The bottom line is: go back and discuss your results with your treating physician/injector.

We live in a mobile society and the rave associated with soft tissue fillers is getting a great cosmetic ‘fix’ with a fast recovery. Restylane fits this bill. In general, downtime with Restylane and soft tissue fillers are minimal.

For several days following an injection of Restylane, there may be mild degree of swelling which can be confusing giving the appearance of a more complete fill.

If at three weeks you feel that you have lost the filler, then I would go back to the physician/injector to discuss your results. Hopefully, pre-injection photographs were taken so that true comparison photographs can be studied.

One of two scenarios will most likely present: the first is that you do have more clinical improvement than you appreciated, but simply need more filler material.

The second condition is exactly what you stated whereby you truly show little to no improvement and the nasolabial fold is completely back. This is probably indicative of Restylane being placed in the wrong area, and completely missing the deep dermis.

The bottom line is: go back and discuss your results with your treating physician/injector.

Thanks for your question.

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Restylane is a great product. One drawback that may be working in your situation is that it loves to draw water into itself soon after injection. Over the course of a few weeks it lets go of the water leaving behind product. Because of this peculiarity many who inject Restylane will underfill to avoid the "bee stung" look that is out of vogue now. You may just need to go back to your injectionist for a reevaluation.

The other thing that may be going on is that the injection was placed too deep ( deep dermal or into the subcutaneous fat). If that was the case, it would get processed very quickly and lose its effect. Restylane is very stiff. In experienced hands it is not difficult to feel it. Your injectionist should be able to tell you whether it is there (conservative initial fill) or not (too deep, all gone).

The reality is that there are better fillers for the nasolabial fold: Radiesse, Evolence, Sculptra, etc. You should investigate these for yourself. Good luck.

Dr. Shah
www.drmanishshah.com

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