Is Being Told Not to Smile for the First Day After Restylan Injections and Swelling Normal?

Question

I just got my first injections of Restylan from my nose to my mouth, cheeks, verticle lines in upper lip and drooping lines at the corner of my mouth. I am noticing alot of swelling, is this normal and how long will it take to disapear? My dermatologist told me to refrain from smiling for the first day or so to let the Restylan settle in. Is this normal? Does it realy make a difference to refrain...hard to carry on conversations today with such a serious look. Curious.

Kenneth Dembny, II, MD · Answer

Everyone experiences swelling after hyaluronic acid filler injections. There is likely to be more swelling when larger volumes of product are used, and/or if more injections (needle pokes) are used to administer the product. The swelling is likely to resolve in about 2-7 days depending upon the above. If you experience some bruising, your swelling will persist a bit longer compared to if no bruising occurred. Cool compresses are helpful for the first 24-48 hours.

	There is absolutely no reason why a patient cannot animate their face normally following treatment. The hyaluronic acid filler does not have to &ldquo;settle in&rdquo;; it is located exactly where it was injected, and it should not migrate.

	Filler longevity may vary based upon its location. Fillers placed in areas of the face that undergo significant movement (i.e. nasolabial folds) may breakdown more quickly than fillers that are placed in static areas (i.e. tear trough). Fillers placed in the superficial dermis may last longer than fillers placed deeper in the subcutaneous tissues. And of course, filler longevity is directly related to &ldquo;complete correction&rdquo; &ndash; achieving complete volume restoration in the anatomic area that is treated (the average volume to achieve complete correction of a single nasolabial fold at the time of initial filling with Restylane is about 1.4cc &ndash; based upon their clinical studies).

	On a similar note, some doctors tell their patients to repeatedly contract the muscles that were treated, immediately following the administration of a neurotoxin (ex: they are asked to repeatedly frown following treatment of the frown lines). This may increase the uptake of the toxin, but has no effect on the quality or ultimate duration of the result.

	Hope you enjoy your Restylane&hellip;if you have a nice result you should be smiling. Best wishes, Ken Dembny

Sam Naficy, MD, FACS · Answer

It's not uncommon for you to have a fair amount of swelling and/or bruising post dermal filler treatments...and the feeling of fullness. I don't think it can really hurt the product (for you to carry on regular conversations, however).

Kenneth D. Steinsapir, MD · Answer

It is very unlikely that normal facial movement such as smiling will cause the filler to migrate. Sometime doctors give advice that is not evidence based. And of course if the result is not to your likening they might even asked if you smiled after treatment! This is harmless advice. Goofy but harmless.

Stephen Prendiville, MD · Answer

I am not sure what the logical basis is for restriction of facial activity after fillers. There is no scientific data to back up this post-treatment instruction and this is not advocated in my practice.

Benjamin Barankin, MD, FRCPC · Answer

Not smiling after fillers is a hard thing to ask of people and I don't do it. That said, it probably wouldn't be the best idea to go to a comedy club the night that you were injected as there may be very slight displacement of the filler. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Hratch Karamanoukian, MD, FACS · Answer

I think those instructions are not practical and not helpful and quite surprising - similing, eating, laughing, making faces are unavoidable and I have not heard anyone else telling patients to refrain from smiling after inections with Restylane or any other products.

Kris M. Reddy, MD, FACS · Answer

Every injector has their own routines and directions for patients. However, not smiling is highly unusual. You should call the injector to clarify the instruction.

Steven Wallach, MD · Answer

I am not quite sure why your doctor does not want you to smile after the procedure.  It should be fine and should not impact the placement in my opinion.

Ted Brezel, MD · Answer

There is no apparent rationale for being advised not to smile after Restylane injections that I am aware of. Some degree of swelling is normal after Restylane injections and will resolve in most cases in just a few days.

Robert L. Kraft, MD, FACS · Answer

I've never told a paitent not to smmile after Restylane. It would have no effect on the effect of the product.  If you swell a lot, then smiling might be uncomfortable.  I hope your doctor advised you to apply ice packs during the first 48 hours after treatment to help reduce the swelling.  Keep smiling and hopefully the swelling will go down quickly!

Is Being Told Not to Smile for the First Day After Restylan Injections and Swelling Normal?

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Answers (12)

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