Had Restylane Inserted Around Nasolabial Folds and The Creases Look More Defined Instead of Less, Normal?

I am a 26 year old female who had Restylane injected into my nasolabial folds just today. The entire 1cc was used on both sides. It is now 6 hours later... And The folds actually look more defined instead of less.. I can actually see a crease that I hadn't really noticed before I had the procedure done.. When I touch the area,it feels like the small worm/lump, but I do not see small worms or lumps. I only feel them. Is this normal on first day? Should I massage during this first day?

Doctor Answers 8

Restylane for nasolabial folds

There can be some swelling after restylane treatments. If you feel unsure it's always a good idea to call and visit back with the doctor so they can assess and guide you. There are several excellent options for rejuvenating the skin and also areas to place the product as well. The most likely outcome is that you will love the results, but the good news is that if at the end of a week or two, you don't like it, there is an enzyme called hyaluronidase that can be injected to "erase" the treatment.

New York Dermatologic Surgeon

Treated areas may look worse before they look better

Greetings Dazzle Girl~

The best thing you can possibly do after injections (especially within the first few hours) is ice your face and ignore it.  Don't look in the mirror.  Don't touch it, massage it, push on it.... leave it alone.  We advise our patients not to make any judgments about their treatment or if they need more Restylane for at least one week.  Swelling is common after injections and can distort what is really going on.  It can change rapidly.  One minute one side looks uneven and a little while later that side is fine and the other side looks crooked.  It is not unusual to feel lumps, bumps or 'worms' , as you said, after treatment.  This should dissipate on its own.  Fight the urge to massage, mush or manipulate the area because you can actually create problems where there were none before.  I have actually seen patients rub their skin raw trying to massage it.  So, my best advice to you is this-- relax. Ice. Ibuprofen for swelling.  Avoid exercise until the swelling resolves and follow up with the office that treated you in one week.

Good luck~

Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 145 reviews

Restylane - Had Restylane Inserted Around Nasolabial Folds and The Creases Look More Defined Instead of Less, Normal?

It's probably too early to tell for sure.

It can be surprisingly tricky to treat these areas, particularly in younger patients.  That's because with tighter tissues (in general, younger people have tighter tissues than older people do....although that's obviously a generalization that may not apply in any individual case) the discrepancy between the two sides of the fold is greater.  In other words, the fold is caused by some puffiness lateral (to the outside) of the line itself, while the tissue medial (toward the midline) is relatively tight.  In placing the filler, the goal is to get more of it just medial to the line; trying to put it only in the line itself risks having too much of it move laterally, into the existing fold and risking actually enhancing the appearance of the fold.

That may be what you have, but it's also too early to tell, since you undoubtedly have some swelling.  Only your physician knows for sure (since he or she knows exactly what was placed and where) so you should speak with him or her.  And, as others have suggested, some of the effect of too much filler in any one spot can be diminished by injecting and "eraser" called hyaluronidase (trade names Vitrase and Amphidase) that basically dissolve hyaluronic acid, which is the primary component of Restylane/Perlane and Juvederm.

I hope that this helps, and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Nasolabial folds more prominent after Restylane injections, now what?

 Restylane should decrease the depth of the fold but can sometimes migrate into the fold itself as it's being injected.  Wait a day or so for all swelling to be gone and if it's unchanged go back to the MD that did your Restylane for evaluation.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Wait at least a week to judge the results of your treatment.

Wait at least a week to judge the results of your treatment.  It is common to have swelling after Restylane.  You need to wait at least one week to let the swelling go down.  If you are still concerned, contact  your doctor for a follow up appointment.

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.2 out of 5 stars 18 reviews

Please do not massage the treatment area.

Swelling is normal after such a treatment.  I strongly recommend some patience here.  Give the area a couple days to calm down.  Do not massage the area as you will be pushing product out of the treatment area and into the surrounding tissues.  After that if you are having an issue, please be seen by your injecting physician.

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

Restylane vs Radiesse in the Nasolabial Folds

It is much to soon to assess the results of your Restylane treatment and there is likely to be some swelling that will obscure your results and can last for several days. Massaging the area now is not advisable and can risk making the swelling worse. For the reasons your are describing, I much prefer to use Radiesse instead of Restylane in the nasolabial folds. Several years ago a study was done where Radiesse was injected into one nasolabial fold and, in the same patient, fillers containing hyaluronic acid such as Restylane were injected onto the other nasolabial fold. Most patients picked the Radiesse side as more natural looking. This is because Radiesse is injected deeper beneath the skin and will generate more volume to create a much better lifting effect.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews


You should return to your doctor. Massage may be needed but, let him decide that. I havefounf that patients are often too agressive and push the fill out altogether

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 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.