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Lip Fillers


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More About Lip Fillers


LIP FILLER INJECTIONS 

Juvederm – injectable gel is a colorless hyaluronic acid gel that is injected into the lips. Hyaluronic acid is a naturally occurring sugar found in the human body. The role of hyaluronic acid in the lips is to deliver nutrients, hydrate the tissue by holding in water, giving the lips a fuller feel and look. Filler injections may be part of a comprehensive treatment plan including dental work and Botox. The treatment may require a series of injections over time to get the desired effect.

Filler injections may require regional nerve blocks or local anesthetic injections to diminish discomfort. Soft tissue fillers produce temporary swelling, redness, and needle marks, which resolve after a few days’ time. 

Continuing treatments are necessary in order to maintain the effect of fillers over time. Once injected, fillers will be slowly absorbed by the body. The length of effect for injections is variable typically lasting 4 months to a year.

ALTERNATIVE TREATMENTS 

Alternative forms of management include not treating the lips by any means. Improvement of lip fullness can be accomplished through alternative types of tissue fillers, or surgery. Risks and potential complications are also associated with alternative forms of medical or surgical treatment.

Lip Fillers: Pre-Injection Instructions

  • Have your injections done at least 2 weeks before an important event as you could initially have swelling, bruising or difficulty pronouncing some letters.
  • Avoid drugs like Motrin, Advil and Aleve (anti-inflammatories) for a day or two before having filler injected into your lips as this may increase bruising.
  • If you have started taking blood thinners or antiplatelet drugs, tell the doctor.
  • Avoid drinking alcohol (including wine) for 24 hours before your injection as this may also increase the risk of bruising.
  • Use acetaminophen (Tylenol) for pain.
  • If you suffer from cold sores, tell the doctor as you may be prescribed a medication like Zovirax to prevent a flare-up. If you have a cold sore, reschedule your appointment.
  • Don’t apply lipstick or gloss prior to your appointment. Lip protection (Chapstick) is fine. 
  • If you are very worried about the pain of injection, talk to the doctor about a topical numbing cream (EMLA) that can be applied at home before the appointment or having the lips frozen like for a dental procedure. 

Lip Fillers: Post-Injection Instructions

  • Most lips bruise and swell at least a little, usually on the second day, if you tend to bruise easily apply ice to the lips (10 minutes on, 10 minutes off) intermittently for the first day. 
  • If there is bleeding from one of the needle punctures apply gentle pressure with gauze or a fresh wet wrung out tea bag.
  • Apply a thin layer of Polysporin Ointment (or similar antibiotic ointment) to the lips to keep them moist for the first 2 days. 
  • Use acetaminophen for pain as necessary.
  • Avoid straws, cigarettes, kissing or other forms of puckering for 24 hours as this could displace the filler.
  • If you develop significant pain or darkening of an area of the lip or surrounding tissue which you do not think is just a bruise call the office. 
  • If you develop increasing pain, redness or swelling call the office.
  • Schedule a follow-up appointment 1 week post-injection.

More Information On Lip Fillers


Risks of Filler Injections

Every procedure involves a certain amount of risk and it is important that you understand these risks and the possible complications associated with them. In addition, every procedure has limitations. An individual’s choice to undergo this procedure is based on the comparison of the risk to potential benefit. Although the majority of patients do not experience the following, you should discuss each of them with your dentist to make sure you understand the risks, potential complications, limitations, and consequences of lip filler injections. Additional information concerning Juvederm may be obtained from the package-insert sheets supplied by Allergan Aesthetics.

Problems associated with the use of tissue fillers can relate to normal occurrences following tissue filler injections, or potential complications following tissue filler injections.

Normal Occurrences During Tissue Filler Injections

Bleeding and Bruising: It is possible, though unusual, to have a bleeding episode from a filler injection or local anesthesia used during the procedure. Bruising of the lips may occur. Should you develop post-injection bleeding, it may require emergency treatment. Aspirin, anti-inflammatory medications, platelet inhibitors, anticoagulants, Vitamin E, ginkgo biloba and other “herbs / homeopathic remedies” may contribute to a greater risk of a bleeding problem. Do not take any of these for seven days before or after filler injections. 

Swelling: Swelling (edema) is a normal occurrence following the injections. It decreases after a few days. If swelling is slow to resolve, medical treatment may be necessary. 

Pain: Discomfort associated with injections is normal and usually of short duration.

Specific Risks of Filler Injections

Needle Marks: Visible needle marks from the injections occur normally and resolve in a few days.

