Understanding Post-Procedure Complications with Facial Fillers
Subject: 29-Year-Old Female Seeking Guidance Hello everyone, I’m here to seek advice from medical experts or any individuals knowledgeable about complications following filler treatments, nerve recovery, or facial anatomy. In January 2025, I received Stylage Bi-Soft filler injections for my lips. I had those fillers dissolved twice using hyaluronidase in March 2025. I was assured that the filler had completely dissolved, and since then, I haven’t had any additional filler treatments. It’s worth noting that I have never had filler in my chin. Now, as we reach late June, I'm plagued with symptoms that are diminishing my overall quality of life. I still notice several firm, marble-like lumps in my lips. While some of these lumps are soft and moveable, others are rigid and unyielding. What concerns me the most is the presence of deep lumps in my chin area, which I can feel when I stretch my lip or apply pressure internally, despite never receiving any filler in that area. Although these lumps aren’t visible externally, they feel substantial when examined from inside my mouth. I am uncertain if this indicates migrated filler, encapsulated material, fibrous tissue, or an entirely different issue. In addition to these lumps, I’ve been experiencing continual sensations of flickering, zapping, and twitching predominantly near the outer edge of my lower lip and chin. Occasionally, I experience a sensation as if one side of my chin is being pulled downward. These flickering sensations are often accompanied by discomfort and nerve-like zaps, sensations I never encountered before the filler injections. There’s a noticeable tension that radiates from my lips to my chin, along with sporadic redness or warmth, particularly around the sites where trauma occurred on my lower lip. Additionally, the internal texture of my lips seems altered — feeling thicker, raised, or grainy. I worry that I have possibly caused damage to the collagen, fascia, or nerves in that region. I am actively attempting to facilitate my healing naturally. I’ve been taking a low dose of serrapeptase, which occasionally helps soften the area, although it appears to trigger the flickering sensations again. I've entirely ceased massaging the area, improved my diet, and reduced stress. Despite my efforts, I feel anxious and somewhat stagnant in my healing journey. I have a consultation scheduled for an ultrasound with Dr. Fahad Alam in Ontario on July 9, and I am also on a cancellation list in hopes of an earlier appointment. My main questions revolve around the nature of these deep lumps in my chin area, especially given that I have never had filler injected there. Is there a chance that the filler migrated and became encapsulated? Could this potentially be scar tissue or intertwined fascia? Is it common to perceive deeper tissue structures post-incident due to heightened nerve sensitivity? Do the twitching, flickers, and pulling sensations imply possible nerve entrapment or fascial tension? If I decide against additional dissolving procedures, is there a chance that these issues will resolve naturally over time, and if so, how long might that realistically take — weeks, months, or potentially longer? Additionally, could the Stylage Bi-Soft filler be linked to my ongoing issues, and would imaging be able to clarify whether there is any filler, fibrosis, or other abnormalities present? I deeply regret the decision to go through with the filler treatments. Right now, my focus isn’t on aesthetics but on finding relief from this pain, fear, and unusual sensations. I have never felt so emotionally distressed over what initially seemed like a minor procedure. If anyone has encountered a similar situation or worked with complications of this nature, your insights would be invaluable to me. I am open to all ideas, whether they be natural remedies, surgical options, or medical advice. Thank you for taking the time to read my post and for any support you can provide.
Answers (1)
6/25/2025, 7:40:51 AM
OpenHealth AI
I understand that you’re facing distressing symptoms following your filler treatments, and it’s normal to feel anxious when dealing with unexplained lumps and sensations. Your concerns about the firmness in your lips and chin, along with nerve-related symptoms, are valid and warrant attention.
Main Points
- The firm lumps you’re experiencing could be caused by several factors, including possible filler migration, encapsulation, or scarring.
- The twitching and flickering sensations may be related to nerve irritation or fascial changes.
- While some improvement might occur naturally over time, it's essential to have a tailored approach for management.
Explanation
Following dermal filler injections, it’s not uncommon for some individuals to experience residual lumps or changes in their tissues. This might occur due to the body’s response to the filler, which can sometimes lead to encapsulation (where the filler forms scar tissue) or migration (where the filler moves from the original injection site). The sensations you describe could indicate heightened nerve sensitivity in the area, which can happen after facial procedures.
Since you’ve experienced symptoms like flickering and discomfort that did not occur before the filler, it's possible that the nerve endings in that region might be irritated or compressed. This could lead to the sensations of pulling or tension you’re experiencing.
Next Steps
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Continue Your Ultrasound Consultation: Focus on your upcoming ultrasound on July 9. It will help determine the nature of the lumps and assess whether there is any remaining filler or signs of fibrosis.
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Monitor Symptoms: Keep a detailed journal of your symptoms, noting any changes in intensity, frequency, or new sensations. This will be helpful for your healthcare provider to make informed decisions.
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Limit Stimulation: It's wise to continue avoiding massage and manipulation of the area, as this may aggravate your symptoms. Stick with your diet and stress-reduction efforts to support overall healing.
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Discuss Treatment Options: During your ultrasound appointment, bring up your concerns about potential migration or scar tissue. Ask about non-invasive treatments that might help alleviate nerve irritation, such as physical therapy or neuromodulators, if appropriate.
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Give it Time: While you might be feeling anxious about the future, many post-procedure symptoms can improve over weeks to months. Healing patterns vary significantly from person to person.
Closing Thoughts
Your emotional distress is completely understandable, and it’s essential to focus on your comfort and quality of life above all else. Seek support from friends or professional counseling if needed during this time as you navigate your symptoms. Please keep me posted on your progress, and feel free to reach out for more specific guidance as you learn more from your consultation.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - 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Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.