How Do I Remove Restylane Irregularities in Lips 5 Months After Injection?

Question

I had restylane injected in my upper lip 5 months ago, I can feel lumps on the inside of my lip, one small visible one where the needle went in in the middle and an irregular appearance above my lipline. I went to a new surgeon to look at it, and he said there was no product left in there and that it could be scar tissue from bad technique. How can I get back to my pre restylane state, I wasn't to concerned about it, because i thought once the material absorbed it would go away...

Arturo Guiloff, MD · Answer

Definitely at 5 months you could have an isolated "lump" of the injected filler and for that the best and quickest solution is to "lance" it with a #18 needle and manually compress out the excess filler. This could be strongly supported if the lump was there from the beginning. Hyaluronidase works well for diffuse overinjection in the lips or other areas

Colin Pero, MD, FACS · Answer

If you see or feel lumps, hyaluronidase injections may take care of your problem.  If they are inflamed, they can sometimes be due to a low-lying infection and may require more aggressive treatment.  You need to have an examination performed by an experienced injector to determine the best course of action.  Typically, Restylane lasts about a year in the lips but this is variable.  Best of luck.

Ron Shelton, MD · Answer

I do not have the benefit to examine you and feel the structure and firmness of your lip compared with the surgeon who saw you in consultation, but your photograph demonstrates a lip that has lost its definition and this is consistent with persistent filler. Many of my patients show Restylane or Juvederm volume effect for more than one year after treatment, but the majority have it for about 8 to 10 months. At five months and with the appearance of your photograph, I would suggest you see a doctor and ask about the safety and appropriateness of dissolving the Restylane with hyaluronidase.

Andrew Campbell, MD · Answer

I would personally inject hyaluronidase into the concerning areas as Restylane can definitely last longer than 5 months in the lips. If the fullness does not resolve, then I would consider an injection of dilute steroid and aggressive massage. More than likely, your lip will return to it's pre-injection state. I have never seen "scarring" in the lip due to injections of Restylane, no matter what the technique is.

Andrew C. Campbell, M.D.

Board Certified Facial Plastic Surgeon

Andrew C. Campbell, M.D.

Board Certified Facial Plastic Surgeon

Anthony Corrado, DO · Answer

It is possible that you still have residual restylane in the lips, which can be causing you problem. It is not uncommon for the product to last that long in some individuals. If this is the case, injections of Hyaluronidase will help to dissolve the remaining Restylane. If scar tissue is present, this may pose a more difficult dilemma. Good Luck, Dr. Corrado

Daniel Reichner, MD, FACS · Answer

The best way to remove the Restylane from your lips is Hyaluronidase.  I will take only a day or two for this product to take affect.

Louis M. DeJoseph, MD · Answer

A small injection of Hyaluronidase will dissolve the Restylane material in a matter of hours.  Then you can have the injection corrected if need be.

	 

	Best regards

	 

	Dr D.

Thomas E. Kaniff, MD, FACS · Answer

Hi-

	Try having hyaluronidase injected into the area of concern. Most likely this will take care of the problem.

	Sincerely,

	Tom Kaniff

Kenneth D. Steinsapir, MD · Answer

Almost any issue with Hyaluronic acid fillers can be resolved with the enzyme hyaluronidase. Think of this as the eraser for these fillers. The fact that these services can be adjusted after the fact makes them the preferred facial filler agents. Restylane persists much longer that advertised. While it is true that filler effects begin to diminish in 6 to 12 months, the product itself and effects can persist much longer. I have personally adjusted individuals who have come to me with an issue 3 years after they were originally injected by other injectors. The service is very unlikely to stimulate scaring. If you do not like the treatment effect at this point, I would recommend having it injected with hyaluronidase enzyme.

Robert S. Bader, MD, FAAD · Answer

First of all, if one does not see it, then you do not have to do anything. Most who have irregularities feel them, but don't see them. If you have to make a real silly face to see them that you never make, again do nothing. If you do see them or just can't stand to feel them, I recommend the following:

	
		Massage the area, which will help smooth things out--this may take 2-4 weeks.
	
		The lumps can be incised and the extra Restylane removed.
	
		The lumps can be injected with hyaluronidase to dissolve some Restylane
	
		Restylane can be injected between the lumps


	In most cases, option 1 is all that is needed unless extremely poor injection technique was used.

	 

	Good luck.

How Do I Remove Restylane Irregularities in Lips 5 Months After Injection?

Answers (20)