Restylane Has Permanently Deformed my Lips? (photo)

Question

I had Restylane injected into my lips 2 years ago and was unhappy with the results. A few weeks later, I had vitrase injections, and the restylane dissolved, but my lips were left uneven. Not only that, they dipped down at the corners and it created a duck-like look. I recently had another injection of vitrase to dissolve any additional filler. It seems as though my lips were permanently deformed after all of this. I want my natural lip shape back, what are my options at this point?

Misbah Khan MD, FAAD, FACMS · Answer

Restylene is one of the older fillers we have on the market. it is also one of the most widely used fillers. I see the lip deformity you have as compared to your "before" pic. I have taken care of this type of Restylene deformities before and surprisingly one of them was also on the upper lip. in my experience it took more than 1 attempt to dissolve the filler. u might have to go back and get it dissolved again until it is better. the longer you wait the more difficult it gets to dissolve the filler

Jonathan Kulbersh, MD · Answer

Hello, and sorry to hear about the issue you are experiencing. In general, a lip augmentation with Restylane can lead to certain side effects. These may include the following:

	1) Swelling
	2) Unevenness
	3) Lumps or bumps
	4) Pouty appearance due to overfilling

	It is possible the unevenness you are experiencing is due to excess filler that still may be present and was not dissolved with the vitrase. Once the filler is gone, your lips should return to their original state and look as they did prior to any treatments. How long has it been since your last treatment with vitrase? I would give it a little bit of time and see how your lips respond. It is not likely that a temporary filler such as Restylane can permanently deform the lips. A touch up can always be performed with additional filler to try and even out your lips. In the future, I would recommend Juvederm, as it is an all-around better filler for lip augmentations. I hope this helps, and I wish you the best of luck.

Kenneth Hughes, MD · Answer

You appear to have a even contour to your lips.  If you are referring to the size discrepancy between the upper and lower lips, a lip reduction procedure can be performed.

Sam Naficy, MD, FACS · Answer

Restylane won't last 2 years in the lips - so using Vitrase at this point doesn't make sense. Your lip shape appears to have changed from the original photo you posted, however without knowing your history of use of other products, it's difficult to say what your options are.

Kenneth D. Steinsapir, MD · Answer

It means nothing really that you had vitrase. Many physicians are uncomfortable with this product and don't really understand the dose. Older HA filler disperses overtime. This means much more enzyme is needed to remove an old treatment than a new treatment. Doses in excess of 1500 units of hyaluronidase may be needed to remove the remains of an old treatment. If 1500 units of hyaluronidase does not make a difference, it is likely that someone used something other than Restylane in the lip, silicone oil is the most permanent.

Richard Baxter, MD · Answer

Restylane does not last for 2 years in the lips. Whether or not hyaluronidase is injected, the material resorbs without any permanent effect. Restylane has a long clinical record of safety and effectiveness, and while it can last up to a year in the cheeks it rarely persists longer than several months in the lips.

Restylane Has Permanently Deformed my Lips? (photo)

Answers (6)