Can Juvederm go on top of Restylane in the lips?

Question

I had 1 syringe of restylane injected in my lips and the swelling made me look like a deformed duck for more than a week. When it settled down however it was not quite the volume that I'd like t to be (I let it settle for about a month). Could I get 1 syringe of juvederm (since the swelling was so bad with the restylane) injected on top of that next week? Will there be any weird side effects from the restylane still in my lips?

Anna Petropoulos, MD, FRCS · Answer

Thank you for your valid question. It is absolutely fine to inject Juvederm after Restylane and I'm sure you will love the results !When we inject lips, we carefully plan out exactly what the patient wants in the mirror together and only inject  half of what the patient needs so as to allow room for swelling and not to have a week of downtime. Then my patients can return a few weeks  later for the other half.  I also avoid filler types that are known for causing swelling. Other ways of preventing swelling is to inject in a very slow, gentle and meticulous manner so as to avoid any discomfort and also avoid internal bruising which can lead to swelling. Finally, the use of tiny needles that are imported from Germany also prevents swelling. Patients should  avoid NSAIDs, Vitamin E and Omega 3's  for 2 weeks before their injections for the same reasons. By implementing the above techniques, our patients hardly ever have any downtime. You may wish to consider the above as you proceed with your upcoming Juvederm injection so as to prevent any renewed swelling.  Best Wishes in your quest for beautiful lips !Dr. Anna PetropoulosBoston's North Shore

Gary Lawton, MD, FACS · Answer

As anyone with experience who injects these products would know, it is more difficult to inject new material over recounted injected filler.  It does not matter even if they are the same product.  The first time, the tissues are able to accept the filler wherever you inject it.  The second time, as you attempt to inject, it may be deflected by the material which is in place.  It is possible to perform this, but may present some additional technical difficulty for the injector.  It is not possible to predict, however, and it may be no significant problem at all. I prefer the viscosity, and longevity of juvaderm.

Young R. Cho, MD, PhD · Answer

I often combine two different filler products in the lips. One is more to volumize (eg restylane or juvederm) and the second is to smooth out the finer lines to give the lips a more hydrated and smoother look (eg restylane silk).   It sounds like in your situation, you're wanting a fuller look than what you achieved with one syringe of restylane.  Either using Restylane or Juvederm to add more volume would be an option at this point.

Jeffrey H. Spiegel, MD · Answer

You can certainly add a different material though the juvederm may cause more swelling.The key, I think, is to use a microcannula for the injection rather than a needle. This should result in significantly less swelling and the results you want.  We do this and it is both safer and more comfortable.

Jason Emer, MD · Answer

yes these can be put into the lips together if it was needed and they both can be reversed if one doesn't like it.  Best, Dr. Emer.

Louis C. Cutolo, Jr., MD, FACS · Answer

Yes, you can certainly inject
different fillers into the same areas. JUVÉDERM and Restylane are both
hyaluronic acids and are essentially they same, just processed differently from
different companies. Hyaluronic acids tend to attract water, and this may have
been the reason for your prolonged swelling. It is rare but does happen and is
more of a potential issue when injecting into the tear trough region. Other
than the usual potential for bruising and swelling, there should be no other
side effects from Restylane injections that would not also occur with JUVÉDERM.
Be sure to check with a qualified provider first, and best of luck.

J. David Holcomb, MD · Answer

Different injectable fillers can be used together in the lips in certain circumstances including not achieving enough volume or definition with the initial filler used.

Andrei Metelitsa, MD, FRCPC, FAAD · Answer

When it comes to lips, both products can produce great results. Although you noticed swelling associated with restylane, you should understand that the same swelling (or even greater) can happen with Juvederm when it comes to lip area. Typically it's best to top-up so soon after the initial injection with the same product especially in the fine area such as lips. However, given that both products are hyaluronic-acid, even if Juvederm were to be used in this area, you should not develop any major "weird" side effects from remaining restylane in your lips. Of course, your physician could also consider another option, which is to dissolve the restylane with hyaluronidase and then use a new vial of juvederm. To optimize your results, you should seek an expert board-certified dermatologist or plastic surgeon who has extensive experience with both products.

Michele S. Green, MD · Answer

Juvederm and Restylane can absolutely be layered on top of each other.  However, generally Juvederm produces more swelling than Restylane.  Be certain to consult a board certified dermatologist with experience with these delicate lip injections before proceeding.  Best, Dr. Green

Connie Hiers, MD, FACS · Answer

Juvederm and Restylane are basically the same product, but processed a little differently. They both can be used together. Remember, lips will initially swell to some degree. Cold compresses after injection can be helpful.

Can Juvederm go on top of Restylane in the lips?

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