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Restylane Effects Gone 2 Weeks After the Procedure

I had 1 syringe of Restylane injected into my left nasolabial fold about 3 weeks ago. I was immediately impressed with the results. However, after about 2 weeks, the wrinkle was fully evident again. Did the doctor do something wrong, or did my body reject it? What happened? I don't have that kind of money to waste. Thanks.

Asked 40 months ago by jenRN in Dayton, Ohio

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nasolabial folds

Restylane for smile lines: think about 2 or 3 vials

Generally the nasolabial folds are deep structures that benefit from significant volume. It was likely injected on the deeper side which can hide some of the fullness but if you inject it too superficially it may be too visible. One syringe is probably not enough for you and you may likely require two or three syringes. Obviously that presents a financial burden for you. The alternatives are to undergo other fillers such as Radiesse which pack more product into each syringe or to... more

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

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... more

Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

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... more

Stephen A. Goldstein, MD

Denver Plastic Surgeon

ASAPS ASPS

Restylane Gone Gone Gone

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... more

Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon

Much of the effect you saw was probably from the swelling

Jen, Most of the effect that you saw was probably due to the swelling. If the doctor took pictures before the injection, you should be able to compare them to what you look like now. Without more information, it is hard to tell if anything went "wrong." However, the Restylane is not metabolized within two weeks. The doctor may have under-treated, which is to your benefit. If they over-treated the area, you would have strange lumps and lines after the the swelling resolved. In all... more

David Shafer, MD

New York Plastic Surgeon

ASPS

That's no good!

When initially injected, the body’s swelling in response to the injection adds beneficially to the visible result. When that initial swelling subsides, the result may appear less full. Additionally, your injector may have deposited the Restylane deeply making the results less noticeable. Either way, return to your doctor and seek the answer. Choose an experienced and board certified Facial Plastic Surgeon or Dermatologist.

Yael Halaas, MD

Manhattan Facial Plastic Surgeon

Restylane lasts months, even a year or more.

Swelling may occur with fillers that can last in a rare case up to 2 weeks (usually only a day or two). It sounds like you were happy with the volume achieved from the swelling after your procedure. What you need is more volume from the Restylane, that means another syringe. The biggest problem with first time filler users is that they do not have enough volume (trying to get a result without using the proper number of syringes).

Susan Van Dyke, MD

Paradise Valley Dermatologist

Depth, skill of injector, and swelling all factors with Restylane.

I agree with what most of the other doctors here have said. Injecting filler too deep can be a waste of money and material. Injecting too superficially can leave lumps or bumps or blueish areas. The key is a balance between amount and location. For deep nasolabial folds, it may in some cases take more than one vial per side. It is not uncommon for the doctor to allow swelling to subside and then later place more filler.

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Jessica J. Krant, MD, MPH

Manhattan Dermatologic Surgeon

Restylane resolved quickly

If Restylane is injected into the mid to deep subcutaneous compartment underneath the dermis, it might be resorbed much more quickly than if it were injected into the superficial fatty layer immediately underneath the dermis. It might be worth another try, somewhat more superficially, or try the thicker and deeper counterpart of Restylane, Perlane.

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Ronald Shelton, MD

Manhattan Dermatologist

2 weeks is too short for Restylane effects to disappear

It sounds like one of two things are going on: It could be that the initial satisfaction you had was related to swelling and now that this has subsided, there may not be enough product to fill the area in question. It could also be that the product was injected incorrectly which will cause premature degrading. Either way, 2 weeks is much too short a time for the product results to disappear. We suggest as a starting point to go back to your injector for a checkup to further explore... more

Harold J. Kaplan, MD

Los Angeles Facial Plastic Surgeon

Nasolabial furrows often require several treatments

One syringe of Restylane may not be nearly enough for the correction of deep naso-labial furrows. It sounds as if your early satisfaction may have also been due to the immediate post-injection edema that is often present in the first week or so. Deep nasolabial furrows may require multiple treatments over several weeks, and we prefer Perlane, Juvederm Ultra Plus, or Radiesse for this area in most cases, since they are all a bit thicker. This area can even require some type of surgical... more

S. Randolph Waldman, MD

Lexington Facial Plastic Surgeon

May need more

Sometimes the initial improvement is a combination of inejction and swelling. If you notice under correction at 2 weeks then the swelling probably subsided and I would recommend further treatment.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

You might have a conservative injectionist!

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... more

Manish H. Shah, MD

Denver Plastic Surgeon

ASAPS ASPS

It was probably showing swelling initially and that went away, leaving you with less improvement

I tell people who do restylane or other fillers to be careful not to get too excited initially as that is mainly swelling. Additionally, I give my patients a mirror initially to look at the results and tell them it may get better after a few hours, but not to believe that these are the final results. If you liked this result, you probably need more. Additionally, it may be that the area to inject is actually the cheekbone area rather than the fold as that can sometimes lift the area... more

Joel Schlessinger, MD

Omaha Dermatologist

Restylane duration can vary widely

There are many important issues with dermal filling. 1. Do you have redundancy to the fold? 2. Is your skin very thick? 3. Male or female? 4. Who is injecting and do they do the procedure frequently? 5. What depth was injection done? In general, Restylane lasts 6 months. The improvement diminishes slowly over time, so 2 weeks is very odd if injected into right depth. It is certainly possible that you were under-treated, but since it is always easier to add than substract if you are over... more

Mary Lupo, MD

New Orleans Dermatologist

You probably needed 2 syringes

While injection techniques differ from doctor to doctor, when a patient feels that they didn't get enough of a result from Restylane after only 2 weks, it is almost always the case that they needed more product. This is especially true the first time you have the product injected because the fat below the Restylane will push down just as much as the skin will push up. After the first injection, as long as you don't let it all dissolve away, a second injection can be layered on top of the... more