Q: I want to have Juvederm injected with hyaluronidase in my lips and have an appointment with my doctor today but have an evening social function. Will I swell a lot?

A: You may bruise and swell any time a needle is inserted into the lip. This is a location prone to showing effect of treatment, even up to a week or more. Don't do an elective treatment on the lip, if you can avoid it, the same day as an important engagement in case you swell and bruise significantly.

Q: Can I have Juvederm injections for smile folds while I'm on Accutane for acne?

A: If there is any open tiny cracks or sores from the excessive dryness and chapping that you may develop on Accutane, then it would not be prudent to inject the Juvederm or Restylane into those areas as there may be an increased risk of infection. If however, the skin is intact, then it might be fine. Of course your physician will examine the skin to ensure it is appropriate to inject the filler.

Q: Why does my cheek look more puffy after the smile fold was injected with Juvederm?

A: It is possible that your doctor was injecting immediately underneath the crease but your anatomy is such that the filler squeezed its way to the side near the cheek raising up its contour. If it is very obvious it can be injected with hyaluronidase to flatten it. Other times, it is more an issue of temporary swelling that the cheek is more raised. This will decrease over a few days and rarely, up to a week.

Q: I was on vacation and had some Juvederm injected into my smile folds but I am not happy with the result. I want it removed but will this leave a scar?

A: The method of choice for removing or lessening the amount of Restylane, Perlane or Juvederm Ultra/Ultraplus is not by surgical removal but by injecting hyaluronidase which dissolves the hyaluronic acid filler. This has been well tolerated by patients but there is a chance that there could be a cross reaction if the patient has a history of being allergic to bee stings.