Intense and painful swelling 5 hours after Restylane, is this normal?

It's been 5 hours since I got 1 syringe of restylane in my lips. The swelling is getting progressively worse and painful. I'm icing on and off and they hurt soooo bad and I look like a complete joke. Do these photos look normal? The top lip seems to have more in the center making my mouth abnormally puffy.

Doctor Answers 9

Prolonged Painful

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Some swelling after filler placement is to be expected particularly with some of the Restylane products which are more hydrophilic - which means they attract water. You may look the way you do because of inexpert injection technique, but there is another potentially serious concern. It is possible that the artery that runs across you lips could have been injected with filler. This can result in thrombosis or a filler embolus within the vessel. This will interrupt the blood flow and when the blood supply is cut off the tissue (lips) become ischemic (inadequate circulation), causing pain, and then the tissue can die (necrosis). You should immediately contact the physician (hopefully it was a physician) who did the injection and get in to see them. 

Swelling after Restylane--Lip Augmentation with Fillers (Restylane, Juvederm) or Lip Implant or Fat

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Yes, there can be some swelling and/or tenderness after lip injections which can last 1-2 weeks. You can apply firm pressure between two fingers on the lips for a few days, for 5 mins a time, in order to help decrease swelling. If you're unhappy with your final results you can have it reversed with hyaluronidase and try a different technique next time. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Please follow-up with your physician

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Thank you for your question.  It's impossible to make an exact diagnosis without assessing you in-person or at least reviewing your photos.  While it's not uncommon to experience swelling for up to 2 weeks after lip filler injections, the intense, worsening pain you're describing is not typical and can be a sign of severe treatment-related complications.  I would recommend following up with your physician as soon as possible to discuss your symptoms and to determine the best treatment plan.  I hope you feel better soon.  

Faiyaaz Kalimullah, MD, FAAD
Chicago Dermatologic Surgeon

Swelling after Restylane

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Dear jpaisal,

you can expect swelling after Restylane. It is the best to apply cold compresses on the treated area. I would suggest you to wait until the swelling resolves. If you are unsatisfied with the results of lip augmentation, hyaluronidase will be the solution. 

Daniel Barrett, MD, MHA, MS 

Certified, American Board of Plastic Surgery 

Member, Am. Society of Plastic Surgery


Daniel Barrett, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 85 reviews

Swelling after lip injection

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Swelling and pain are not unusual after lip augmentation,.Restylane is hyalorunic acid which attracts a great deal of water so  the swelling will get worse over the first few hours. Keep doing what you are doing and it should straighten out over the next week to give you the final appearance

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 7 reviews

Swelling and Pain after Lip Augmentation

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Thank you for your question.  Swelling is certainly expected after lip augmentation and typically resolves over the course of two weeks.  Although everyone experiences pain differently after injection, the intensity of pain you are experiencing is a bit concerning.  I recommend that you reach out to your injector today to express your concerns and potentially be seen.  Although quite rare, I would personally want to make sure that there is no evidence of vascular compromise.  Hope that helps, good luck!

Leslie Kim, MD, MPH
Columbus Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Intense and painful swelling 5 hours after Restylane, is this normal?

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Hello and thanks.

Painful swelling is not normal and should be evaluated promptly by your injector. Please call them ASAP. I cannot see the photos you're referencing in the question BTW.

Best, Dr. ALDO 

Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 216 reviews

Intense and painful swelling 5 hours after Restylane, is this normal?

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Hi there,

I do not see any pictures, however this level of intense pain is not normal. I think you should go back to your board certified dermatologist or your plastic surgeon that injected  you immediately and make sure that everything is fine. Go immediately. 

Good luck, 

Dr. Downie

Jeanine B. Downie, MD
Montclair Dermatologic Surgeon

Painful Swelling after Restylane in the lips

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Thank you for your question. It is not possible to do an adequate assessment without seeing you. Swelling following Restylane injections is extremely common as this is a hydrophilic product, meaning it attracts and holds on to water. Pain is not out of the question but I would suggest following up with your physician as soon as possible to be certain there is not a treatment complication.

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.