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How to Manage Bumps and Lumps from Cosmetic Fillers

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Someone asks why there are so many differing doctors’ opinions on the lumps and bumps that can happen after Juvederm application. Some recommendations they read say they require immediate medical attention, and others say it is a normal occurrence in the beginning of the treatment process.
New York Oculofacial plastic surgeon Amiya Prasad, MD, reviews these concerns in this video, and explains the different reactions to Juvederm treatment or different areas of the body:
1:17 - Dr. Prasad’s medical experience with different fillers over the past 20 years, and how there is a lot of confusion about them
2:07 - How Dr. Prasad believes in a natural look when it comes to fillers, notably in the lip area
2:50 - How Dr. Prasad uses fillers as a tool in an artistic way to augment lips, following established ratios for natural-looking beauty
3:38 - How treating volume in the lips involves different areas, and different levels of the tissue
4:13 - How entering the lips with a needle results in short-term reactive swelling, which can initially hide bumps from excess filler being placed
4:40 - How bumps from a little excess filler can be smoothed with just natural lip movement
5:02 - How Dr. Prasad normally sees patients after two weeks of filler placement to assess results, determine if there is any excess, or if additional filler is needed
5:33 - Factors of concern for filler placement include: pain, inflammation, infection, and or hardness, which requires more urgent medical attention
5:56 - How Dr. Prasad explains to patients to choose the right doctor, especially since fillers are increasingly commoditized
6:26 - How quality of follow-up care can be a concern when filler treatment is chosen by price alone
6:33 - Why Dr. Prasad treats filler application as an invasive procedure like surgery, as the needles break the skin and introduce a foreign material under the skin, so Dr. Prasad’s filler patients are treated like his surgical patients
7:18 - Why the relationship with the doctor and their ability to examine patients determines urgency, which is why many doctors on online forums recommend medical attention when people post photos
7:49 - Generally speaking, subtle irregularities of fillers, without any reactions, are not considered urgent
8:20 - How Dr. Prasad sees filler patients regularly and knows them since fillers do require maintenance
8:40 - How people can have fillers done by different providers, which do make it less consistent in application
9:13 - How fillers generally require about two weeks to settle before determining if any additional intervention is needed
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Опубликовано:

29 авг 2024

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Комментарии : 103

@life.as.victoria 4 года назад

Such a great video! You put me at ease. I'm 1 week out and worried about some slightly noticable irregularities. I think I may need to massage and wait another week. Thanks for all the info!!

@AmiyaPrasadMD 4 года назад

You're welcome, Tiffany Victoria Laguna! I'm glad the video helped you!

@wyngaardmarlene5199 4 года назад

Hello Doctor, I am going to have the lines on my upper lip filled I had it done 10 years ago no one could see what I've done my upper lip. I'm an ex smoker stopped 20 yrs ago. Keep up the good work doctor and your voice is very calming. Marlene Wyngaard

@AmiyaPrasadMD 4 года назад

Thank you for your kind words, Wyngaard Marlene! I did video recently about treating vertical lip lines, which may help you - ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-ZVb57Amvt1w.html

@twinsweare2 2 года назад

I had Juvederm fillers 3 weeks ago. This was done by an RN who is certified to do injections. I notice a hard lump on one side of the upper lip. I will go back since it looks like it didn't integrate with the surrounding tissue.

@AmiyaPrasadMD 2 года назад

I hope it works out well for you, Marlene Miller.

@claudetted198 Год назад

I have the same problome did you see your doctor is it ok now?

@Skittlesskittles-om6hp 4 года назад

The Best Doctor In The World....❤️❤️

@AmiyaPrasadMD 4 года назад

Thank you again for your kind words, Skittles31 skittles31!

@Skittlesskittles-om6hp 4 года назад

Amiya Prasad, M.D. Please accept my genuine comment. For I truly believe you are. You seem so caring about your patients and their needs. On your videos you take the time to explain procedures and the differences. A non caring doctor would not take the time and explain to random people . It not only shows you are a great doctor but it shows you are a true awesome human being. Not many doctors like you in this world. Be safe doctor. The advice you give is PRICELESS....GOD bless..❤️

@AmiyaPrasadMD 4 года назад

Hi@@Skittlesskittles-om6hp, I'm really happy you appreciate the work. I do these videos so people can make better, more informed decisions about cosmetic procedures. Thank you for your concern. I hope you and your family are also keeping safe through this challenging time.

