Even as hyaluronic acid filler is injected into the lips, there is immediate swelling in addition to the added volume. The reaction of the tissue to the distension and the substance of the filler is what causes this reaction to occur. For many patients, there’s almost always some micro or even heavy bruising, which can also contribute to the swelling. This swelling can last for the first few days following the injection, which can cause lips to appear larger and then shrink. It may take up to two weeks for the lips to reach the baseline state.
Hyaluronic acid is broken down by the body over a long period of time, typically months. This timeline varies depending on the filler product and the cross-linking of the molecules. The enzyme hyaluronidase can be injected to dissolve the filler in just a few days thus restoring relatively normal lips. The result may not be fully appreciated for several days or even weeks, but it should last several months beyond that point. Generally speaking, it is better to under correct and add rather than to overcorrect and have to dissolve some of the filler.
For some patients, the lips are definitely better after a few days. Not only are they plumper but the lines indicating looseness of the labial mucosa have largely disappeared. If the patient wants more plump lips, then she should return to her injector and have more filler place which usually means increased cost to the patient. Parenthetically I am strongly against” permanent fillers”. Silicone injections which were used as fillers at one time created many complications. Nearly any substance which is not incorporated into the body’s tissue such as “permanent fillers” can be problematic. In addition, another factor which is not widely discussed is that injection of almost anything in the body whether medication or filler material will cause a body reaction including collagen formation or scar tissue. This has a very long life and can be seen or experienced in patients who have injections over a long period of time. As the filler is injected by advancing the needle, scar tissue can be felt by the injector and sometimes by the patient also. This is not necessarily bad because the collagen tissue can cause additional plumping. Side effects of fillers in the lips can include firmness leading to an abnormal feeling. Lumping either due to filler augment also is sometimes seen. Hematomas eventually will resolve but also can leave behind some minor scar tissue.