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Lips Are Too Big After Restylane - Can I Get Hyaluronidase?

I had restylane injections in my top and bottom lips two days ago. I look like a duck! I have heard of Hyaluronidase, does is really work and are there risks? I do not want to have to hide out for the next 6 months but there is no way I am willing to go out in public either.

Sort 28 expert answers by:
+3

Reduce Big Lips after Hyaluronic Acid Filler

First, give yourself time to allow swelling to resolve. Most swelling after lip enhancement goes down in a couple days. As others have already mentioned, waiting a week is appropriate. Lip augmentation with hyaluronic acid injectable fillers such has Restylane or Juvederm is common today. Fewer cosmetic specialists are using collagen for lip enhancement. The lip naturally swells & bruises from the injection. Most of the swelling, which contributes to the increased projection and... more
Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
+2

Hold off on hyaluronidase after Restylane to lips

A number of things can affect swelling after Restylane injections to the lips, such as the amount, degree of bruising, where it was placed, and so forth. It is also not uncommon to feel that they are too big right afterwards, but just right when the swelling goes down. The thing with hyaluronidase is that it is usually "all or none" so you can't "fine tune" the results that way. There are some tricks and techniques to making lips look natural with HA products so it is... more
Richard Baxter, MD
Seattle Plastic Surgeon
+2

Lip augmentation

Although it is entirely safe to use Hyaluronidase to dissolve excessive Restylane that was place in your lips, you may want to wait a week or so prior to undertaking the procedure. Most injectors are striving for a natural and full appearance to the lips with the use of fillers. Multiple injections can lead to prolonged edema which can last days to weeks. Give your lips a chance to "calm down" and then reevaluate your results. If your still not pleased, Hyaluronidase can be used in... more
Philip S. Schoenfeld, MD
Chevy Chase Facial Plastic Surgeon
+1

Hyaluronidase 2 days after lip Restylane is too early!

You still have swelling from the needle sticks, and the tiny amounts of bleeding that always occur with these treatments. In addition, the Restylane absorbs fluid, and can provide more fullness than desired, especially for the first week or so. Like other answers here, I would definitely wait a week or so before asking for hyaluronidase (Wydase) injections to reabsorb some of the Restylane. If indeed you are larger than you wish, this works nicely. (Wydase is an enzyme that helps... more
Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
+1

Hyaluronidase will dissolve Restylane, but at two days, it is probably too early to treat

Hyaluronidase will dissolve Restylane. But at two days after injection, you are probably at the peak of the swelling and so do not have a true view of how things will look. I would wait several more days before removing the product, and then, rest assured that if you still do not like the look, it is possible to reverse the filler.
Elizabeth Lee, MD
Bay Area Plastic Surgeon
+1

Lip augmentation with Restylane

At 2 days after injection with a hyaluronic acid filer such as Restylane, the swelling is at its worst. Certainly give this at least another week before taking this drastic measure. Hopefully, you had seen before and after photos of lips done by the person that injected you and know that their results are in line with your aesthetic ideals. Hyaluronidase works well, but you need to wait before jumping the gun here. Best of luck!
Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
+1

Hyaluronidase can be use after Restylane

Hyaluronidase is okay to use after getting Restylane injections in your lips. I would first suggest waiting 1 to 2 weeks after injection and taking a antihistamine to see if the swelling is reduced. You lips will swell after the injection and you can use ice to reduce the swelling after the procedure.
Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
+1

Restylane and the lips - give it a week

Since you just had the filler placed a few days ago, I would give it a week or so for the swelling to come down. If you feel it still looks "ducky", then I would suggest hyaluronidase inejctions.
Steven Wallach, MD
Manhattan Plastic Surgeon
+1

Give Restylane injection for lips time

Some swelling after Restylane injection is normal and you should definitely wait at least two weeks to assess the result. In several months your lips will be back to normal. There can be serious allergic reactions to hyaluronidase and if used, you will likely lose the entire result. Definitely do not use hyaluronidase if you are allergic to bee stings, but if you do decide to go ahead, a simple skin test should first be performed to test for allergy.
Joseph Rabson, MD
Philadelphia Plastic Surgeon
+1

Swelling two days after Restylane

You most likely still have some residual swelling following the procedure. REstylane is a hyaluronic acid based filler. This material pulls water in from the surrounding tissue. This is why some of the results one sees immediately after injection are somewhat exaggerated. I would wait a few more days before considering something like hyaluronidase as they will likely settle down to a more acceptable size.
Ritu Saini, MD
New York Dermatologic Surgeon
+1

Restylane for the lips

Since you are just 2 days out from your procedure a lot of the swelling may be from the injection reaction and not too much volume. For most people, 1 syringe is usually appropriate for the lips.more than that can be too much for some people with voluminous lips to begin with.so first check with your doctor to see how many syringes were used. At 2 weeks if you feel your lips are still too big then hyaluronidase is the safest and quickest answer for sure. You will be back to normal in... more
Shawn Allen, MD
Boulder Dermatologist
+1

Hyaluronidase after Restylane in lips

20 units of hyaluronidase works quickly (within 24 hours) to reverse the volumizing effect of Restylane, Juvederm, and other HA fillers... However, 2 days after an injection it is very normal for the lips to remain a bit swollen. I agree that waiting one week is best. By then you'll know what was swelling and what was truly too much Restylane. As an aside, many of us find Restylane a bit thick for lip volumization. Next time you might want to try Juvederm instead, or Prevelle Silk, which tends more
Chad L. Prather, MD
Baton Rouge Dermatologist
+1

