Extreme swelling of lips following Restylane silk injections. (photo)

Question

I had my lips injected about 6 hours ago. For the first 2-3 hours, I thought they looked amazing! However, since then they have swelled significantly. I have done my research and know swelling is normal but is it to this extent? I'm embarrassed to go out in public.

Larry S. Nichter, MD, MS, FACS · Answer

Extreme swelling after Restalyne Silk injections tends to be pretty usual especially if injected on the lips.  In our office, we get patients started on a Medral pack right  away as well as an antihistamine like Zyrtec and that seems to make the swelling a bit better .  You may want to   call your provider's office and ask for a steroid pack.  Be patient, your lips will look beautiful in a few weeks.

Aldo Guerra, MD · Answer

I'm sorry about your extreme swelling. This occurs more often with all the new generation fillers. You should not massage as this has been shown to lead to worsening swelling. I suggest elevation when sleeping and continue icing. 
Call your injector if this continues.

Jason Emer, MD · Answer

Since you're concerned, I recommend following up with your injector. Swelling is normal after lip injections and can last 1-2 weeks. I recommend warm compresses and applying firm pressure between two fingers on the lips for a few days, for 5 mins a time, in order to help decrease swelling. See an expert. Best, Dr. Emer

Milan Shah, MD · Answer

Swelling after a Restylane Silk injection is not uncommon and can be more pronounced in some individuals. It’s typically temporary and should subside within a few days to a week. To manage the swelling, you can try applying ice or cold compress to the area and avoid touching or pressing on it. If the swelling persists or worsens, it’s important to consult with the healthcare professional who administered the treatment for proper guidance and to rule out any complications.

Monika Soni, MD · Answer

Thank you for your question and the photo. This is not a normal reaction to fillers. You should go to your local emergency room to seek medical attention to ensure there is not hematoma or anaphylactic reaction. You should have the filler reveres right away with hyaluronidase. Best of Luck!

Chaitali Nangrani, MD · Answer

It is normal for your lips to swell to this extent after being injected. It's your body's natural reaction to something new that has been injected into your body. Your lips are a very vascular area and Restylane Silk is a Hyaluronic Acid, which means it's going to draw water to plump them up really nice. Your lips should start to look more natural again by the end of your 2nd day post treatment, maybe even through your third day. They will start to feel soft again by the end of week 1 or 2. Apply ice often and take a vitamin K supplement to speed up the healing process. Have a followup appointment with your provider if you are worried. Every patient is a little different, but yes it's expected. It happens to me every time mine are injected.

Regina Rodman, MD · Answer

I have actually had this level of swelling myself!  The first time I got my lips injected I swelled so much it looked like I was having an allergic reaction, it was so embarrassing!   I put ice on them overnight and 24 hours later they were still swollen, but looking more normal.  Benadryl might help too.  
It is not the typical reaction, but not unheard of
Best of luck
Dr Rodman

Steven F. Weiner, MD · Answer

This is way beyond normal and needs steroids to calm it down. I think that this is due to overly aggressive massaging during the procedure. Alternatively, this can be due to angioedema which is when swelling goes beyond normal for mostly unknown reasons. Sometimes this is associated with taking ACE inhibitor blood pressure medications.

Lenore Sikorski, MD · Answer

Restylane Silk can cause significant swelling in the lips. Although you have an unusual large amount of swelling, this can occur in some people with Restylane Silk in the lips. I would recommend you contact your injector so you can get prescribed some oral prednisone which will help to reduce the swelling. Also starting on an OTC antihistamine would be helpful.

Shaun Patel, MD · Answer

Swelling is not uncommon after lip filler injection using Restylane Silk. The small particle size that is responsible unique characteristics of Restylane Silk as a filler for lips and perioral lines is also the reason there is more swelling associated with it than other lip fillers. That being said, swelling from Restylane Silk can be minimized if the injector limits massage after injection, decreases speed of injection, and minimizes number of needle sticks. You swelling though a lot is not out of the ordinary. It may take a few days to resolve.

Extreme swelling of lips following Restylane silk injections. (photo)

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