Question
Restylane side effects - What can I do to treat bruising after lip augmentation?
I had Restalyn injected in my lips yesterday. I made it clear to my practitioner that i wanted the results to be very subtle, that I was starting a new senior job next week and did not want to deal with any bruising or freakish swelling. They assured me that it would be fine and that I could even go out that same night. They also promised to be very restrained in how much they used - saying that i could always inject more later. Well, going anywhere is not a possibility and I'm really worried about my first week at work.
The biggest problem is the duck like appearance, an imbalance between my top and bottom lip and, most importantly, severe bruising which has turned the left side of my bottom lip black. Oddly enough my top lip is totally fine ( although they did do more injections on the bottom) I'm icing all the time, taking Benadryl and Arnica, and sleeping upright. I think the swelling will probably be gone by Tuesday ( start day) but I'm worried about the black bruising. It's even on my skin next to my lip. is there anything at all I can do to make the blackness dissipate? I can't even cover it with concealer. Does anyone know of any make-up that can cover black and blue lips? It almost looks like they're bleeding black and blue
Answers (6)
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1
October 14, 2008
You are doing everything you should be doing
Dear Black and Blue,
Keep doing what you are doing. Unfortunately you were not given the proper information. There is always a possibility of bruising and swelling and you should have been informed so you would have been prepared for the outcome. The bruising and swelling should subside over the next few days.
Kao Plastic Surgery
2
October 12, 2008
At this point, you are doing what you can...the problem was with the promise.
Answer by Michael Sinclair, MD
You are already doing the right things to help resolve the bruising. Keep it up and you the bruising will resolve. The problem is that there is no way any doctor can reasonably promise no bruising with any filler. The procedure requires that needle is going to be used to inject you. ANY needle poke in ANY living person can cause bruising! There are things that can be done to reduce the bruising. The most important part from the injection technique point of view is to avoid going too far posteriorly...that is where the lip artery is located. If you are light skinned, an IPL treatment might help get rid of the bruising a little faster.
As far as the duck lips are concerned, you are going to have to wait until the swelling and bruising is gone before you can truly evaluate the result. If there is too much filler in your lips, it can be dissolved with Hyaluronidase. Some people do very well with Restylane, others do better with Juvederm.
In order to minimize the brusing associated with lip enhancement, I do a number of things ....
- Long thin needles
- Vasoconstricting topical anesthetic
- Slow injection technique
- Avoid meds that cause bleeding for at least a week prior to injection
- Proper entry point
- Mix small amounts of vasconstrictors into the filler
Some of the techniques are off label, but very useful. But even with all my best efforts, I occasionally cause bruising. The point is, don't give up on the fillers. Find somebody with experinece and you will minimize the chance for side effects.
Michael J. Sinclair, MD
www.epilution.com
3
October 12, 2008
Bruising will subside with time
Bruising is a commong problem when injecting the lips. Over the years I have found that it is very important to avoid aspirin, ibuprofen, alleve and other anti-inflammatories for at least a week before your treatment. Alcohol, vitamin E supplements and gingko can also make you bruise more easily.
Regardless of the technique, bruising is common and you are doing the right thing to ice and take benadryl for the swelling. The swelling seen with Restylane will subside over the first two days.
Try to find a color stain lipstick such as Revlon's colorstay that stains the lip and hides the bruising then apply a gloss on top. Hope you look great!
4
October 11, 2008
You are doing all the right things, but make sure to avoid any aspirin, advil or aleve while healing
This is common, even with good physicians. The only thing that is a shame is that the doctor didn't tell you to not do it. If a patient tells me that they have a major event coming up, I tell them to avoid restylane in the lips prior to it for 2 weeks because it is always a possibility to have bruising and swelling. The good thing is that the swelling typically goes away soon (maybe 3 days), but the bruising is probably with you for about 2 weeks.
We sell a good makeup at our office, ColoreScience, that seems to cover it up fairly well, but you may still have a little bruising that shows through, even with it. In the future, make sure to avoid this type of procedure for two weeks prior to major events and make doubly sure that you avoid any aspirin or non-steroidal anti inflammatories like advil or motrin, etc before the procedure by at least a week. Also, avoid any herbal remedies or vitamins prior to it or you may have more bruising.
5
October 10, 2008
Dermablend or CoverMark are good coverup makeups
You are doing everything you can at this point. I would recommend not taking any alcohol drinks or aspirin nor advil for at least 5 days before your next injection session. Don't blame the restylane or the physician for the bruising. It happens regardless to the best of us physicians from time to time. It doesn't mean that it will happen next time so don't give up on fillers for your lips unless you want to go to the permanent (but reversible) implants that look and feel very natural. They run about $1500-2000 per lip but saves you alot of money and painful injections in the long run.
A good makeup is either CoverMark or Dermablend.
David Hansen,MD
6
October 9, 2008
Restylane bruising: Ice, Arnica, Auriderm, and pineapple... sometimes IPL
Answer by John Tang, M.D.
Here's my advice:
- I would continue to ice as much as you can.
- Arnica is also helpful. It is available in the gel form and in tablets. The tablets you normally would need to get at a doctor's office. You would take 4 tablets twice a day.
- I would have you eat fresh pineapple. The pineapple has bromelain which is a natural anti-inflammatory and helps with bruising. You would need to eat at least several servings. It has to be fresh since the canned ones lose the bromelain with age.
- Auriderm gel is also helpful. It has specialized form of Vitamin K which counteracts the bruising. It is most helpful when used right away but can still be helpful later. You can probably get this online but it would take some time before you get it. It would be helpful the next time you do it again (that's if you do it again).
- To actually treat the bruising, sometimes IPL (intense pulse light) can be helpful. I have used this especially underneath the eyes, and I have found it to speed up the recovery process.
Good Luck.
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10/11/08
The rate of reactions to RESTYLANE is very low. However, after the treatment some common injection-related reactions may occur, such as swelling, redness, pain, itching, discoloration and tenderness at the injection site. These typically resolve spontaneously within a few days after injection into the skin and within a week after the injection into the lips. Other types of reactions are very rare, but about 1 in 2000 treated patients have experienced localized reactions thought to be of a hypersensitive nature. These have usually consisted of swelling at the injection site, sometimes affecting the surrounding tissues. Redness, tenderness and rarely acne-like formations have also been reported. These reactions have either started a few days after the injection or after a delay of two to four weeks, and have generally been described as mild to moderate and self-limiting with an average duration of two weeks. This text does not contain all the information known about these products. For more information please consult your practitioner.