Restylane in Smile Lines - I Look Like a Chipmunk. Is This Swelling?

Question

I had restylane put in my smile lines and a u shaped line above my lip 3 days ago Now my usually thin face and high cheek bones look round and above my lip is puffy I look like a chipmunk could this be swelling?

Brent Moelleken, MD · Answer

Swelling after the heavier hyaluronic acid fillers are definitely common.  Usually by about a week most of the acute swelling is gone and you can make an accurate assessment of how things look.

	One thing experienced injectors have learned is not to expect too much from fillers.  Fillers can overcome focal volume loss, but they cannot reverse drooping.

	One very common cause of swelling that persists beyond that point is when we try to do too much with the filler.  For example if too much filler is placed in the nasolabial area in an attempt to overcome the nasolabial folds completely, the corners of the lips swell downward, causing an unusual appearance of the mouth.

Harold J. Kaplan, MD · Answer

Hi Washington.  Being that it is only 3 days since your injection, it is quite possible that the chipmunk appearance you are referring to is related to swelling from the procedure.  

	Give it a week and then call back your injector if you are still concerned about your results.  Good luck.

Ron Shelton, MD · Answer

There may be swelling from not only the product, Juvederm or Restylane, the hyaluronic acids which attract water, but there can be swelling from the trauma of the procedure. If there is no reduction in a week, you should see your doctor to determine if there is overcorrection which can be addressed.

Matthew Schulman, MD · Answer

I personally find that swelling is minimal after Restylane injections, but it can happen. Everyone swells a little differently and it can be at its worst in the first 48-72 hours. After this, it will go down. If the swelling persists after a week, you should see your doctor so he/she can take a look at you. Avoid salt, heavy exercise, medicines that make you bleed (aspirin/ibuprofen), and apply ice - these may help resolve the swelling faster.

Kenneth D. Steinsapir, MD · Answer

Dear Washington in DC

	Swelling after these services is pretty typical.  For most swelling lasts about a day and a half.  Having said that it can also persist much longer.  If the swelling that is bothering you has not settled in the next day or so, I would immediately call your injecting physician and be seen.  These services are highly technique dependent and not all injectors are created equally.

Steven Hacker, MD · Answer

The results three days after treatment are not the intended results. Your swelling should resolve within a week max. Be patient and evaluate your result after all post op swelling and edema has resolved.

Jessica J. Krant, MD, MPH · Answer

Washington,

	I find that even when patients know ahead of time there may be swelling after their filler injections, they are still sometimes taken by surprise when it really happens and is more dramatic than they expected. I would continue to use ice packs on and off for comfort, and wait a few more days (even up to a week or two more) to watch the swelling decrease. If it does not improve daily, see your injector after a few days and go from there.

Grant Stevens, MD · Answer

Since it has only been 3 days since your injection, it is likely that you have some residual swelling at the injection sites.  Post Injection swelling peaks at about 24 hours and takes 1-2 weeks to fully go down.  I would recommend following up with your injector 1 week after the injection. 

	To help the swelling resolve, take it easy - anything that increases your heart rate, blood pressure or body temperature can make swelling a bit worse.  Taking Arnica or applying it topically can help with any bruising you might have.  Cold Ice Packs can help as well. 

	Good Luck!

Steven Wallach, MD · Answer

You may have swelling from the filler injections, which is quite common. Give it a few more days to settle down.

Mary P. Lupo, MD · Answer

The puffiness usually lasts 2-3 days. Lumps may last a very long time. To be sure you are doing well, please see the physician after several days if the look of a chipmonk does not resolve.

Restylane in Smile Lines - I Look Like a Chipmunk. Is This Swelling?

Answers (14)

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