Swelling after a few months could be due to a few reasons: Late onset inflammatory response to hyaluronic acid. This is a rare complication which can occur 4-5 months after treatment but in extremely rare cases up to 14 months after. This information is readily treatable with oral steroids.
Inflammatory nodules can occur anywhere from days to years after filler placement and vary according to their etiology.
Why do dermal fillers cause swelling? Dermal Fillers commonly cause swelling and sometimes even bruising. The injection process disturbs the skin and soft tissue, causing minor trauma to the area, and swelling is a natural bodily response whilst the area heals.
Delayed-onset nodules occur in 0.5% of HA filler treatments, typically four weeks to over one-year post-treatment. These nodules are believed to occur due to either delayed onset inflammation or bacterial biofilms. Often, these nodules have preceding infectious or immune triggers.
You may experience considerable swelling during the first two days of getting a lip filler injection. However, this swelling should subside by the fourth day. If you experience extreme swelling three or four days post treatment, you should consult your doctor or dentist immediately, as it may be something serious.
Bruising may occur if an artery or blood vessel has become blocked due to filler injection. Bruising may range from a blue discoloration to a dusky purple-grey appearance. Swelling is likely to occur in and around the injection site if vascular obstruction is present, and may range from mild to severe.
Migrated lip filler is visibly noticeable and usually presents as lumps, but can also appear as a puffy upper lip, lack of a defined border between lip edge and above and/or below the lip border – think duck lips.
Severe allergic reactions to lip fillers are rare, but remain a possibility nonetheless. In some cases, patients have an allergic reaction to the Hyaluronic acid or polylactic acid (PLA) that is present in some fillers.
This is common and most likely to be a cross antigen reaction. In most cases it can be settled down with some anti-inflamattories over the next few weeks. Your injector would know exactly what to do to settle this down, most often it does not need to be dissolved.
Experiencing asymmetric fullness can also indicate an allergic reaction either from the medical ingredient itself or the liquid gel in which the ingredient is suspended. Allergic reactions are uncommon, so they should be treated with care. Other indications of an allergic reaction include tenderness and swelling.
If your lip fillers have migrated, it will almost always be noticeable visually. This can be presented in many ways; from a puffy upper lip, a lack of a defined border between the lip edge and above and/or below the lip border.
Answer: Swelling after lip fillers
It is not true that swelling decreases with second treatments unless less product and/or fewer needle pokes or cannula passes are needed. Swelling is mostly dependent on how much filler is used and the patient's innate tendency to swell.
Not to worry though, lumps following a filler treatment are completely normal. The lumps you may experience are often caused by swelling and bruising of the treated area. We would not recommend massaging or using force to reduce the lumps yourself, as this may impact your final results.
Over time, as facial movement increases in areas like the lips or cheeks, it causes the filler to break down and dissolve at a quicker rate. This makes the filler disappear faster in more active areas of the face.
These swellings commonly remained at the site of injection and disappeared with adequate treatment; however they are now infrequent. Clumping of a filler causes lumps and bumps that usually have to be surgically removed. Permanent fillers cause permanent side effects.
Delayed hypersensitivity is a common immune response that occurs through direct action of sensitized T cells when stimulated by contact with antigen. It is referred to as a delayed response in that it will usually require 12–24 hours at a minimum for signs of inflammation to occur locally.
Hyaluronic acid-based fillers are gels with a liquid-y formulation. The basic rules of science tell us that any liquid can move. However, migrating filler isn't necessarily an immediate effect. Instead, it's one that happens gradually over weeks, if not months or even years.
Tissue death (necrosis)
Although very rare, this is one of the most severe complications that can occur as a result of dermal fillers. Necrosis can occur immediately or a few hours after treatment.
Lip fillers aren't permanent. They slowly wear away over time, usually 12 to 18 months after you get them, depending on your metabolism. You may need routine touch-up treatments to maintain your desired volume.
DON'T: massage your lips.
Massaging freshly injected lips risks moving the filler around causing the possibility of desportation and undesirable results.
If you still have lip filler lumps months later, it may be time to dissolve the lumps using an enzyme called hyaluronidase.
Whilst it is somewhat normal to feel small lumps, depending on how thick the filler used was), if they feel one lump in particular, they can gently massage it in between their finger and their thumb, over a period of time, and it will help to “break down” the lump.
If you believe that your filler has migrated, then don't panic, as it can be treated. The beauty of modern-day filler is that it is semi-permanent, so over time your body will naturally break down and metabolise the substance.
An injection technique that uses fewer incisions, therefore creating fewer "holes" in the "hose," will be less likely to result in migration, says Dr. Durairaj. Creating fewer punctures on the border of the lip is always the cleanest and best technique, she adds.
You can get repeat treatments every six months. Scientists have found that hyaluronic acid injections prompt the skin to produce more collagen, creating more natural plumpness in the lips.