prickling here and there with an occaisional burning. My concern now in my lip is rather prickly and the overfilled side has a bit of a irritation in lipline, with some discomfort. I don't know if that is from being overfilled and is just tissue irritation? Would I be better off at this point to find a qualified Hyaluronidase injector and take that route or continue to wait this out? It has been a month since I had the Juvederm. I am just really concerned with having all these symptoms and now this irritation in lipline. Thank you!

Please get on the web and and try to find a board certified dermatologist (one who is experienced with fillers) who can see you ASAP. Once you find one, call their front desk staff and tell them that you are a new patient, but you need to get help fast, because you think you might be having a complication from a filler treatment from another office. Tell them you’ve really tried several times to get help, but it’s just not working, and ask if they please see you ASAP for a second opinion on the filler problems you described above. Hopefully that will help get you in the door.

If you need a helpful resource for finding a great dermatologist in your area, try my guide to regional offices here.

When DO you need a second opinion on filler problems?

  • When you’ve called your doctor’s office, tried to the best of your ability to explain the problem, and they just aren’t understanding that you need to be seen and working you in right away;
  • When you’ve been seen at your doctor’s office, but the explanation and treatment plan just don’t make sense to you and/or you’re not getting better;
  • When you are having a more serious problem like numbness, pain in the area, an odd blue color, unusually severe bruise, or blotchy red area. These can be signs that an artery was plugged (arterial occlusion). This is considered a medical emergency and you should be seen that day, if at all possible.

I know that many of the excellent derms in this country are very booked, and that can be frustrating; but most of us will absolutely help any patient in need who may be having a complication. The more you tell the front desk, the more they can try to help you!

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 skin care advocate.

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