The hyaluronic acid is still there, but not the swelling

Restyland consists of hyaluronic acid, a natural substance.  Because of factors such as the crosslinking, thickness, free hyaluronic acid, etc.  hyaluronic acid products cause swelling.  After injection, a single syringe of Restylane may "act" as 2 or even 3 syringes, depending on the body's swelling response.  When that swelling subsides after about a week, patients have the impression that the Restylane has gone away, when in fact only the acute swelling has gone away.

There are differences in the metabolism of hyaluronic acid, from different areas of the face, differences between athletic patients and sedentary patients.  However these differences are noticeable on the order of months, not a week later.  There are also differences between different types of fillers.  Many patients have less swelling with Juvederm, and therefore see a more realistic "final result" earlier than with a filler that, with their physiology, swells more.

The most likely explanation for your problem is that acute swelling has subsided.  Some patients may wish to have their injections "staggered" so once some of the swelling has subsided, they have another injection.  This of course does not solve the issue of how to completely "fix" the nasolabial folds with a single syringe of Restylane, which may in fact be insufficient.

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Hi Jen RN,

Restylane needs to be injected in the proper level of the skin to be effective. If it is injected too deep, then once the initial swelling is gone, the fold may again be apparent. Some injectors may not be using the whole syringe. Restylane lasts from 6 to 9 months, will not disappear in two weeks unless it is injected with hyaluronidase.

Another common occurence is that a patient may really need more than one syringe for adequate correction of the fold, but for economic reasons do not have enough injected for complete correction of the fold. Both Restylane and Juviderm are both offering specials for complete correction where once you pay for one cc, the second cc is half price.

You should return to your physician and voice your concerns. Perhaps a second syringe will do the trick. It is important to choose your physician carefully and trust your physician with your face. Be well.

Dr. P

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