@StAnger561to770 6 лет назад

Dr. Prasad I would say you are like the Picasso of (oculo)Plastic Surgery, but I am more of a Van Gough guy. Bravo! Dali was pretty good too.

@AmiyaPrasadMD 6 лет назад

Thank you Lev Can, but Picasso was an abstract artist who alters the look of his models so they are unrecognizable. I would consider my work to be more of an impressionist, not to brag, but because I believe in enhancing the unique facial characteristics of my patients so they look like better versions of themselves, with natural-looking results, so people still recognize them for who they are. It is common for many surgeons to make their patients look like a different person, which is the opposite of my philosophy and aesthetic style.

@dawi942 4 года назад

i’m more concerned about the texture of one side of my lower lips (only swelled where the needle was inserted) but it feels very tough to the touch. What is the correct technique for massaging?

@AmiyaPrasadMD 4 года назад

Hi dawi, You should bring this up with your doctor who performed your injection treatment for a proper evaluation before trying to attempt corrective action. I hope you understand I can't give you specific advice without diagnosing the problem with a physical examination. I hope this helps you.

@Lambecht 6 лет назад

A very interesting and informative video, thank you for creating it!

@AmiyaPrasadMD 6 лет назад

Thanks for watching, Rio! Glad you found it informative!

@monicastraub3372 Год назад

I had tear trough filler for the 1st time done 5 days ago. I have a small ridge that is going down under my right eye and a bit of a bump under my left. My doctor told me I can try to smoothen it out a bit with light touch finger massage. I'm afraid it will migrate? Writing this now I. 2023. There have been many reports of migration from this area. He told me it will settle at 2 weeks. He didn't ask me to set up a follow-up. I use them for other things. I guess he just expects that if there is a problem. I will just make an appointment. I also had sculptra done, I know this needs to be massaged 5,5,5. How many times can I massage my undereyes before it's a problem?

@AmiyaPrasadMD Год назад

Hi Monica Straub, Sorry to hear about your problem. It is standard procedure for me to see my patients two weeks after filler treatment to see how the filler material has settled, to observe results, and to see if additional enhancement is needed. If filler migrates, which I can generally prevent with placement technique, it tends to not move far from the intended location. I hope you understand that I can't advise how often you should massage your treatment area as I have not seen your condition, or know details of your treatment, so I suggest you get the specifics from your performing doctor. I hope this helps you.

@claudiazuma 6 лет назад

I had juvederm fillers around my mouth. Specifically marionette lines a week ago. I see Two bumps besides each injection site making my lines look hollow and deep. Can that be corrected with time?

@AmiyaPrasadMD 6 лет назад

Hi claudiazuma, It is possible, but I suggest following up with your doctor as I can't see the exact issue, and I don't know about details of your treatment. I hope this helps you.

@susanantoniades4296 6 лет назад

Dr Prassad hi I watched your video with interest as I had some hyaluronic injections nearly two years ago which have left me with several hard lumps. I have had them repeatedly treated with hyaluronidase but they haven't dissolved. Is it possible to have them surgically removed and if so how to I go about it?

@AmiyaPrasadMD 6 лет назад

Hi Susan Antoniades, Sorry to hear about your problem. I would need to physically examine you to determine if the filler was perhaps encapsulated, which made dissolving them difficult. Removal of these lumps depends on where they are in the skin, and their depth. I hope this clarifies things for you.

@laanmac1 2 года назад

I have a hard knot in my cheek right after 1 ml injection in both cheeks and 8 days later still here. Size of a nickel. Follow up is soon I have sent pics to Dr. He said it may resolve if not he can dissolve with hyalarindause but what else could dissolve it? It's very visible

@AmiyaPrasadMD 2 года назад

Hi laanmac1, Hyaluronic acid fillers are safely metabolized over time by the body, as the body has its own hyaluronic acid, which is constantly turned over by the body's own hyaluronidase. Your doctor may mean that the hard knot may be a temporary bump or lump of excess filler that may flatten out, or a reaction to the needle or cannula penetrating the skin. I hope this clarifies things for you.

