Q. I've been having fillers done for my lips for over five years. Last time I had a filler, I had a weird reaction. My lips hurt very badly, they got purple and I had little blisters around my lips. Is it possible that I have to stop using my fillers? I don't want to.
A. That’s a very good question. Injectables are not without risks. This is why it is important to go to a doctor who knows how to handle problems when they arise. Before having fillers done, your doctor will generally describe what the risks and benefits are with your procedure and will have you sign a consent form. All procedures have both risks and benefits.
There are a few things that probably occurred with your last injection. While rare, you could have had an allergic reaction. In addition, you could have had a herpes outbreak. Patients who have cold sores are more prone to have a secondary herpes infection. Another possibility is that the material that was injected went intra-vascular (in a vessel) or the material could have gone near a blood vessel and obstructed the vessel. This last problem could be very devastating and must be attended to quickly.
If the material goes into a vessel, it is a medical emergency and should be handled right away. You and your doctor should not wait for days to pass as this can cause tissue necrosis (death to the skin and surrounding tissue). You should call your doctor if your lip becomes red and you develop intense pain.
If you’re using hyaluronic acid fillers such as Restylane, Perlane and Juvederm, they are treatable with hyaluronidase. Hyaluronidase is an enzyme that will break down the hyaluronic acid and improve the situation. In addition, your doctor may have you take aspirin to increase circulation or recommend that you use Nitropaste, which also improves circulation. Under the extreme situation that you do not get better, your doctor may recommend bariatric oxygen. This also helps healing and increases circulation. While your situation is exceedingly rare, it is important to know what to look for and what to do.
Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email your questions to him at Cwolf@miamiplasticsurgery.com.