How filler injection lip bumps can occur

Hello I had Juvederm in my lips 2 months ago and now I have a hard lump on my top lip. I have been massaging for a week now, however it’s not going away. My question is, Why do lumps occur? Many thanks Emily (22 years of age)

I’m so glad you asked this because it’s a very common problem. The below pertains to hyaluronic acid (HA) fillers only, and NOT Sculptra. Please avoid little plastic beads (Bellafil & Artefill), Radiesse (calcium based) or silicone (avoid!). If a bruise is large, very painful, dark purple or blotchy, it could be the sign of a small clogged artery. Call you doctor/provider if you are experiencing this! Filler injection lip bumps occur because too much filler was placed in that spot, the filler migrated a little after placement, there is a bruise there, or the type of filler used was too dense for your particular lips.

Filler injection lip bumps 7-10 days after

In general, most hyaluronic acid (HA) fillers will mature (I call it that) over the first week or so. They all have some degree of flexibility. The motion of your muscles around the mouth sort of mold them to your face in a nice way. These HA fillers look good initially and tend to look even better after a week or 10 days.

  • If a small filler lump is there in the first week, and there is NO bruise with it, these will usually smooth out on their own in 7-10 days.
  • If a small lump is there WITH a bruise, it will take more like 2-3 weeks. The swelling associated with the bruise should gradually resolve. It pays to just be patient and not massage these, so massage only once a day for a minute or so very gently. Rough massage will make the bruise worse.
  • A large lump with NO bruise in the first week means you need to call your doctor or nurse.

Bumps in the lips 1 week to 1 month

  • If there is a bruise, you may have some tenderness and swelling there for several weeks. Be patient.
  • As above, a large lump with NO bruise means you need to call your provider. An HA filler lump can be made smaller or completely removed with an injection into the filler of an enzyme called hyaluronidase.
  • If it’s hard to get back into your doctor, it’s reasonable to try GENTLE massage twice a day for about 1 minute for two weeks.  If it’s not gone by then, you’ll need your doctor! Gentle means GENTLE! You can actually cause irritation and make these look worse with too aggressive massage.

Bumps that occur later or last longer than a month

  • First, your doctor/provider can help figure out exactly what the bump is so call them!
  • Secondly, remember inflammation (makes the bump larger) can be caused by aggressive massage.
  • There are at least 20 skin diseases/problems that can cause bumps in the lips, in addition to a filler problem.

Hope this helps,  Dr. I

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