@elizabethgrayson530 7 лет назад

Should you always feel "bumps" after injection? I had mine done last week and can clearly feel and see the bumps. Should there never be any "bumps" in your lips afterwards then?

@AmiyaPrasadMD 7 лет назад

Hi Elizabeth Elizabeth, Bumps can be avoided with good technique, but are nothing to worry about if they do happen. Keep in contact with your provider if they do happen, but normally some massage and settling of the material can resolve the bumps. I hope this helps you.

@Callisto000 7 лет назад

Thank you for the videos, very informative! I had my very first lip injection (only in the upper lip) one day ago and have a soft localized bump appear on one side pretty much immediately after the procedure. My upper lip in general has not gotten inflamed and has minimal bruises (barely seen). I was wondering whether i should try and massage it a bit or just leave it be and wait till my checkup visit to the doctor next week. Like I said, its a soft bump not a hard one so I don't know whether its simply a very localized inflammation or the filler just concentrating in that one spot.

@AmiyaPrasadMD 7 лет назад

Hi Callisto000, You can wait until your followup appointment, or call your doctor sooner for some advice. You can ease the material a bit with just movement (talking, smiling, moving your lips) this early in the healing period, but your doctor can give you more definitive recommendations as they know the details of your procedure, and can physically examine the placement. I hope your lip resolves soon.

@murielmorales5332 6 лет назад

Thank you very much for the video! So educational. I just got Voluma on my nose 2 Days ago and i feel a bumb in the middle area of the nose (like over the lip close to the nose). People don't see the bump but i feel it, it's kind of uncomfortable and it hurts a bit, but just a bit, like inflamation. My nose looks perfect but i feel this wierd kind of sphere. Should i call my doctor? Should I wait a little longer cause it could be just inflamation? Thank you very much and sorry for my english, im from chile haha. ☺️

@murielmorales5332 6 лет назад

Amiya Prasad, M.D. Thank you very much for your answer ☺️💕I'll listen to your words and wait for 3 more days. I'm always trying to improve my english, thanks for the compliment about it :)

@AmiyaPrasadMD 6 лет назад

Hi Muriel Morales, You're welcome! Glad you find the videos helpful. 2 days out might still be from swelling and healing from the procedure. If you still feel it 5 days out, you should have your doctor check it to be sure. Edit - just wanted to add that I do see my patients about two weeks after filler treatment after the filler has settled, and to see if there is any additional need for enhancement. Your English is quite good, and you should be proud of it!

@AmiyaPrasadMD 6 лет назад

You're welcome Muriel! Your practice has surely paid off! :)

@anaf4414 Год назад

How long after injection should I be worried of lumps?

@AmiyaPrasadMD Год назад

Hi @anaf4414, I answered your other comment in detail. Bumps are usually due to the injection technique, and can last as long as the filler itself, so the filler may need to be dissolved to solve this issue, and treatment started over with a placement technique that avoids lumps. I hope this clarifies things for you.

@missbrownskin0 3 года назад

I had hyaluronic filler (hyacorp mlf2) added primarily to the top of my butt. The dressing has left a slight bump and caused a dent in the middle of my butt, before it rounds out again at the bottom of my butt. I’m only 3 days post op but concerned with the shape after removing the plaster this morning. Will the dent smooth out on its own or should I start massaging now? The Dr recommended leaving it for 4 weeks, to see the full results. Please advise

@user-te5xq4sx2b 4 года назад

I’ve got a little bump under my top lip. Should I be concerned or is it normal and do I continue massaging? Thankyou!

@AmiyaPrasadMD 4 года назад

Hi Cece Girl, It's not clear if the bump was due to filler treatment. If it is, it should be safe to massage, but you should also consult the doctor who performed your filler treatment for a closer examination, or details of your lip anatomy or the procedure they personally saw during your treatment. I hope this helps you.

@user-te5xq4sx2b 4 года назад

Amiya Prasad, M.D. Thankyou!

@AmiyaPrasadMD 4 года назад

You're welcome, @@user-te5xq4sx2b!

@elizabethgrayson530 7 лет назад

I wish you lived near me! Would love to come to you to get it done, plus you are cute to boot!