Lip Sensitivity: Itching, tenderness and swelling may occur following injections. After treatment, you should minimize exposure of the treated area to excessive sun or UV lamp exposure and extreme cold weather until any initial swelling or redness has gone away. If you are considering laser treatment, chemical skin peeling or any other procedure based on a skin response after filler treatment, or you have recently had such treatments and the skin has not healed completely, there is a possible risk of an inflammatory reaction at the implant site. 

Infection: Although infection following injection of tissue fillers is unusual, bacterial, fungal, and viral infections can occur. Herpes simplex virus infections around the mouth can occur following a tissue filler treatment. This applies to both individuals with a past history of Herpes simplex virus infections and individuals with no known history of Herpes simplex virus infections in the mouth area. Specific medications must be prescribed and taken both prior to and following the treatment procedure in order to suppress an infection from this virus. Should any type of skin infection occur, additional treatment including antibiotics may be necessary.  

Erythema (Skin Redness): Erythema of the lips occurs after injections. It can be present for a few days after the procedure. 

Under / Over Correction: The injection of soft tissue fillers to correct wrinkles and soft tissue contour may not achieve the desired outcome. The amount of correction may be inadequate or excessive. It may not be possible to control the process of injection of tissue fillers due to factors attributable to each patient’s situation. If under correction occurs, you may be advised to consider additional injections of tissue filler materials. 

Asymmetry: The human face including the lips are normally asymmetrical in appearance and anatomy. It may not be possible to achieve or maintain exact symmetry with tissue filler injections. There can be a variation from one side to the other in terms of the response to injection. Addressing this may require additional injections. 

Damage to Deeper Structures: Deeper structures such as nerves and blood vessels may be damaged during the course of injection. Injury to deeper structures may be temporary or permanent. 

Lip Lumpiness: Lumpiness can occur following the injection of fillers. This tends to smooth out over time. In some situations, it may be possible to feel the injected tissue filler material for long periods of time. 

Visible Tissue Filler Material: It may be possible to see any type of tissue filler material that was injected in areas where the skin is thin. 

Granulomas: Painful masses in the skin and deeper tissues after a filler injection are extremely rare. Should these occur, additional treatments including surgery may be necessary. Fillers should not be used in areas with active inflammation or infections (e.g., cysts, pimples, rashes or hives). 

Skin Necrosis: It is very unusual to experience death of skin and deeper soft tissues after injections. Skin necrosis can produce unacceptable scarring. Should this complication occur, additional treatments, or surgery may be necessary. 

Allergic Reactions and Hypersensitivity: As with all biologic products, allergic and systemic anaphylactic reactions may occur. Fillers should not be used in patients with a history of multiple severe allergies, severe allergies manifested by a history of anaphylaxis, or allergies to gram-positive bacterial proteins. Allergic reactions may require additional treatment. 

Drug and Local Anesthetic Reactions: There is the possibility that a systemic reaction could occur from either the local anesthetic or epinephrine used for sensory nerve block anesthesia when tissue filler injections are performed. This would include the possibility of light-headedness, rapid heartbeat (tachycardia), and fainting. Medical treatment of these conditions may be necessary. 

Antibodies to Fillers: Presence of antibodies to hyaluronic acid tissue fillers may reduce the effectiveness of this material or produce a reaction in subsequent injections. The health significance of antibodies to hyaluronic acid tissue fillers and other fillers is unknown. 

Accidental Intra-Arterial Injection: It is extremely rare that during the course of injection, fillers could be accidentally injected into arterial structures and produce a blockage of blood flow. This may produce skin necrosis in the lips. The risk and consequences of accidental intravascular injection of fillers is unknown and not predictable. 

Scarring: Fillers should not be used in patients with known susceptibility to keloid formation or hypertrophic scarring. The safety of patients has not been studied. 

Unsatisfactory Result: Filler injections alone may not produce an outcome that meets your expectations for improvement in wrinkles or lip fullness. There is the possibility of a poor or inadequate response from filler injection(s). Additional injections may be necessary. Surgical procedures or other treatments may be recommended in addition to additional treatments. 

Pregnancy and Nursing Mothers: Animal reproduction studies have not been performed to determine if Hyaluronic Acid Filler or other facial fillers could produce fetal harm. It is not known if Hyaluronic Acid Filler or its breakdown products can be excreted in human milk. It is not recommended that pregnant women or nursing mothers receive Hyaluronic Acid Filler or other facial filler treatments.  

Travel Plans: Any surgery holds the risk of complications that may delay healing and delay your return to normal life. Please let the surgeon know of any travel plans, important commitments already scheduled or planned, or time demands that are important to you, so that appropriate timing of surgery can occur. There are no guarantees that you will be able to resume all activities in the desired time frame.

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