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Robert M. Freund, MD answers: What to do when Restylane won't dissolve?

I had Restylane injected under my eye area a year and a half ago. It has not dissolved on its own.

It seems to have caused some extreme heaviness in my cheek area that has cause my mouth to look like its pointing downward. The left cheek is much bigger and both sides look different. Also, when I smile the cheek pushes up so high into the eye area and causes so many lines under my eyes it looks terrible.

Can I use something to remove it?


Robert M. Freund, MD
12 months ago
By Robert M. Freund, MD - New York City Plastic Surgeon

You are attributing a large number of findings related to aging to an injection of Restylane more than a year ago. Even if the Restylane was injected around the eyes, in an off-label use manner, the Restylane cannot be the reason for the corners of your mouth turning down.

The only filler that I have seen to cause the symptoms you describe is silicone microdroplets. I have had many patients who present for facelifts with silicone in their cheeks and describe the same symptoms.

Are you sure you got Restylane? If you would like, you could pursue another consult with another plastic surgeon for a second opinion. It sounds like the effects of aging and gravity have not waned in spite of Restylane injections, which is totally normal.

Best of Luck.

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More answers to “What to do when Restylane won't dissolve?”

A: You need a careful examination

David Shafer, MD
12 months ago
By David Shafer, MD - Manhattan Plastic Surgeon

Michelle,

The Restylane should be completely gone by now. You really need to either go back to your original injector or seek out someone who specializes in injections and periorbital surgery. It sounds like you may need some type of intervention, but you need a complete evaluation prior to rushing into anything.

David Shafer, MD

Web reference: http://www.DoctorShafer.com
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A: Restylane is not the cause

George J. Beraka, MD
12 months ago
By George J. Beraka, MD - Manhattan Plastic Surgeon

It sounds like you have a somewhat complicated problem that requires detailed examination. I doubt that Restylane is the culprit. Restylane would be long gone at a year and a half.

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A: Off-label use

Steven Wallach, MD
12 months ago
By Steven Wallach, MD - Manhattan Plastic Surgeon

Fillers in and around the eye are used in an off-label fashion.  Because restylane is a hyaluronic acid product, some physicians are using hyaluronidase to dissolve unwanted restylane.  This is also off-label use of this product.  It may not help a year and half later, because you may have a foreuign body tissue reacton to the restylane which should have broken down months earlier, or you have residual edema from the product.

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