@AmiyaPrasadMD 7 лет назад

Thank you Elizabeth! It would be great for you to come visit us!

@claudetted198 Год назад

How many times a day for massage and how long

@AmiyaPrasadMD Год назад

Hi claudette d, You should be asking your doctor who performed the procedure as I have not seen your results, nor do I know details about your anatomy, or how your procedure was performed. I hope you understand.

@Complexionprincess 4 года назад

I just got lip filler today and I can see and feel a big lump in my bottom lip. The opposite side of my lip has no lump and looks flat/don’t feel any filler. Does this resolve itself or should I be calling the injector tomorrow?

@AmiyaPrasadMD 4 года назад

Hi Shaleeka Pottard, I think it's better to contact your injector so they know there was a problem soon after your treatment. I hope this helps you.

@tivviapatel2660 3 года назад

Dr i had Chin filler 2 weeks back and expected sharp v face..instead i had Chin with deep line make it look like Chin dimple..and i have bump over there..when i asked my injector she said my Chin needs another 2ml filler

@AmiyaPrasadMD 3 года назад

Hi Tivvia Patel, If this was not done by a doctor, I advise you see a doctor about it as they do have more experience, and can make necessary corrections if needed, like dissolving filler and starting over. I hope this helps you.

@rimshazaman6610 3 года назад

Ive had a keloid from an industrial piercing before but I’ve got so many other piercings that were fine such as my belly, nose and earlobes, do you think getting lip filler would be okay?

@AmiyaPrasadMD 3 года назад

Hi Rimsha Zaman, The needle or cannula used with lip filler application is tiny, and should not cause keloid scarring. However, you should disclose the incident of keloid scarring with whomever you choose for your lip filler application. I hope this helps you.

@floydzepplin5025 8 лет назад

i just got juvederm voluma in my lips yesterday and i have some pretty bad and noticeable lumps

@AmiyaPrasadMD 8 лет назад

Hi mandi w an i, In the future if you don't like the way the filler was applied, you cal always have them dissolved with hyaluronidase if it's a hyaluronic acid filler such as Juvederm Voluma. Fillers in the lips can also be massaged soon after application for better consistency and smoothness. I hope this helps you.

@lisadee4490 7 лет назад

jake mckee me too

@ideklex 5 лет назад

floyd zepplin same I got vollure horrible experience I just want it dissolved

@miam5330 8 лет назад

I love your videos! So educational:). Thank you!

@AmiyaPrasadMD 8 лет назад

Thank you Mia M! I'm so glad you are learning from them. You are most welcome!

@shafeenaali5210 7 лет назад

Amiya Prasad, M.D. I had fillers where there now are noticeable lumbs I want to remove them I had injections to dissolve them but it didn't work what can I do

@saharachoudhury8335 4 года назад

Hi, I got my lips done like a week ago and they’re perfectly fine now apart from on my lip there is a viable bump on the outside of my lip which look a tad pale and I’m not sure what it means or what to do about it.

@AmiyaPrasadMD 4 года назад

Hi Sahara Choudhury, Sorry to hear about your problem. The bump could be where the needle penetrated your lips. I suggest you follow up with doctor who performed your lip filler placement for a proper diagnosis of the issue. I hope this helps you.

@asharanibhola4131 3 года назад

Hey...sir... When I was 12 year s old....In one accident, I had a lump in my lower lip....Now I am 21 years old....that lump looks bad....am feeling bad for that...sir plzz tell what should I do for that....it will looks disappear 🙏🙏🙏

@AmiyaPrasadMD 3 года назад

Hi Asharani Bhola, Sorry to hear about your problem, but I would have to examine your lip and lump before I make specific recommendations. I hope this helps you.

@fereshtebahaedini2520 2 года назад

Hello i d appreciate if u read and reply ; im so panicked,48 hours ago i had jawline filler 1,5 m each side, now it’s swelled and i feel bumps when i touch them,they’re not smooth! I saw my doctor she didn’t respond well enough, what should i do? Do they dissolve and become smooth under my skin or they’re gonna remain like this? Please reply😭🙏🏻

@AmiyaPrasadMD 2 года назад

Hi Fereshte Bahaedini, It's hard to tell what happened to you without seeing it. If a hyaluronic acid filler was used, it does metabolize eventually, with thicker fillers taking longer to metabolize. You can have hyaluronic acid fillers dissolved with hyaluronidase, but 48 hours after may be too early for the filler to settle. I usually see my filler patients again after 2 weeks to see how the material has settled. If they happen to not like their results, or were unhappy with results of filler treatment performed by another doctor, I dissolve the filler with hyaluronidase, then start over. I hope this clarifies things for you.

