Lip "Dermatitis" for 3 mths. Adverse reaction Galderma Restylane Silk extreme swelling.Dermatologist says out of options!(photo)

Juvederm for several years with no issues. No mention of swelling side effects although evidently well aware -claimed nothing could have prevented. Within 12 hours of single syringe 4/4/16, awoke to near rupturing lips, 4-5 times normal; had taken acylovir as precaution as usual. Burning, tingling started within days so took the anti-viral for month while tiny blisters, redness, and burning pain persisted. Flucticasone Propionate, then Prednisone and Elidel, no improvement. Appreciate advice

Doctor Answers 4

Reaction to silk

I'm not sure if this was done or not, but dissolve, dissolve, dissolve.  Restylane is created from a particular type of Gram positive bacteria - which is then removed after fermentation of the hyaluronic acid - and if you are prone to excessive immune response secondary to Gram positive bacteria, then you will react more with restylane than with juvederm (the intrinsic properties of juvederm prevent this from happening).  I suggest if you had not discussed dissolving the product, you really do.  However continue with the all other treatments as well.  Best of luck, I hope you get better quickly!

Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Lip Dermatitis

I'm sorry to hear of your experience! I must say I have never heard of this happening before with Restylane SILK or any other HA filler for that matter. I can't help wondering if your oral herpesvirus is remaining active perhaps stimulated by the inflammation from the dermal filler. I would keep an occlusive moisturizer on your lips like Aquaphor applied multiple times a day, take Lysine 2000 mg per day- Lysine is an amino acid supplement which is inexpensive and seems to inhibit the virus (reduce outbreaks). You can get dietary L-lysine from foods such as yogurt, fish, potatoes and brewer's yeast. At the same time, you should cut back on foods containing L-arginine, another amino acid that may promote outbreaks. These foods include chocolate, peas, nuts and seeds.
I would consult with an Infectious Disease expert regarding possible persistent viral flare. You may need to go onto a trial of suppressive dosing with an anti-viral to see if that impacts your symptoms.
Lisa Vuich, MD

Lisa Vuich, MD
Nashua Physician
4.7 out of 5 stars 11 reviews

Dermatitis for 3 months...

Based on what you're saying, it doesn't look like your treating physician has made an attempt to dissolve the product. I think this is the first line of defense when an adverse reaction occurs. If your were my patient, I would go back and consider having hyaluronidase injected until the physician feels the product is gone. 

Best wishes, Dr. ALDO

Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 201 reviews

Persistent lip swelling after Silk

You have not mentioned that it was dissolved with hyaluronidase. I would do that right away. It sounds like possible infection. I don't think it is necessarily product related because there is only minor differences between Juvederm and Silk in their composition. Make sure it is completely dissolved with a couple treatments with Hylenex - my choice.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

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