Four Days and Still Not 100% Satisfied?

I spent $1770 on my Perlane injections ...3 vials. I still have quite a few wrinkles on the side of my chin. Left cheek has alot of lines still. I am pleased with the Marionette lines. (hope I am calling the areas correctly)....I don't know if I should be patient and will it fill in more. I do have a follow up appointment on Monday morning. I expected more for my money. I drank water as instructed, no bottle, no straw. I have a HUGE bruise under the left corner of my lip. Thinking of Botox

Doctor Answers 4

Swelling, bruising, new "lines", too many remaining wrinkles, and expectations with Perlane, Juvederm, and Restylane.

Didi, your question brings up many issues in the search for cosmetic treatment perfection. I often find the lack of "100% satisfaction" is often due to lack of informed consent, and a setting of realistic expectations. Dermal fillers like Perlane, Restyane, Juvederm Ultra and others can only do so much. They do not treat fine surface lines very well. They do a very good job at filling in hollows and loss of volume, in the right facial locations. They also do swell up immediately after treatment, which can make some new lines seem to appear where they weren't before, but which will ultimately smooth out if the treatment was done right. I agree with the other doctors who say to wait at least 2 weeks (I'd say 3 or 4) before going back to your doctor to assess what else can be done to achieve your goals. My advice is to be extremely clear and specific with the doctor about what your goals actually are. The doctor may think she knows what you want, and you may assume she does, but in reality you could both have different expectations entirely.

     At the end you mention "thinking of Botox". Just make sure you bring this up with the doctor. If you are thinking of it to "fix" the parts you now see that you are not happy with, you are likely thinking of Botox in the wrong way. It is generally not used for the areas that fillers are mainly used for, and it does entirely different things. Go in for a follow up conversation in a couple of weeks, and continue your journey with full information.

New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

Unsatisfied with fillers after four days

It's only been four days. This is far too early to assess the situation. You need to wait a minimum of 2 weeks to make any adjustments or additions for bruising and swelling to go away. Frankly, if you still have lines, you simply may have need more than 3 syringes. Depending on the depth of the lines and the number of areas being injected this simply may not have been enough filler for all that needed filling. Do not do Botox in these areas - it is not the same thing and will inhibit mouth and lip function. It is not a filler, it inhibits muscle movement which is absolutely not something you want in your cheeks!

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Perlane and swelling

It sounds like you need to allow time for the product to swell and settle down. It can take several days for you to see the final outcome, and following up with the provider as you've mentioned will help with your expectations. It's not uncommon to bruise, and those can last sometimes up to 2 weeks.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Unsatisfied after Injections

It has only been four days since your injections. I usually tell my patients that it takes up to 2 weeks for the filler to "settle" and "plump".  This is when you should see best results. Regardless, if you are unhappy, you should return to your injector and discuss your concerns with them. I am sure they will do what they can to make you a happy patient.

Matthew Schulman, MD
New York Plastic Surgeon
4.9 out of 5 stars 324 reviews

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.