Why Does Restylane Swell So Much More Than Juvederm?

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.I believe that the swelling can be both due to the nature of the product as well as the technique of the injector.  I do a lot of training for other injectors and find that the more manipulation of the lip while injection, the more swelling one gets.

Both Juvederm and Restylane can cause, in very rare circumstances, excessive swelling in the lip areas.  There may not be a difference in the two products in terms of swelling.  Restylane is more particulate and can be used when greater structure is needed to lift a tight crease but Juvederm is nice to provide a smooth lip augmentation.  Restylane also produces smooth lips though, and ultimately, it is up to the physician to decide what they prefer to use and answer your questions about alternative fillers.

Hi Mama.  We would guess that the swelling previously had more to do with technique than with the product.  Restylane and Juvederm are very similar products and we find them to cause the same amount of swelling when injected into the same area of the same patient. 

We wonder if the technique with the latter practitioner was superior and the reason for less swelling.  Either way, at least now you know what combination of practitioner and product work well.

Although both Restylane and Juvederm are different hyaluronic acids I have not noticed any difference in patient response. In my experience swelling and bruising after injections are often related to 1. where the filler is placed, and 2.patient related issues.

1.The closer the filler is placed to the eye, bruising is a possibility, due to the thin skin and multitude of blood vessels.

2. Patients who swell after a treatment should watch their salt intake three days before the procedure, avoid any aspirin, Motrin, baby aspirin, etc for 10-12 days before the treatment. I have rarely prescribed a medrol dose pack prior to a procedure to help reduce swelling in the unusual patient who has a dramatic swelling response to the filler.

I have personally had both Restylane and Juvederm in my lips and also found Restylane swelled more than Juvederm. I had the same injector both times (me!) so it was not due to injector technique. Where I practice in Orange County Juvederm and Restylane lip injections are very popular and I see many patients for this. I have not consistently found a difference in my patients however and very few have mentioned either one being a problem.  A rougher technique, more injection "pokes" and/or a more vigorous massaging of the lips after treatment can also increase swelling.  Also, were your post-treatment instructions different?   If you iced the area after wards or took Arnica Montana, it might have swelled less.  Overall however, after the swelling dissipates, the final result depends on the artistry of who is injecting you more than which hyaluronic acid gel is used.  

The two fillers Restylane (Medicis, Inc.) and Juvederm (Allergan, Inc) are relatively comparable products.  In my hands, there seems to be slight more post procedure swelling with Juvederm than Restylane but I have never scientifically studied this issue.  For some injectors, the "smoothness" of Juevederm means a lower incidence of lumps and bump when treating structures like the lips.  For other injectors, Restylane holds better in the tissue than the Juvederm.  Certainly when injecting with Restylane, it is important to shape and settle the product once it is placed in the tissue.  However, injector technique and the amount of trauma associated with a service also makes a big difference and this is likely what you are experiencing rather than a true difference in the two products.

Both Restylane and Juvederm are good products and both are based on the same molecule, hyaluronic acid or HA. It is a naturally occurring molecule but broken down quickly so it is altered through a process called crosslinking, which increases the particle size. However, the crosslinked part has to be diluted into a little bit of the uncrosslinked part in order to make it smooth enough for injection. Because HA's attract water, especially the uncrosslinked portion, the more of this the more initial swelling; Restylane has about 20% vs 10% for Juvederm but the difference in swelling is usually minor if at all for most patients.

Both Restyllane and Juvederm contain the same basic chemical component but are marketed by different companies. in all likelihood, the critical distinction between your reaction to the two treatments is the technique used by the physicians. Both products should produce similar results; as for physician preference, it is like the difference between Coke and Pepsi. Some physicians opt for Juvederm because of preferential pricing and others for Restylane for precisely the same reason!

Both are excellent fillers and in most places can be used interchangeably however I do prefer Juvederm Ultra as lip filler as I find it is more pliable and gives a softer look and feel and Restylane in the tear troughs, where it has less capacity for traveling.

I have seen no difference in the swelling caused by either Restylane or Judederm. I believe injection technique and the amount of product used make the most difference. I try to limit the number of times that that I put the needle in the lips to 2, because I have found tha the trauma of multiple pokes is the biggest cause of swelling.