After Restylane - 5-fu or Corticosteroids Scar Tissue in Lip

Question

Thankyou for the advice I have recieved.I got my records and yes it actually was restylane injected I did bruise alot, so some have said that could have caused scar tissue. I have had the vitrase 3 days ago with no response, so far. Is it possible it will require more vitrase and multiple injections to remove these lumps? If it is scar tissue I am dealing with, would 5-fu be a good option instead of steroids to get me back to pre restylane state? I hate the unnatural ridge/bump my above lip.

Kenneth D. Steinsapir, MD · Answer

Three days should be enough to see a difference provided enough enzyme was injected. You did not indicate how much vitrase was injected. If the vitrase does not take down the volume issues, it is much more probable that notwithstanding your medical records, your doctor injected you with something other than Restylane. "Scar tissue" does not make lips look this way unless it is scar tissue organized around small droplets of silicone oil.

Ron Shelton, MD · Answer

Scar tissue can feel different from Restylane but a resolving hematoma may feel similar to Restylane depending at which stage the hematoma is in its lifespan. If this is thought to be overcorrection then you may need more hyaluronidase depending on how much was used and if it was diluted or used full strength.

Emily Altman, MD · Answer

I recommend waiting another week or so, even though the results of the vitrase should be visible fairly quickly after injection.

	If there is no response, I think it would be useful to do a very small biopsy of the lump area.  If done on the lips, these little scars are rarely visible.  But it would give a clue as to what is going on in the tissue and would guide firther treatment if necessary.

	Restylane and other hyaluronic acids do respond to hyaluronidase treatments.  If something else is going on, you need to know what.  Consult with a board-certified dermatologist with experience in lip augmentation and think about doing a small biopsy before undertaking any other treatments.

Steven Wallach, MD · Answer

Give the vitrase some times to work. I would wait two weeks before trying something else. Sometimes a drop of kenalog can help but I would wait.

Darryl J. Blinski, MD · Answer

You are in to much of a hurry! It takes time to see improvement. As for % FU I have limited experience with its use, just be careful. From MIAMI Dr. Darryl J. Blinski

Edward Lack, MD (retired) · Answer

5FU is best combined with cortisone for reducing scar tissue. Lumps due to restylane are best treated with hyaluronidase. Sometimes it is best to begin with repeat injections of hyaluronidase before proceding to 5FU.

After Restylane - 5-fu or Corticosteroids Scar Tissue in Lip

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