Had Ultra Plus in lips. After swelling went down, looks like there's no filler. Possible that fillers don't work on some people?

Question

I went back and we added a syringe of Restylane Silk. Again, after swelling, the result was barely noticeable. At this point, they added yet another syringe of Restylane Defyne recommended by the rep, after a week, my lips are back to normal. There is Barely a Subtle Difference from before I had any fillers. After 3 full syringes, it should be more than subtle. What's the deal?

Jason Emer, MD · Answer

This is difficult to answer without before and after pictures. If you're unhappy with your final results, you can have it reversed with hyaluronidase and try a different technique next time. These fillers, (Volbella, Restylane, Juvederm) are good to create a symmetrical and full lip. PDO Nova threads can also be used to improve shape and provide lift. Fat or implants are a permanent alternative. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Elham Jafari, MD · Answer

Hi and thank you for sharing your question! What you are experiencing appears to be out of ordinary. Fillers you have received are all based on hyaluronic acid - a gel that is naturally present in the skin - so one would assume that if your body is somehow breaking it down very quickly, it should be doing the same to your own natural hyaluronic acid as well. Of course not all fillers are created equally, and for many patients specially those who want to see fuller lips with longer lasting results, I usually recommend Voluma. Also with some fillers such as Restylane Silk, the results might be more subtle, so it would be best to do another follow up with your doctor and do an accurate reassessment including comparison of before and after pictures. I hope it helps and good luck!

Nelson Castillo, MD · Answer

Thank you for sharing your question and I am sorry that your results have not been what you anticipated.  It would be useful to see a series of images before and after your images, as well as your goal look so that the best treatment recommendation can be made.  After three syringes of filler I do agree with you that your results should be anything but subtle.  Some patients do have the ability at absorbing filler quickly but not within a week.  You may want to consider a second opinion on treatments.

Monika Soni, MD · Answer

Thank you for your question and I am sorry to hear about your experience. It is true that a small population of people absorbs fillers faster than normal. I think you may have better results with a firmer filler such as Restylane or Voluma. I recommend discussing your concerns with your injector. Best of Luck!

Michael S. Mall, MD · Answer

Hello and thank you for your question.  I am sorry you had a negative experience with fillers.  There is a very small population of people who simply absorbs fillers and there is no way of knowing until after the product has been injected.  I recommend you speak with a Board Certified Plastic Surgeon about a lip implant.

Zein E. Obagi, MD · Answer

Its hard to really comment on this without pictures. Please provide before and after pictures for us to analyze. In general, filling of the lip is done with very low g prime fillers. Sometimes some people need more filler than others. I would loop back with your MD and have him take a look to see if you want more.

Inessa Fishman, MD · Answer

While I do not think filler can be reabsorbed in a matter of weeks, I do find that some patients do better with firmer fillers (such as regular Restylane or Voluma) in the lips.  In my experience, these tend to travel or spread less than some of the softer fillers (like Restylane Silk or Juve Ultra).  Discuss this with your treating physician, and consider these fillers at your next treatment.  While there are permanent lip augmentation options available (lip implants, silicone, and fat grafting), in general, I prefer the hyaluronic acid fillers in the lips.  Good luck!

Dan Mills, MD · Answer

We use our lips constantly to talk to think to emote and in some people, filler just doesn't stay around very long. In cases like yours, you could consider using a lip implant. This is a silicone implant that is tucked into a tunnel that your surgeon would create under the mucosa and on top of the muscle to give that fullness to the lip that you desire. This is a permanent implant. My patients tend to think they feel natural and they like that their result will stay and that they don't need to come back for touch ups!. Make sure you see a board certified plastic surgeon to ask about these procedures. I hope this helps. -Dr. Mills.

Kiran Polavarapu, MD · Answer

It would be best to return to your injector and discuss your concerns. It is difficult to advise you without before and after photos and an exam. Good luck!

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many lip augmentation procedures using dermal fillers or lip implants for over 30 years.  It would be very unusual for the HA filler to all go away so quickly.  It's more likely that you prefer your lips fuller than the amount of dermal filler being used can achieve.   Following my beauty principles, the upper lip should be approximately 75 % the size of the lower lip for the lips to appear balanced. The lips can be augmented using a either more of an HA dermal filler or a Permalip implant.
 Dermal filers and lip implants offer a much more reliable volume for augmentation of the lips than permanent fillers or fat injections which are associated with increased, unwanted, side effects.
Hope this helps

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