Should I have firmness, swelling and pain after 5 days with Restylane Lift?

Hi and thank you for your question. Swelling is a common minor adverse event that can occur after the injection of dermal fillers (or anytime a needle is placed into the skin) and may cause the skin to feel firm. Fortunately, this is temporary and there are ways to help minimize the effects. Arnica (a homeopathic medication used to help alleviate bruising, swelling, and inflammation) can be take a 2-3 days prior to your injections. During and immediately post injection, it is important to apply ice to the area being treated. Post injections, we apply a topical Arnica gel and provide Arnica tablets, which has been found to significantly prevent and reduce any bruising and swelling.
It can take up to 2 weeks for the adverse events to resolve and for your fillers to be settled into your lip tissue. If you’re unhappy with your results or the lumps do not resolve, the filler can be reversed with hyaluronidase. I hope this helps.

Yes, this can be typical. I would wait a full 2 weeks before judging the results. If it is after the two week wait, you can have the filler reversed with hyaluronidase.
I hope this helps!

It is not uncommon to have swelling and pain after filler injections. Sometimes they are just fluid accumulation (edema) from having needles and product under your skin, and sometimes they are due to hematomas. A hematoma is a collection of blood under the skin.  It might be too deep to see the actual bruise caused by the blood, but they cause swelling and can be quite painful. Or you may just be very sensitive to injections and product and have prolonged swelling. I have never seen this issue last longer than 2 weeks, but 5 days can be normal. I would want to see my patient again in the office if this persisted longer than 7-10 days. Hang in there. The issue is very likely to resolve over the next week and if it seems to be getting worse instead of better you should go see your injector and have them look at it. I think you will have nice results when the swelling resolves, and hope you enjoy it in the end. Sometimes this can be avoided by using cannulas for placement - you did not say if needles or cannulas were used. We just started using a bruise and swelling treatment called OcuMend, which we expect will improve this problem for our filler patients. We love Restylane Lyft and hope you ultimately do too. -Dr. Jenny

I'm sorry you are experiencing so much pain from your filler! It is common for one side to have more swelling than the other side after filler injections, so that in and of itself I would not be worried about. Sometimes if one side had more bleeding during the treatment than the other side, you can get blood formation under the skin (known as a hematoma) that can feel like a firm ball as it sounds like you are experiencing. Your body will break down the hematoma over time on its own (usually days to weeks) if that is what the firmness is from. Another possibility is that the firm ball is from a bolus of filler - this will usually not go away until the filler itself has dissolved (6 months to 1 year in most cases) unless a dissolving agent is used to dissolve/smooth out the filler. Pain is always possible after filler injections, especially the cheeks, since you are having to go through the muscle with the needle. Mild-moderate pain is normal, however severe pain is not. It is not common to need narcotics for post filler pain. Severe pain can be related to infection or vascular occlusion - if you are 5 days out from your procedure and your pictures look normal, I have a low suspicion for vascular occlusion. If it was due to infection, you would have other symptoms as well, such as redness, warmth to the area, drainage from the area, fever, chills, and body aches. If you have any of these symptoms, I would let your injector know immediately. I hope your pain and swelling resolve soon! 
Blair Hayes, PA-C