Pain, Hardness, Difficulty Smiling After Restylane Lip Injections

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?

Doctor Answers 10

Swelling after Restylane lip injection.

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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.

Pain, hardness, difficulty smiling

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All of your symptoms at this point are normal following restylane injections and can be attributed to the significant swelling that occurs for the 2-3 days following injections to the lips in particular with hyaluronic acid fillers. At this point, I would suggest intermittent application of cold compresses (using a washcloth and ice water) and Tylenol every 4-6 hours as needed for pain. Your symptoms should gradually subside within the next week. If you are still having these symptoms at 1 week, I would consult with your injecting physician.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist

Moderate Swelling after Restylane SILK for Lip Augmentation

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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

Ronald Moser, MD
San Juan Capistrano Physician

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Restylane Lip Injections

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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.

How Much Swelling for Restylane in the Lips is Normal?

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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.

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

Restylane lip swelling

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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.

What to Expect after Lip Injections

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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!

Paul L. Leong, MD, FACS
Pittsburgh Facial Plastic Surgeon
4.8 out of 5 stars 50 reviews

Swelling in lips after fillers

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

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Pain, hardness, difficulty smiling after Restylane lip injections

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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

Swelling from Restylane making lips hard and uncomfortable

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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.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.6 out of 5 stars 23 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.