Hollows and Grooves After Restylane Removal: What Procedure Will Fix This?

Restylane Injected into Lines Around Nose It Immediatley Caused Worm Like Lines Above Mouth and Smoker Like Lines Above lips. The doctor injected Restlayne above lips and it just got worse. I have had restalyne removed and now I have hollows and groves/dents above lips. What do I need to do?

Doctor Answers 8

Restylane for hollows

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You should wait another week and have assessment with a dermatologist or plastic surgeon.  You probably require more Restylane with an experienced injector.

Toronto Dermatologist

Restylane for lip lines

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It sounds as you had Restylane injected for the upper smile folds near the nose and some spread into the cutaneous (skin-colored) upper lip.  It also appears as if you had Restylane removed by either hyaluronidase injections or incision and expression.  We have not found that hyaluronidase dissolves normal tissue. If corticosteroids were injected to reduce swelling (it won't dissolve Restylane) then some fatty tissue could have atrophied.  It may be that each revision that is trying to improve the last result has created new contour irregularities.  You may have to wait for it all to resolve back to baseline.  As long as no strong concentration or large amount of corticosteroid was injected, it should all return to normal, but this can take many months to a year. Sometimes, meticulous filling of the the voids with more Restyalne, done judiciously, and hyaluronidase to dissolve over correction, can help.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Unsightly grooves after Restylane Injection and Restylane Removal

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Injecting any dermal filler in this area requires meticulous technique to avoid what you described.  Once the product was dissolved to address the negative outcome of the treatment, it sounds as it you began to notice other issues. 

It's not clear if you possibly had filler placed in secondary areas that were affected by the hyaluronidase treatment.  However, as one panel member suggested, you may only be noticing something that was pesent before your treatment.  A review of photos with your practitioner will better assist you both in understanding if something has changed and what your options are.

In some situations, the treatment plan may involve a step forward, step backwards, and so on.  A good practitioner will make attempts to remedy the situation and find the perfect recipe for your treatment plan.


Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Hollows and dents after Restylane removed

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 The possibility of creating bumps, lumps and dents when attempting to remove or dissolve Restylane, Juvederm or Perlane is the reason, IMHO to just wait and allow these fillers to just dissolve and go away on their own.  IMHO, you should consder gentle massage to the area and then just wait until everything goes away on its own.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Photographs or an actual examination is needed to understand your issues.

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First if you just had your Restylane taken out, I would wait another 10 days before deciding more needs to be done.  Persistent swelling can distort the tissue.  Time is very helpful for this.  If your issues persist, the first most likely possibility is that more enzyme is needed.  One all the material is removed, what ever issues are left can be addressed with a small addition of HA fillers.  These can be very fussy treatments.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Filler problems

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As you have found out, restylane and fillers are not perfect.  In the past you may have been the ideal candidate for a collagen injection.  Collagen was a great solution for upper lip lines.  Unfortunately the product is no longer available.  However, there are still other treatment options, including laser and surgery available, or perhaps other fillers.  I suggest you discuss this with your doctor, or seek a second opinion.

Yoash R. Enzer, MD

Yoash R. Enzer, MD, FACS
Providence Oculoplastic Surgeon

Grooves and hollows after Restylane

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You should definitely discuss this with the injecting physician and get his or her input. He will be able to understand what happened to give you the result you have, and to guide you in how best to restore the areas to their previous appearance

Barry Resnik, MD
Miami Dermatologist

Hollows and grooves after Restylane removal

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It sounds like the restylane may have been injected too superficially.  Restylane can be removed by injecting the region with Hyaluronidase, an enzyme that will dissolve the Restylane.  This will cause the wrinkles to come back, but should not cause hollows and grooves  unless they were there before. There are several  ways to improve wrinkles. Fillers are probably the most common. Other ways involve resufacing, peels and surgey.  The hollows and dents that you refer to may benefit from any of the above, and would best be evaluated by a plastic surgeon who performs all of these procedures to determine which would be best for you.  Good luck.

Beverly Friedlander, MD
Short Hills Plastic Surgeon
4.8 out of 5 stars 19 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.