A few milliliters are sometimes enough to change the appearance of a smile. In just a few years, hyaluronic acid injections have become one of the most popular aesthetic medicine procedures to reshape the contour of the lips, correct asymmetry or add more volume. Their success is based in particular on their temporary nature and the possibility of obtaining a relatively discreet result when the procedure is carried out well. However, this popularity sometimes contributes to trivializing a procedure that remains medical: unlike a cosmetic treatment, an injection consists of introducing a product into the tissues using a needle or cannula.
However, even if hyaluronic acid is naturally present in the body and generally well tolerated, its injection is not without risks. According to Health Insurance, complications can notably take the form of inflammatory reactions, infections, unsightly results or, more rarely, skin necrosis. Some occur immediately after the session, while others can appear several weeks or even months later. An important point to know before making an appointment.
Migration, small lumps under the skin: aesthetic complications that we don’t always think about
This is one of the complications that particularly worries people who have already had injections: the migration of hyaluronic acid. The product may move beyond the initially targeted area and create unwanted volume around the lips. The mouth can then lose definition, have a swollen appearance above the upper lip or give the impression that the natural contour has disappeared. This phenomenon can in particular be associated with an excessive quantity of product, repeated injections or an unsuitable technique. However, real migration should not be confused with simple post-injection swelling, which can temporarily change the appearance of the lips.
Another possible complication: the appearance of nodules, in other words small balls that are palpable or visible under the skin. They may be linked to an accumulation of product, poor distribution of it or an inflammatory reaction of the tissues. In certain cases, granulomas can also form: these are more complex inflammatory reactions around the injected product. The US Food and Drug Administration (FDA) lists nodules, granulomas and migration among possible adverse effects of fillers. These complications may require medical evaluation and sometimes specific treatment.
Infections, allergies, inflammatory reactions: sometimes delayed effects
Like any procedure that crosses the skin barrier, an injection also exposes you to an infectious risk. Bacterial contamination can cause a red, warm, painful, swollen area, sometimes accompanied by a fever. Non-compliance with hygiene rules, the use of non-sterile equipment or poor care of the injected area can contribute to this type of complication. There is also a risk of allergic reaction, in particular to certain components of the product or to the anesthetic used. In the most severe situations, a generalized allergic reaction can lead to anaphylactic shock, which constitutes a medical emergency.
What is less known is that certain inflammatory reactions can appear some time after the injection. The area may thus swell again, become sensitive or present redness several weeks or months after the session. The FDA particularly reports inflammatory episodes that can occur near a filler product after certain infections, viral or bacterial diseases, vaccinations or dental care. These manifestations do not systematically mean that the product was injected incorrectly, but they require medical advice to identify the origin and adapt the treatment.
The most serious risk: vascular occlusion which can lead to necrosis
This is the complication that health professionals particularly seek to avoid. In rare cases, hyaluronic acid may be accidentally injected into a blood vessel or compress a vascular structure. Blood circulation is then hampered and the tissues no longer receive enough oxygen. This is called vascular occlusion. If not quickly treated, this obstruction can cause necrosis, that is to say the death of the tissues concerned. The skin can then change color, becoming whitish, then purplish, and present unusual pain. This complication is particularly serious and requires urgent medical intervention.
The consequences can exceptionally be even more serious when the occlusion affects certain facial vessels connected to the ophthalmic circulation. Visual disturbances, including loss of vision, have been reported after filler injections. These accidents remain rare, but they remind us that aesthetic injections are never completely harmless. The FDA details these vascular risks, including the risks of necrosis, blindness and, in some cases, stroke. Intense or unusual pain during or after the injection, whitening of the skin or any change in vision should lead to immediate medical attention.
Can hyaluronic acid be dissolved in the event of a complication?
This is one of the often stated advantages of hyaluronic acid compared to certain permanent fillers: there is an enzyme called hyaluronidase, capable of degrading the injected product. It can be used by a doctor in certain situations, notably in the event of overcorrection, product-related nodules or vascular complications. It then makes it possible to reduce or dissolve all or part of the hyaluronic acid present in the tissues. It is also a solution sometimes proposed when the aesthetic result does not correspond to expectations.
Be careful, however, not to consider hyaluronidase as a guarantee of an immediate return to normal. Its use depends on the nature of the complication, the quantity of product present and its location. It itself requires medical evaluation and can lead to adverse reactions, particularly allergic ones. Furthermore, dissolution does not necessarily repair any damage already caused to the tissues. In the event of a suspected vascular complication, every minute counts: you should definitely not wait for a traditional aesthetic appointment to seek an opinion.
How to limit the risks before having your lips injected?
The first precaution is to choose the right professional. In France, hyaluronic acid injections for aesthetic purposes are reserved for doctors. Health Insurance recalls this regulation, as well as the need for a consultation prior to the procedure. You should therefore be wary of particularly attractive offers offered on social networks, in beauty salons or by people presenting themselves as professional injectors without being doctors. The Ministry of Health also warns of illegal practices and their consequences in its file devoted to cosmetic injections.
Before any intervention, a real discussion with the doctor must make it possible to assess the expectations, medical history, possible contraindications and risks specific to each person. It is also important to know the name of the product used, to check its traceability and to ensure that the practitioner knows how to recognize and manage a vascular complication. Finally, it is better to be wary of promises of spectacular results or repeated injections without re-evaluation. When it comes to aesthetic medicine, a natural result never justifies taking unnecessary risks. And above all, if the lips become abnormally painful, pale or purplish after an injection, or if visual disturbances appear, you must consult urgently.
FAQ: the most asked questions about hyaluronic acid injections in the lips
What are the risks of hyaluronic acid injections into the lips?
The most common side effects are swelling, redness, local pain and bruising. More rarely, infections, inflammatory reactions, nodules, product migration or vascular occlusion may occur.
Can hyaluronic acid injected into the lips migrate?
Yes. The product may move beyond the area initially injected, particularly when quantities are excessive or injections are repeated. This can change the contour of the lips and create unwanted volume around the mouth.
How long after an injection can complications appear?
Some reactions, such as swelling and bruising, occur immediately and usually disappear within a few days. Other complications, including inflammatory reactions or nodules, may appear several weeks or months after the injection.
Can hyaluronic acid injected into the lips be dissolved?
Yes. A doctor may use hyaluronidase, an enzyme that breaks down hyaluronic acid, to correct certain overcorrections or treat complications. However, this intervention is not trivial and does not always guarantee complete disappearance of the problems.
How do you know if a hyaluronic acid injection has caused a serious complication?
Unusual or intense pain, skin that turns white then purplish, significant redness accompanied by fever or visual disturbances should alert you. If vascular occlusion or visual disturbance is suspected, immediate medical attention is essential.
