Serious bumps and bruising after Restylane Silk injection in lips. Will they go away? (Photo)

Question

Yesterday I had a Just about an entire syringe of Restylane Silk injected into my lips. Reading from doctor "you have full lips, this will even it out." However, 75% of it went Into my top lip. Now it's so bumpy, you can see it. It looks gross and feels terrible. Is this something that will go away?

Harold J. Kaplan, MD · Answer

Hello,  Sorry to hear about your situation.  The lips, in particular can have much swelling after dermal fillers are injected.  Usually we recommend patients wait at least one week before coming in for a checkup because swelling can sometimes last this long.  Gentle icing, Ibuprofen, Benadryl, and a gentle touch will help hasten the process.  As one panel member suggested, we sometimes will prescribe an oral steroid to help reduce profound swelling.  We recommend contacting your injector to schedule a check up for their feedback.  Rest assured, swelling always improves.  If the lumps are not improving in the first week, your injector should be able to correct this using Vitrase.  Vitrase (aka:  Hyaluronidase) is an injectable mediation that quickly dissolves the lumps of product.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate
your question.Some nodules can occur from swelling and should resolve in 3-5 days.  However, in some patients injected with Restylane silk, swelling can last 2-4weeks.  You can ice the injected area off and on to help with swelling and take some benadryl in the evening as it may make you sleepy.  If swelling/nodules worsen or there is no change in 1 week, I would follow up with injecting MD to discuss best treatment options.  Possibly dissolving the filler, prescribing you some steroids for a few days to help expedite resolution of swelling.

The best way
to assess and give true advice would be an in-person exam.

Please see a
board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.

best of luck!

Dr Schwartz

Young R. Cho, MD, PhD · Answer

Swelling is expected after a lip injection with fillers.  I do see more with the Restylane silk as it is has a smaller particle size and can thus attract more water (i.e. swelling).  I have noticed less swelling as my technique has evolved to minimize any post-injection massaging, placing the product very superficially and using indirect injection techniques to get a more lip fullness by lifting the surround tissues.

Jason Emer, MD · Answer

It is common to get swelling after fillers into the lips.  It is not normal to have irregularities or severe swelling.  If you are unhappy you should speak to your physician and have the area injected with hyaluronidase, an enzyme that reverses the hyaluronic acid filler.  For the next injections, consider Restylane Silk with cannula injection, this technique will limit the pain, swelling or bruising after the filler placement.  It often takes up to two weeks for swelling to subside on its own.  Find an expert in filler injections for your future treatments.  Best, Dr. Emer.

Stanley Kovak, MD · Answer

I have found that Restylane Silk in most areas tends to give less swelling other than the lips. Lips give swelling with any product approved for lip injection, so a significant amount of swelling is not unusual. Typically with the lips being so vascular, bruising is also a common side effect. Some patients have found that Arnica can help reduce both swelling and bruising. Cold packs are a must to help reduce your swelling and they can also minimize bruising. As for the 75% placement in the upper lip, most likely this may just be due to the apparent increased attention to placement in the upper lip. Some patients do prefer a larger upper lip, as this look has become more prominent with the advent of the Kardashians, but in my experience, the upper lip appears to swell much more than the lower lip and after a short period of time, the swelling reduces and the appearance balances between the upper and lower lips.

Monika Soni, MD · Answer

Thank you for your question. It is difficult to give you advice without examining you in person. However, Restylane can feel a bit swollen and lumpy after injection, but this usually resolves within 1-2 weeks after injection. It is not common to be developing new lumps 2 weeks after injection. I recommend following up with your injector for evaluation and treatment. Best of Luck!

Michael T. Somenek, MD · Answer

It is completely normal for swelling to occur with Restylane Silk. Because it is such a "thin" product, it attracts large amounts of water in the first 24 hours. There are several ways to minimize this and I tell all my patients to avoid doing the following:1) Do not massage the area as this can increase swelling2) Do not place ice over the areaAlso, taking a Benadryl or alternative antihistamine that night helps to reduce the swelling. Best of luck.

Quenby Erickson, DO, FAAD, FACMS · Answer

In my experience, Restylane Silk swells more than some of the other fillers I use.  The swelling can be pretty extreme sometimes however it does go down after 2-3 days and tends to have a much more natural look than some of the other fillers. The lumps are likely to be smoothed out by the swelling. Swelling will also get worse if you are massaging or manipulating your lips, so try to refrain from that, and ice instead.  Finally, if the lumps persist after 2 weeks, you should go back and see your doctor, a small amount of massage to smooth it out at that point can be helpful or as a last resort the product can be dissolved. I hope that you love your lips in a few days!

Steven F. Weiner, MD · Answer

The way that Restylane Silk has to be injected, superficially with needle technique, leads to a little more bruising then when using blunt cannulas to fill the lips.  Also, the nature of Silk, smaller particle size, leads to more water absorption, therefore more swelling.  The small particle size also cause some spread of the product, leading to a smooth and more uniform appearance of the lips.  What you are experience is only temporary.  I would wait a week before deciding to do anything else.

Heidi A. Waldorf, MD · Answer

Swelling and bruising is not uncommon after filler injection in the lips.  In my experience, Restylane Silk swells more than the other hyaluronic acid fillers.  Patients are often quite swollen for 2 - 3 days.  However, once that resolves, they are happy with the results.  Be sure to call your physician.  She may be able to prescribe an oral steroid or diuretic to reduce the swelling.  Its also a good idea to let her know your response so she can help guide you with future treatments.

Serious bumps and bruising after Restylane Silk injection in lips. Will they go away? (Photo)

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