@alexandrastevan7587 4 года назад

hello doctor! almost two years ago I had ellansé injections (just a little of it) on the wrinkles of the sides of the nose. Now I have two lumps on the line of the jaw, they feel like little marbles, but dont hurt . Is this something dangerous and can it be fixed??? I´m worried!!! Please tell me what to do.

@AmiyaPrasadMD 4 года назад

Hi alexandra stevan, Sorry to hear about your problem. I don't use Ellanse in my practice, which can't be dissolved like hyaluronic acid fillers, but supposedly they can be metabolized. Encapsulation of the filler is possible, but a physical examination is needed to determine if this is the case. I suggest you see your original doctor about possible removal of the filler material as dissolution is not possible. You can refer to this recent video about encapsulated filler, however the dissolution treatment featured is only for hyaluronic acid fillers - ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-XY7RBviX0_o.html

@alexandrastevan7587 4 года назад

@@AmiyaPrasadMD thank you for your answer, if ellansé can´t be dissolved, is it dangerous??? Does it can be removed with surgery????

@AmiyaPrasadMD 4 года назад

Hi@@alexandrastevan7587, My understanding is that Ellanse is metabolized, but I don't use it in my practice. It may require surgical removal if the filler is encapsulated. This is a question best directed at your practitioner as they know the material, its safety, and its potential complications. I hope this helps you.

@alexandrastevan7587 4 года назад

@@AmiyaPrasadMD thanks much !!!!

@AmiyaPrasadMD 4 года назад

You're welcome,@@alexandrastevan7587 !

@mayharb1814 6 лет назад

I did hyalas twice to dissolve lip filler but i still feel my upper lip especially the philtrum area bumping up

@AmiyaPrasadMD 6 лет назад

Sorry to hear that, May Harb. I would need to examine your lip area before determining if you need further hyaluronidase treatment.

@claudetted198 Год назад

When can we start massage

@AmiyaPrasadMD Год назад

@Natalia-xc1yk 7 лет назад

Hello dear i had teoysal deep lines in my lips...AFter like 3 weeks I have noticed some bumps..It has been a month now and i would like to massage it but i am scared to make it worse? after this time will it even help? Please help!!!

@punanamousme8486 6 лет назад

I had Juvaderm removed (under eyes). Now there's a bluish/white haze in it's place.

@AmiyaPrasadMD 6 лет назад

Hi Alechia Patterson, Sorry to hear about your problem. You should see your doctor who did the treatment as they know details of your procedure. I would have to perform a physical exam and go through your medical history to say what the haze is.

@aprilsmith9422 4 года назад

On Thursday I will have had my lip fillers for 2 weeks I have a new bump every day. My lips look really good bit fill so bumpy

@AmiyaPrasadMD 4 года назад

Hi April Bechtold, Sorry to hear about your problem. It may be from your doctor using several pokes through the lip skin to add the filler, which I avoid by minimizing pokes through the skin. I suggest you follow up with your doctor to see if they can help you with it. I hope this helps you.

@urubanisar5886 6 лет назад

I feel lumps under my skin after my nasolabial fillers. It’s been 2 days. Is this normal?

@AmiyaPrasadMD 6 лет назад

Hi uruba nisar, There are variables with filler placement, especially with technique. It's best to ask your practitioner if you have concerns with lumps.

@JustMe-dn9fh 7 лет назад

How does the filler stay only in the area that is injected? How does it not migrate to other areas of the body?

@AmiyaPrasadMD 7 лет назад

Hi Lucky Blessed, Having fillers stay in the intended area depends on the skill, knowledge, artistic sense, and experience of the practitioner, and the choice of filler. If your practitioner has these attributes, then you should have nothing to worry about. I hope this clarifies things for you.

