How Long Does Perlane Take to Work?

I had two syringes of perlane injected to my smile lines one on each side. I can feel the area is full however, I don't see a difference in the lines. I can feel the lump where she injected. It feels like the perlane is deeper in the skin while the folds are not so deep is it possible I needed restylane instead of perlane? Why does perlane cause lumps? Does it have anything to do with how it is injected?

Doctor Answers 7

How long for Perlane to work

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Perlane should provide an immediate fill and if lumps persist, it is due to uneven injection. The ability to correct the fold is not only up to the filler but also the technique used. Restylane would not work better than Perlane if Perlane did not help when properly injected.

Perlane in smile lines

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Fillers like Restylane, Perlane, and Juvederm should have an immediate effect. You will definitely have some swelling and possible bruising after any of these injections, but you should be able to see immediate improvement. Sometimes a small lump will be present where the injection site was, but that will either resolve with time, or can be removed with hyaluronidase. You should not be able to feel a large lump though. Also, sadly from your description, it sounds like the Perlane may have been injected too deeply, but it's hard to tell without a photo to evaluate. I would not say that Restylane would have been better, though. In fact, Perlane is a larger molecule and thicker filler so it works better in deeper lines and wrinkles, which it sounds like you were trying to fill. I'd wait a few more days and return to your injector for an evaluation.

Perlane in the smile lines

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Without a photograph to evaluate, I cannot give you an accurate assessment.  However, I generally expect immediate correction/results when injecting hyaluronic acid fillers (Restylane/Perlane, Juvederm Ultra/Ultra plus).  Occasionally, some swelling at the time of treatment can obscure the final result; but nontheless, I can see whether or not I've corrected the area.  Perlane is a thicker, more robust, filler than Restylane, and is generally injected a bit deeper than Restylane.  For a up to a week post-treatment, it is possible to feel lumps due to swelling.  My general rule of thumb is to wait for 2-3 weeks for determining if additonal filler is needed to complete the desired correction.  It would not be unreasonable to layer Restylane on top of your Perlane, should you desire further filling of your smile lines.  A picture is worth a thousand words....bring a photo to your follow up visit.  Good luck.

Lesley Clark-Loeser, MD
Hollywood Dermatologic Surgeon

Perlane for the nasolabial folds

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Perlane is generally a great choice when improving the appearance of the nasolabial folds. Lumps are a potential side effect of Perlane, and could be due to the product itself or swelling. Technique could be a factor. I would recommend speaking with your provider about this and following up with them. If it is soon after your injections, they may massage the product. If necessary, any excess product can be dissolved with the enzyme hyaluronidase. I hope this helps, and I wish you the best of luck.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Perlane works right away

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You will see the results from your treatment immediately, and typically will experience swelling for around a week, peaking at day 3-4. Follow up with your provider after the swelling subsides to determine whether or not you need massage, removal, and/or to assess how you like the look. It can look lumpy if it's injected in a bolus too superficially.

Volumizing Fillers Work Well For Shaping, Lifting & Recontouring, and Fillers Work Well For Fine Lines

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

From the description provided, it is really difficult to assess the problem. Several possible scenarios come to mind, however. The simplest answers would be that either not enough material was injected to do the job or the material was injected too deeply to achieve the desired result. 

Several other possibilities are also likely. Deep wrinkles and furrows, as is frequently the case in long-standing smile lines, have two main components--a deeper component, related to loss of volume in the fat pads underneath and a more superficial "etched" line appearance--due to years of folding the skin when smiling, etc. If the latter is the case, treating and elevating only the depth of the furrow with volumizers, such as Perlane L or Radiesse, will do little for improving the overlying, disturbing "etched" lines that persist on the surface. These would require separate treatment with a superficial filler, such as Juvederm Ultra.

It is also possible that a more robust volumizer, such as Radiesse (in the U.S.) or Voluma and Stylage XXL (both approved in Europe and Israel) would have resulted in a more dramatic improvement.

Still another possible explanation is that a mid-face (mid-cheek augmentation) rejuvenation with a volumizing filler might have been required  BEFORE treating the smile lines directly--which could account for the elevation perceived without the desired visible aesthetic improvement.

Today, sophisticated and experienced injectors do not simply jump to treating smile lines, etc., without evaluating the volume changes in the surrounding face. Loss of volume in the central cheeks (the mid-face), for example, may contribute significantly to jowly smile lines and simply restoring volume in the mid-cheek, in such cases, can significantly improve the smile lines without even the need for directly treating them. And, if done in this way, even when direct treatment is required, the amount of the material needed to achieve a gratifying improvement may be signficantly less. 

Perlane Results

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Perlane is designed and should instantly fill out your depressed areas, leaving a smooth appearance on the skin. Some swelling and redness may occur as well as some associated pain. This typically does not last longer than a week. Allergy or granuloma formations are rare. The lump you feel may have been an area that was overfilled. There is a solution; Hyaluronidase can simply be injected into the area dissolving the product immediately. The wrinkle free effects of Perlane last for about 6-8 months after your injection. This is a much longer period than any of the currently available temporary dermal fillers.

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 123 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.