Lip filler nodules harshing your look? We’ve got the answers.
Have you noticed strange lumps or bumps on your lips weeks after getting lip fillers? While a bit of swelling is normal at first, persistent nodules or painful masses long after injections may signal complications.
What causes lip granulomas, and is your pout at risk? How can you banish stubborn lumps for smooth, plump lips again? Read on as we explore the causes, symptoms, and treatments for this filler complication. With vigilance and prompt care, you can nip granulomas in the bud.
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A lip filler granuloma refers to a painful, abnormal lump that can develop after receiving injectable dermal fillers in the lips. Granulomas arise weeks or months after the injection as a delayed immune reaction to the filler material, as discussed in this NCBI study.
Dr. Soni explains that on a microscopic level, granulomas feature clusters of immune cells called macrophages that fuse together to surround the filler, attempting to isolate it.
This leads to concentrated chronic inflammation in one area, as your immune system continues trying to eliminate the perceived foreign invader.
Signs and symptoms include:
A lip filler granuloma typically looks like a nodule or lump in your lips or the surrounding tissue. You may notice the nodule feels firm or cystic when you press on it. It is usually movable under your skin and non-tender.
There may also be some associated swelling, redness, or hardness around the granuloma lump. Dr. Soni advises that on a microscopic level, analysis of the nodules shows:
A granuloma after lip filler injections is caused by an immune response to the injected filler material, triggered by contaminants, poor technique, or patient factors.
The symptoms of a filler granuloma include nodules at injection sites, swelling, redness, pain, asymmetry, hardness around bumps, and movable lumps in treated areas.
Lumps and bumps after receiving lip filler injections are common and usually temporary. However, there are a few potential causes to be aware of:
Some swelling and bruising at the injection sites are normal side effects that Dr. Soni says you can expect after lip filler treatment. This can make your lips feel uneven or lumpy for the first few days or weeks as the area recovers.
Gently massaging your lips can help smooth out the filler and reduce swelling. Dr. Soni also recommends applying ice packs to the treated areas to alleviate swelling and lumpiness. Any bruising and swelling should resolve on its own within 1-2 weeks.
In some cases, Dr. Soni explains the filler may be inadvertently injected unevenly or migrate slightly out of position when you smile or eat. This can lead to regions of too much or too little filler, causing a lumpy texture.
Massaging your lips and allowing time for the filler to settle can often correct this. If any lumps persist, Dr. Soni may use hyaluronidase injections to gently dissolve excess filler for smoother results.
Rarely, some patients may have an allergic reaction or granuloma formation from the filler material itself. According to Dr. Soni, this can result in firm, tender lumps that don’t improve on their own. Seeking prompt medical care is important, as steroid or hyaluronidase injections may be required to treat this type of adverse reaction.
Dr. Soni emphasizes that improper filler injection technique can increase the chances of a lumpy outcome. Selecting an experienced, qualified injector is important for this sole reason.
Lip filler nodules refer to small lumps or bumps that can form after you receive dermal filler injections in your lips. They represent a potential side effect of the lip augmentation procedure.
Dr. Soni advises that nodules may occur due to:
According to Dr. Soni, minor swelling, bruising, and small temporary lumps are common and normal after lip filler injections. However, more significant or persistent nodules are not normal and may indicate an issue with the filler placement or a complication.
Dr. Soni recommends that any nodules lasting longer than 2 weeks, or ones that are growing larger or more painful, warrant medical evaluation to determine the underlying cause and appropriate correction. Let our team know if you have any concerns.
Yes, granulomas can potentially form from lip filler nodules that develop after you receive the injections. As a reminder, lip fillers are dermal fillers injected into your lips to add volume and fullness. Nodules, which are benign bumps or lumps, are a common temporary side effect of lip fillers.
However, in some cases, Dr. Soni explains that these nodules can progress to form granulomas.
Dr. Soni advises that granuloma formation is an uncommon but potential late complication of lip fillers, occurring in 0.1-1% of cases. Granulomas usually develop months or even years after your initial lip filler injection, with an average onset of about 3 years based on medical reviews.
Importantly, not all nodules turn into granulomas. However, histological analysis shows many lip filler nodules removed from patients do contain foreign body granulomas upon examination.
The granulomas are thought to represent a delayed hypersensitivity reaction by your immune system to the filler material itself.
Based on our research, certain fillers like silicone seem more prone to causing granulomas compared to modern hyaluronic acid fillers.
Lip filler granulomas are treated with intralesional steroid injections, hyaluronidase to dissolve hyaluronic acid fillers, antibiotics for infection, and surgical excision for severe cases.
Dr. Soni advises that injecting corticosteroid medications directly into the granuloma is considered first-line treatment. Medications like triamcinolone or betamethasone are used.
The steroid helps resolve the inflammation and reduces the size of the granuloma. Typically, a series of injections every 4-6 weeks for several months is needed to fully dissipate the lesion.
The 2022 systematic review found that intralesional steroid injections and hyaluronidase injections are effective treatments for delayed-onset granulomas from lip fillers. The steroids help resolve inflammation while the hyaluronidase breaks down the hyaluronic acid filler material.
For granulomas caused by hyaluronic acid fillers, Dr. Soni may recommend hyaluronidase. This enzyme breaks down and dissolves the filler material when injected into the granuloma. Combining hyaluronidase with intralesional steroids can help facilitate resolution.
If infection is contributing to the granuloma, Dr. Soni may prescribe oral antibiotics like doxycycline along with intralesional steroid injections. The antibiotics help resolve associated inflammation.
In severe or refractory cases, granulomas may need surgical removal. However, Dr. Soni notes this can be challenging given granulomas often invade surrounding tissues and lack defined borders. Excision can potentially leave scarring or deformity.
A 2015 paper explains surgical excision of granulomas can be challenging due to ill-defined borders and the risk of scarring/deformity, which is why it’s almost always a last resort.
The prognosis is generally good with appropriate treatment applied promptly. Most granulomas resolve within a few months, though some take longer.
Lumps after lip filler typically resolve within 2-4 weeks as swelling and bruising subside; if persistent beyond 1 month.
Yes, you can get lip fillers with a cleft lip but choose an experienced injector and start with a conservative amount due to scar tissue; avoid overfilling to prevent more lumpiness.
Yes, you can get lip filler after a lip flip but wait 1-2 weeks for swelling to resolve so your injector can properly assess your lips; combine treatments for a subtle plumping effect.
Yes, lip filler can potentially cause mucocele by obstructing salivary gland ducts but this is uncommon; see your injector if a cyst forms for drainage or hyaluronidase.
No evidence shows delayed granulomas are more common after filler since COVID-19; proper technique minimizes this rare risk so see an experienced injector.
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