Lips Are Too Big After Restylane - Can I Get Hyaluronidase?

I had restylane injections in my top and bottom lips two days ago. I look like a duck! I have heard of Hyaluronidase, does is really work and are there risks? I do not want to have to hide out for the next 6 months but there is no way I am willing to go out in public either.

Doctor Answers 32

Reduce Big Lips after Hyaluronic Acid Filler

First, give yourself time to allow swelling to resolve. Most swelling after lip enhancement goes down in a couple days. As others have already mentioned, waiting a week is appropriate.

Lip augmentation with hyaluronic acid injectable fillers such has Restylane or Juvederm is common today. Fewer cosmetic specialists are using collagen for lip enhancement. The lip naturally swells & bruises from the injection. Most of the swelling, which contributes to the increased projection and fullness, goes down within a day or so, but sometimes longer.

Lip exercises and ice packs help reduce the swelling. After several days, if you are still unhappy with the lip size, you have 2 options after hyaluronic acid injection. Either wait it out, as your body naturally absorbs and breaks down the injectable filler over a few months. Another option to consider is using hyaluronidase, a material which accelerates the breakdown of hyaluronic acid. The last option is to have your plastic surgeon make a very small skin incision and squeeze out hyaluronic acid.

Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Hyaluronidase 2 days after lip Restylane is too early!

You still have swelling from the needle sticks, and the tiny amounts of bleeding that always occur with these treatments. In addition, the Restylane absorbs fluid, and can provide more fullness than desired, especially for the first week or so. Like other answers here, I would definitely wait a week or so before asking for hyaluronidase (Wydase) injections to reabsorb some of the Restylane. If indeed you are larger than you wish, this works nicely. (Wydase is an enzyme that helps dissolve unwanted hyaluronic acid--Restylane).

As with most things in cosmetic intervention, it is much easier and better to add more than to take away. The same applies to overaggressive hyaluronidase reduction of your Restylane. I have used Wydase for over 20 years and have seen no side effects to date.

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Don't rush hyaluronidase after Restylane in lips

The swelling on the lips might take about a week to diminish. Lips swell very easily and could scare the patient into thinking that it is the product making the lips look unnatural.

Best thing to do is put an ice pack for the first few days and give a total of 10 days before you decide if its too big for you or not. At that point, if it is still too big and duck shape, then hyaluronidase would be an option which would dissolve the product and allows us to get the result of your preference. 

Key here is to not ever inject too much.  It is much easier to do future touch ups and more injections as opposed to making them smaller after.  Remember, always be conservative, more is not necessary better!

Peyman Ghasri, MD
Los Angeles Dermatologist
3.3 out of 5 stars 3 reviews

Hold off on hyaluronidase after Restylane to lips

A number of things can affect swelling after Restylane injections to the lips, such as the amount, degree of bruising, where it was placed, and so forth. It is also not uncommon to feel that they are too big right afterwards, but just right when the swelling goes down. The thing with hyaluronidase is that it is usually "all or none" so you can't "fine tune" the results that way. There are some tricks and techniques to making lips look natural with HA products so it is worth spending some time to find the right injector for what you want.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 54 reviews

Lip augmentation

Although it is entirely safe to use Hyaluronidase to dissolve excessive Restylane that was place in your lips, you may want to wait a week or so prior to undertaking the procedure. Most injectors are striving for a natural and full appearance to the lips with the use of fillers. Multiple injections can lead to prolonged edema which can last days to weeks. Give your lips a chance to "calm down" and then reevaluate your results. If your still not pleased, Hyaluronidase can be used in small increments to remove only a portion of the filler.

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.7 out of 5 stars 30 reviews

Lips are likely swollen two days after injections

At two days after your Restylane injections, you are most likely swollen, which is the reason your lips look so big. Swelling following dermal fillers for lip augmentation is extremely common, but this is not your final result. The swelling should reduce on its own within a week at the latest, after which you can see the final result. If you still feel that your lips are too big after the swelling has reduced, hyaluronidase could certainly be an option to safely dissolve the filler and allow your lips to return to their natural shape more quickly.

Mitchel P. Goldman, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 25 reviews

Wait for swelling to subside before assessing results

You should wait a couple of weeks for swelling to subside before assessing your results. The swelling may be contributing to the current size of your lips.

Bumps may be excess product. Hyaluronidase injections can break up hyaluronic acid based filler so that it gets absorbed by your body faster, reversing your results. If it's another type of filler, you'll have to see your PS for an assessment as surgery may be necessary.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Lip reduction or removal of silicone and juvederm - Los Angeles

I have a large series of patients who have undergone lip reduction or lip revision after injection of fillers ranging from juvederm to silicone. Raffy Karamanoukian Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Hyaluronidase after Restylane to lips

Give yourself another week to allow the swelling to subside. If after that time, you remain unhappy with the results, you can consider dissolving the extra restylane with hyaluronidase. As with the dermal filler injections, only an experienced dermal filler expert should perform the hyaluronidase injections.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 42 reviews

Hyaluronidase will dissolve Restylane, but at two days, it is probably too early to treat

Hyaluronidase will dissolve Restylane. But at two days after injection, you are probably at the peak of the swelling and so do not have a true view of how things will look. I would wait several more days before removing the product, and then, rest assured that if you still do not like the look, it is possible to reverse the filler.

Elizabeth Slass Lee, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 54 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.