How Soon After Restylane Can I Have Another Filler in the Nasolabial Fold Area?

I had Restylane in the nasolabial fold area 1.5 months ago. The bruising lasted 3 weeks but the effects seem to be rapidly deteriaorating to the point it really doesn;t look any different than before. I am 42 years old and never had this before. I was told the results would last 9 months. Can I have Radiesse (I have read longer lasting) now or how long should I wait?

Doctor Answers 12

Adding another filler after Restylane was injected into the nasolabial folds

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Hi Tylie,

  I agree with several of the other physicians in that you felt a "fuller" more desirable effect initially after the injections due to the inflammation. You didn't mention how much Restylane you had injected into your nasolabial folds (1cc, 2cc's, etc). In my opinion, one syringe of 1cc of Restylane used to fill the nasolabial folds of a patient in his/her 40's is likely not enough to produce much of an effect. Also, since it's only been a month and a half since you had the injections, it is highly likely that the product is still in place (your body would not likely have broken it down that rapidly).

  There is no need to wait any longer to have another filler (whether it is another syringe of Restylane, Juvederm, Radiesse, Sculptra, or fat from your own body injected into those sites). One thing to think about is that oftentimes - due to the progressive volume loss in the muscle/bone/fat in our face as we get older - we are losing the "structual support" that was initially holding the skin of your cheeks upwards and outwards. This results in flattening of the cheeks, more prominent nasolabial folds, as well as deeper/more noticeable "malar creases" (lines extending below your eyes near your tear troughs). Due to this loss of underlying support - depending upon your case in particular - you may want to consider Radiesse (or, my favorite deep filler of choice in this area - Sculptra) to raise those areas of your cheeks back up. This will subsequently result in your nasolabial folds appearing less prominent. Sculptra is indicated for use in the nasolabial folds themselves, so that is an additional option. However, I usually like to get as much correction as I can in the nasolabial folds by restoring lost volume to the cheeks and then going back and "fine-tuning" the nasolabial fold area - only if necessary - with a more superficial filler like Restylane or Juvederm. In my opinion, if your cheeks are starting to appear "flattened out" and you request that your practitioner focuses all of his/her attention into filling in the crevices within the nasolabial folds, the proportions of your face become somewhat distorted and the overall appearance can appear unnatural.

   Again, these are just my opinions, derived initially from what I learned while training with some of the most amazing mentors in our field during a cosmetic surgery and laser fellowship, and further supported by my own experience injecting several hundred patients.

    I hope this helped to answer your question. Good luck! MK

Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Can I get Radiesse after Restylane?

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Hi Tylie.  It would be interesting to have a picture to see what your nasolabial folds looked like and then to know how much product was injected.  It's unusual to have three weeks of swelling for the fairly common procedure you had.  

With that said, if you are not satisfied with the result and would like more correction for this area, then by all means, Radiesse is a great product.  It should last longer than Restylane, but also does have some swelling involved with injections so wait 2 weeks to see the results.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

No need to delay Radiesse injection

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It sounds like you may have been under-treated with the Restylane. Your initial 'result' that you noticed was probably just swelling from the treatment. My guess is that the product is still there, but you just needed more. However, if you would prefer to switch to Radiesse, that would be fine too. I get excellent results with both products, and it is true that Radiesse seems to last a little longer.

Ryan Greene, MD, PhD
Fort Lauderdale Facial Plastic Surgeon
5.0 out of 5 stars 85 reviews

No time restrictions on more fillers, but let swelling subside

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If your results dont seem adequate,  you may benefit from additional filler once the initial swelling has subsided.  This could be more restylane, or radiesse, as you mentioned.  The radiesse would likely be placed  deeper and support the restylane already there.

Christopher J. Peers, MD
South Bend Facial Plastic Surgeon

Radiesse can be used after Restylane or juvederm

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RAdiesse being a thicker and different filler than Restylane or Juvederm, can be injected now that your swelling is over. Radiesse is placed deeper to the Restylane. There are some patients that have such deep folds that I inject Radiesse deeply and Restylane superficially at the same visit, as a layered technique. There is a disadvantage though, that if a reaction occurs later (which is extremely rarely reported) then it would be hard to say which product caused the problem and then you might be forced to avoid two products when at least one is safe for you.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Fillers in folds

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The improvmeent you noticed may have been product and swelling. The product is probably still there.  You can fill it some more if you are unhappy with the final result.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Radiesse injections after Restylane

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Radiesse is a different type of filler then Restylane.  It is a hydroxyapetite filler and usually is injected deeper and may be longer lasting as it is a stimulatory filler.  It stimulates your body to produce collagen and in doing so may provide a more substantial longer lasting result.  Previous use of a hyaluronic acid filler such as Restylane is not a contraindication to using Radiesse as long as the swelling and bruising has resolved. 

Stephen Delia, MD
Boston Plastic Surgeon

After any bruise or swelling has resolved

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It sounds like you could do the Radiesse at any time now. I do not re-inject until all bruising or swelling is resolved. It is certainly OK to switch to Radiesse to see if you get a better result. Good luck

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

Radiesse Injection Need Not Be Delayed

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There is no reason to delay the Radiesse injection having had a Restylane injection 1.5 mos. ago.  The Radiesse can be injected somewhat deeper and should indeed last longer.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Combining Restylane with another filler in nasolabial folds

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You may need additional product, and either more restylane or radiesse can be used to provide corrrection. Contact your injector to have him/her evaluate and suggest a proper. The initial infammation may have been misunderstood to be correction.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.