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

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.

Doctor Answers 12

Restylane and swelling

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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).

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Not smiling after fillers

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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. 

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

To smile or not to smile after Restylane

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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.

Fillers and smiling

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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.

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

Fillers and smiling

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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.

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

Hyaluronic Acid Fillers Do Not Require Specific Activity Limitations Following Injection

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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 “settle in”; 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 “complete correction” – 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 – 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…if you have a nice result you should be smiling. Best wishes, Ken Dembny

Kenneth Dembny, II, MD
Milwaukee Plastic Surgeon
4.9 out of 5 stars 36 reviews

Smiling after Restylane injections

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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. 

Ted Brezel, MD
Long Island Dermatologic Surgeon

Smiling after Restylane?

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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!

It is a goofy recommendation.

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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.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Restrictions after Restylane injections

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Everybody practices a little differently. I don't restrict activity in my patients, as it is impossible to walk around with a stone face. Life is too short! Swelling, however, can be quite significant, and shouldn't alarm you. Of course, your injecting physician is the best source for answers to these questions.

Barry Resnik, MD
Miami Dermatologist

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.