Pain, Hardness, Difficulty Smiling After Restylane Lip Injections

Question

I had Restylane injected into my lips 13 hours ago. The redness has went away, but the pain is unbearable still. My lips feel hard and pouty (I like the pouty), but its hard to smile and eat. Is this normal?

Steven H. Williams, MD · Answer

Restylane has lidocaine in it that can alleviate pain for a couple of hours. After it wears off, the treated area can definitely feel sore. The tenderness and firmness usually improve over the next few days as the swelling decreases. You can apply a cold pack to your lips to help alleviate the tenderness, but do not place it directly on your skin. Head elevation can also help reduce swelling. Give it some time and things will likely get better. If there is anything that concerns you, definitely contact your injector.

Young R. Cho, MD, PhD · Answer

Thank you for your question.  It is very common for the lips to look 
over corrected or fake the next day.  This is due to all the swelling 
that ensues.  I often tell my patients that this
 is the "oh my gosh" day.  It can be 'oh my gosh' my lips are so 
swollen!  It could also be 'oh my gosh' I love my lips even more than 
yesterday.  Either way, the swelling may last a few days with every day 
showing a decrease 
in swelling. The more you ice the first day or two, the less swelling 
you will have.   I would wait a few days to a week and then return to 
your injector if you still have concerns after that.  If you like the 
look of the lips at some point during the swelling reduction, then take a
 picture.  This way you know what volume you like in the lips for the 
future.

Harold J. Kaplan, MD · Answer

Hi Chloe.  Injecting Restylane into the lips can be one of the most painful locations.  It's also a location where dramatic swelling (and therefore tightness) can occur.  It can take up to several days for the swelling to go down.  If it does not during this time period, be sure to call your injector to schedule a checkup.

	Based on the picture and the description, we do not feel that your situation is out of the ordinary.

Monika Soni, MD · Answer

Thank you for your question. All the symptoms you have described are normal immediately following injections to the lips. The tenderness and firmness will improve as swelling resolves over the next 2 weeks. You can help reduce the swelling with cold compresses and take Tylenol for the pain. It is best to avoid NSAID’s, such as Ibuprofen because they thin the blood increasing and increase swelling. If you have any concerns it is always best to contact your treating physician. Best of Luck!

Ronald Moser, MD · Answer

After lip augmentation treatment with Restylane Silk, it is not unusual to experience moderate swelling that might last up to 2 weeks.  Avoiding over-the-counter anti-inflammatories such as ibuprofen, green tea and fish oils will help to minimize bruising and bleeding .   Cold compresses can help and avoiding hot drinks .If the swelling progresses , it is always best to seek a follow up visit for evaluation

Paul L. Leong, MD, FACS · Answer

It is normal to have some swelling after any injection, but particularly in the lips due to the sensitivity of this area. Periodically applying ice on and off for short periods of time helps to reduce swelling and inflammation. You can expect the swelling to resolve within a few days. Given your concerns, I would certainly schedule a follow up appointment with your doctor. Good Luck!

Leyda Elizabeth Bowes, MD · Answer

Swelling after Restylane lip injection is not infrequent, although it is quite manageable. Typically, patients should apply ice packs for twenty to thirty minutes of every hour until the evening on the day of injection. It appears that your injection was done exclusively to the lips and the volume was significant, likely at least one syringe just on the lips. You do have marked swelling, and this should go down in the next day or two. The tightness may be do to the new volume present. My impression is that you will have a nice outcome and be happy with the results in the long term.

Steven Wallach, MD · Answer

It is quite common for you to have lip swelling after injections with fillers.  As for the hardness I would contact your doctor.

Darryl J. Blinski, MD · Answer

First, CALL your injector ASAP! You need guidance and even a re visit just to be safe!!!! These fillers can cause increased swelling for the first few days, this is common. As Dr Pilest has pointed out, the HA's absord water so swelling occurs. But why did you not know this is my question? I ALWAYS discuss the risk/benefit ratios. Did you not have ice compresses applied for the first 3 hours after the injections? I think NOT!

	You need better post injection care instructions. But needless to say use ice compresses, be patient and this SHOULD resolve in a few days. If not than you were over injected, again an issue with the injector. 

	Best of Luck from MIAMI DR. B

Nissan Pilest, MD · Answer

Hyaluronic acids absorb water. Restylane has powerful absorption powers and in the lips it is very normal to have swelling that is beyond what you anticipated. Until the body balances the fluid levels between your tissue and the Restylane, the swelling will exaggerate the appearance and make your lips feel very firm.
As suggested by Dr. Chen, cold compresses and Tylenol are helpful. I would add too that you might avoid highly salted foods and be careful to keep your face our of the sun. The tissue will be stretched and far more susceptible to burn or irritation.
A good lip balm that is soothing will keep your lips from over drying too.
Your lips will "go down", so don't be too over concerned. Of course if any unusual hardness lasts past 5 to 7 days, you should revisit your physician.
Everyone has variable response levels to Restylane - and resolution times for the balance of tissue fluid and filler.

Pain, Hardness, Difficulty Smiling After Restylane Lip Injections

Answers (12)