What are the long term risk of Restylane?

I think I am interested in subtle lip augmentation. I am learning about Restylane and fat transfer. The risk of lumpiness for fat injections worried me though. I also read about patients who have had Restylane and gotten negative reactions including tumors from Biofilm even years later. What could have caused that? I think there was some connection with dental work? Can it be prevented? I also have allergies so I thought fat transfer might be safer for me but I do not know! Ugh. Thank you so much!

Doctor Answers 3

Lip augmentation with fillers vs. fat transfer

Lip augmentation can be accomplished by a variety of techniques:

1. Injectible fillers: this is the most commonly used technique and is very capable of producing the subtle result that you are requesting.  Both Restylane and Juvederm are reasonable choices, but I generally prefer Juvederm because it diffuses further from the site of injection, yielding a smoother appearance.

2. Fat transfer: fat can be suctioned from your abdomen or thighs and injected elsewhere in the body, including the face.  While this works reasonably well in many areas, it is typically less successful in the lips.  Why?  The lips are in constant motion, making it difficult for the newly injected fat cells to obtain a stable blood supply. 

3. Permanent lip implants: I regularly place PermaFacial implants for lip augmentation.  These are soft, flexible, solid silicone implants that have the advantage of permanent results.

Any of these techniques is reasonable, though I would favor fillers and lip implants over fat for the reasons above.  With regard to tumors and biofilm, I am unaware of these difficulties with Restylane or Juvederm, as both products are temporary and resorbable.  This type of complication is more likely with permanent injectibles, such as liquid silicone, which I do not recommend.

Plano Plastic Surgeon
5.0 out of 5 stars 46 reviews

Restylane versus Fat Transfer

Restylane is made of a substance already in your skin, a sugar that is easily reversible if you do not like the apperance.  It is not longer in the skin 9-12 months after injection, althogh I have seen patients years later with evidence of it.  Fat, also a natural substance in your body, is less predictable with injection and some of it does not take so you have the ability to have irregularities weeks to months after injection.  Although, I do a lot of both procedures, it is hard to give a good opinion without seeing you in person. Both are good options and I would say it is best to chose the best injector for this and not necessarily the material -- although I would avoid silicone, Radiesse, Artetfil, and Sculptra to these areas.  If this is your first time, Restylane is a good choice since it can be reveresed if you are not happy.  I would avoid lip implants, I never like the apperance of them.  I'd gladly take care of you.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Always a risk

Biofilm coach every implant so there is always a risk of immediate or delayed infection. Fat grafts always have a risk of immediate infection, but not late ones. In addition, fat grafting survival can be irregular and form lumps and take some time for the swelling to subside. Restylane is usually the best bet for lips and one  just needs to take oral antibiotics if dental work is being done.

Robert Reiffel, MD
White Plains Plastic Surgeon

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.