@angelajudd1018 5 лет назад

I got the white bump on the bottom of my lip in the corner the bad or good

@AmiyaPrasadMD 5 лет назад

Hi nolli Amber ruloff, A physical exam is needed to determine what it is, because it can mean many things. Do you have the bump after injectable filler?

@notyourbae19 7 лет назад

love your videos so informational thank you! how quick after getting your lips done should you start massaging? i dont want any lumps

@AmiyaPrasadMD 7 лет назад

Hi notyourbae 19, Thank you for your question. I generally suggest waiting a few days (to allow for some swelling to diminish) after lip injection with a hyaluronic acid filler like Restylane or Juvederm to massage an area if it looks too high or "bumpy". I see people who I've injected after 2 weeks to assess if any further adjustment is necessary. I hope this helps you.

@notyourbae19 7 лет назад

Amiya Prasad, M.D. thank you so much for your answer . unfortunately my doctor is far away so I cant simply go back in 2 weeks to see the doctor again but is there anything I can do myself? I haven't got much swelling more bruising. I really love my lips Im just adraid Ill get lumps if I dont massage them

@AmiyaPrasadMD 7 лет назад

Hi notyourbae 19, If you are happy with the way the filler has settled, then there is no need to massage them in place. Massaging is a way to spread the filler material out, and you aren't likely to get lumps if you don't massage them. If you are happy with the result, great! The result will last until the filler is gradually and safely absorbed by the body. I hope this clarifies things for you.

@mylinyanez6931 6 лет назад

notyourbae 19 hi doctor..i have my lips injected by collagen..but it’s almost 2years it’s still big and i don’t like it it’s an even and want to remove what she inject in it and don’t know what to do.

@AmiyaPrasadMD 6 лет назад

Hi Mylin Yanez, I would have to know the exact time of filler you used because collagen fillers have not been in the market for years, and are no longer made. The exact type of filler material is important as this determines whether they can be dissolved, or surgically removed. I hope this clarifies things for you.

@truestar070 7 лет назад

I had my lips done two days ago and I don't like it. How long does it take for the filler to get dissolved?

@AmiyaPrasadMD 7 лет назад

Hi truestar070, You can have a hyaluronic acid filler dissolved almost immediately with hyaluronidase. Sometimes, some filler does remain, which would require another hyaluronidase session. I hope this clarifies things for you.

@truestar070 7 лет назад

Thanks for your reply xx

@AmiyaPrasadMD 7 лет назад

You're welcome truestar070!

@beautifulnailco3473 6 лет назад

Such good info

@AmiyaPrasadMD 6 лет назад

Glad you found the video helpful, Beauty Obsessed!

@sevinhunsenol7192 6 лет назад

Hello just came by your video and want to ask a question. I got Juvederm ultra 3 injected to under eye area three days ago. A swelling and bluish discoloration occured after a few hours through the tear line. Today the swelling is likely to diminish but there is a visible lump and a very tiny nodule can be palpated. My doctor suggested doing a soft massage but I am very concerned if something will go wrong. What is your medical opinion about massaging under eye area? Thank you...

@AmiyaPrasadMD 6 лет назад

Hi şevin hun, Gentle massage is common after filler placement, but it is important to do it with guidance from your doctor. I hope this helps you.

@anaf4414 Год назад

2 weeks and still bumps

@AmiyaPrasadMD Год назад

Hi @anaf4414, Sorry to hear that. Bumps are usually due to filler placement technique, where multiple needle points inject the lip. The filler may have to be dissolved, and treatment started over with a more optimal technique to avoid bumps altogether. I hope this clarifies things for you.

@anaf4414 Год назад

@@AmiyaPrasadMD thank you so much. She's a well known doctor in my country and I trust her but this little bump worries me. She said to wait it's going to disolve by itself which I now start to doubt. She proposed if after a few weeks it's still here to disolve it. But I wonder if we do that if my lips are going to be asymmetric and if this substance to disolve is going to disolve my own hyaluronic acid. I had such a beautiful natural lips I regret so much.

@AmiyaPrasadMD Год назад

Hi@@anaf4414, Dissolving filler will not affect your natural hyaluronic acid, as natural hyaluronic acid is constantly replenished by your body. I defer to your doctor's advice since I have not physically examined your condition. I hope this helps you.