Nodule formation following lip augmentation using porcine collagen-derived filler

In 2006, a novel, porcine-derived collagen filler (Evolence) was introduced to the Canadian aesthetic market. Evolence, unlike bovine-derived collagen, does not require skin testing and was marketed as an alternative to hyaluronic acid based fillers for augmentation of the lip and facial defects. The authors injected the lips of 20 female patients with the Evolence filler for the purposes of lip enhancement and/or augmentation. Sixteen of the 20 patients (80%) experienced multiple lip nodules despite firmly molding the product immediately after injection. Many of these nodules required further treatment. Some nodules regressed over many months, but some nodules were still quite visible in 6 patients over 1 year later. Given this direct clinical experience, it is the authors' conclusion that the Evolence filler should not be injected into the lips due to the high incidence of nodule formation.