Is it normal for my lips to be bigger in the morning? Restylane (photo)

Dear koriannkendl:

Thanks for your question
and sharing your photo.

Many things happen at
the time of filler injection.

1.If
a local anesthetic is injected first, such as for a cheek injection or
sometimes for lip injection, the amount of fluid will add to initial volume. Lidocaine
also has a vasodilatory effect and therefore swelling.

2.Then
the gel filler is injected causing the volume to further increase from the
amount of filler. A normal inflammatory response will occur with swelling. Particular
areas such as the lips and eyes generate a exaggerated edema response from
specific immune mediators (IgA and IgE) and histamine. Lidocaine in the filler for anesthesia will
also further swell the area.

3.As
these effects tame down during the next 1 to 14 days, the particular filler
will attract more or less water from the surrounding tissues to create the accentuated
volume of the filler. “Thinner” fillers such as Silk, are more polar and
therefore attract for water giving this injectable a greater fill appearance.
More “linked” or “denser” fillers are less polar and attract less water volume
but are less deforming and more projecting.4.Your
normal “hormonal” and physical activities during the day may attribute to
changing appearances as well.

If your response is too
exaggerated, there are inflammatory moderators which can be recommended by your
physician including:

1.Sedating
and non-sedating anti-histamines

2.NSAID’s
(non-steroidal anti-inflammatory drugs)

3.Tapering
steroid 4. Hyaluronidase
to enzymatically breakdown the injected filler
This is a lot to
appreciate but typically, it takes 2 weeks for patients swelling to calm and
subside and therefore a good time for follow-up with your injector. Please consult with a
Board Certified, skilled and experienced Plastic Surgeon or Dermatologist for
filler injection. I hope this is helpful!
All the best!

Hello Koriannkendl,If you are noticing fluctuations with the morning being the time when they are the biggest, then this is residual swelling from the product being injected.  The reason is that swelling tends to be pulled downwards from gravity during the day. When you sleep at night, if you sleep flat, then swelling will accumulate at the area of the treatment.  Of course having swelling beyond 2 weeks is not very common.  But you did say you had a touch up 4 days later with the lips being squeezed which can cause even more swelling than normal.  I would recommend you continue to follow up with your injector to express your concerns.  If you remain dissatisfied then you can receive an injection that dissolves the filler.  I hope this helps and good luck.