Swelling after lip augmentation is expected and common

If you are concerned about the swelling after lip augmentation that seems to be staying around and is not responding to cool compressions, talk to your physician about maybe doing a little intralesional steroid injection into the area(s) to decrease the inflammation and swelling. I would not rush into using hyaluronidase. It is not necessary at this time in your treatment. I hope you find my answer helpful.
Steven E. Rasmussen, MD
Austin Dermatologist
+1

Don't rush hyaluronidase after Restylane in lips

The swelling on the lips might take about a week to diminish. Lips swell very easily and could scare the patient into thinking that it is the product making the lips look unnatural. Best thing to do is put an ice pack for the first few days and give a total of 10 days before you decide if its too big for you or not. At that point, if it is still too big and duck shape, then hyaluronidase would be an option which would dissolve the product and allows us to get the result of your... more
Peyman Ghasri, MD
Los Angeles Dermatologist
+1

Swelling of lips after Restylane injectios will subside

Reserve judgement for one week after your lips are injected with any filler. It is not uncommon for first impressions to be overwhelming but as the swelling subsides and you adjust to the volume, the majority of Restylane users love their new lips. 
Lee Robinson, MD
Portland Facial Plastic Surgeon
+1

Big lips right after Restylane should improve

Don't panic--lips often swell for up to a week after Restylane depending on injection technique. Antihistamines by mouth (Benadryl, Zyrtec, Claritin) and ice help. Ask your physician about 2-3 days of Prednisone, especially for the next time. After a week, your doctor can use hyaluronidase to dissolve it. If your injector says this is unavoidable, find a different injector. it doesn't have to happen.
Margaret Weiss, MD
Baltimore Dermatologist
+1

Ice compress, oral Benadryl prior to hyaluronidase for Restylane/Juvederm swelling

Hyaluronidase is fairly straight forward in the hands of experienced injector; however, there have been reports of anaphylactic reaction. Therefore, you should always perform ice compress, oral benadryl prior to prior to hyaluronidase for Restylane or Juvederm swelling. It's critical for you and your injector to avoid excessive massaging after Restylane or Juvderm injection as doing so will trigger if not exacerbate post-treatment swelling which typically resolves in few days. more
William Ting, MD
Bay Area Dermatologic Surgeon
+1

Lip swelling after Restylane can last a week or so

If this is the first time you have had Restylane, do not panic yet. Swelling from lip injections can last up to a week or so and during this period it would not be advisable to use Hyaluronidase. Once you've waited a week or so, visit your injector if you still have concerns. If you do not like the look after a week then Hyaluronidase may be a good option for you.
Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
+1

Hyaluronidase after Restylane.

Hi! You have plenty of good answers.  You may have a lot of swelling.  Wait a month before doing anything.  If you are unhappy then, hyaluronidase is the answer for misplaced Restylane.
George J. Beraka, MD
Manhattan Plastic Surgeon
+1

Hyaluronidase after Restylane

The use of hyaluronidase for dissolving hyaluronic acid fillers such as Juvederm, Restylane, Perlane, and Teosyal is a safe and effective remedy to reduce any misplaced or overdone product. That said, there is typically some swelling and bruising (both visible and sometimes deep down invisible) that may settle out, so it's always worth waiting 2-3 weeks after filler injection to see if it will naturally settle out on its own.
Benjamin Barankin, MD
Toronto Dermatologist
+1

Restylane: Swelling at 2 Days is Normal

Swelling 2 days after Restylane lies within the Bell curve of what to expect. This is a little longer than a patient expects, but well within the parameters of what I have seen. The vast majority of patients are extremely happy with Restylane or Juvederm in their lips after 1 week. I advise you call the Doctor involved and speak to him/her or his staff for reassurance.
Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
+1

Wait before you get hyaluronidase for Restylane in lips

After 2 days is much to soon to entertain additional injection type treatments (Hyaluronidase). You MUST wait at least 2 weeks for the swelling if any decreases. I recommend use of iced compresses, possibly medrol dose pack (steriods by mouth foe 1 week), or the old 'tinture of time'. If after 2 weeks you still have deformities and significant swelling, go see the doctor injector. Than you can discuss injection options to decrease the swelling. Please, be careful, not in a hurry. more
Darryl J. Blinski, MD
Miami Plastic Surgeon
+1

Be A Little Patient

   You should wait until the swelling subsides and they you and the physicians can make a determined choice as to whether you would benefit from hyaluronidase. It saeems proper to me to wait a seek before any  drastic moves.
Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
+1

Wait a little longer

Swelling after Restylane can be significant, and can last up to a week in some people. Also, bruising can cause swelling, and can take one week to fully resolve. Don't panic yet. Give it some more time. Don't touch or play with the area. I wouldn't recommend that you get hyaluronidase unless there is a large lump or obvious asymmetry. When you inject hyaluronidase, it dissolves all of the Restylane. There is no way to "tweak" it, or to only remove a little. It is all or... more
Jordana Gilman, MD
New York Dermatologic Surgeon
+1

Lips always swell- Be patient

Don't worry, yet. If your doctor was experienced with fillers then it will probably turn out just fine. No one wants to look like a duck and that can happen if the lips were not properly filled. There is a great deal of skill in doing a great lip treatment. It requires experience and good judgment. The good news is that the hyaluronidase is there if you don't like the final result. Wait a week or two. Good Luck.
Robert F. Gray, MD
Bay Area Facial Plastic Surgeon
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