Breast Milk and Restylane

Dear Avargas

It is very likely to be perfectly safe.  However, it is not reasonable or prudent.  It is not worth taking even a tiny risk with your baby to have Restylane while breast feeding.  It is not likely that we will ever have an answer for this because, unlike BOTOX which is medically necessary, there is not reason to using restylane filler while breast feeding.  BOTOX is used for important medically necessary indications, and it is possible that a doctor and patient may elect to use BOTOX off-label while pregnant or breast feeding.  Over time this created a body of experience with treatments in this time frame.  However, no one will be undertaking this type of study when the only reason to be using the product is to make mom look better-sorry.  FInish breast feeding and then we will get you treated, mom.  Please do not lie to your doctor about the breast feeding, you will feel devastated should something untoward happen to your baby.

Although it does not appear theoretically to be a problem to give Restylane to pregnant women or those who are breast feeding, as it is a natural substance in the human body, the FDA would not approve such a study because of the liabilities.

No Restylane while breast feeding. The safety of Restylane for use during pregnancy in breastfeeding females or in patients under 18 years has not been established.

Restylane is a very common cosmetic procedure, especially in young woman of child-bearing age. A concern which always comes up is the timing of Restylane around pregnancy or breast feeding.

The current recommendation is not to have any elective procedure, including Restylane, if you are pregnant or about to become pregnant, or breastfeeding. As far as I know, no known risks have occurred if a patient becomes pregnant after injection.

A safe answer would be


wait at least 4 months after your last injection before trying to become pregnant

absolutely no Restylane while pregnant

absolutely no Restylane while breast feeding



Speak to your Ob/Gyn or pediatrician about your concerns.

Hi Avargas.  Unfortunately, we don't have a recommendation for you for a lab to do a test, but we would doubt that if you did find a lab to test for this that you would find any traces in the breast milk.

As Dr. Persky has pointed out, this is not just about safety, it's about liability.  Most, if not all, practical physicians know that there is legal risk performing any elective procedure on a pregnant woman and will not do it because we live in a litigious society.  Even if you find a physician to inject you, we would still recommend waiting until you are done breastfeeding just to be sure.

Hi Avar,

You bring up an excellent topic.  The medical-legal climate today is too volatile for any physician in their right mind to do anything to a breast feeding mother, or to a pregnant woman.  You obviously have been treated.  If my wife, breastfeeding my child wished to have Restylane I would not hesitate to treat her.  If anything should happen to either the baby or mother after Restylane injections, even though totally unrelated, some attorney, somewhere will file suit.

I am not aware of any lab that you can send your breast milk to and have it analyzed for hyaluronic acid (empirically I'd predict that there will not be any).  If your infants lips begin to get too pouty, perhaps you should back off at that point.

Thanks for the "breast" question of the day here on RealSelf.

Good luck, be well, and enjoy your baby.

Dr. P

There are no studies on the safety of Restylane (or any other filler) in nursing women.  It is unlikely that the company would be willing or would be allowed to perform such as study since the benefit is minimal and the liability is unlimited.  It is unlikely to have any effect but I would advise you holding off for now.  I don't know of any lab that does testing for Restylane in breast milk.

Hyaluronic acid (Restylane and Juvederm) is naturally occurring, our bodies are constantly making it.  I don't know if breast milk normally contains hyaluronic acid, but would guess there is some, but not much.  Juvederm and Restylane are cross-linked, which makes them slightly different than naturally occurring HA.  Anyone who eats meat, has eaten HA, but not the cross-linked kind.  There has never been a study on infant consumption of cross-linked HA and it is unlikely that one would ever be done because of the propensity of lawyers to litigate without any actual evidence of cause and effect.  Should a single patient have an adverse event occur, regardless if it had anything to do with the hyaluronic acid or not, someone would file an expensive lawsuit.  Is it possible that cross-linked HA somehow changes a woman's breast milk, I doubt it, but I wouldn't say it is impossible.  But I suspect there are a hundred things a breast feeding mother does every day that are more likely to harm their infanct than using Restylane, like securing them in the car seat and driving on a road with other cars.

While I agree that there are no studies that you suggest to determine whether or not it is safe to have restylane injections while breast feeding, the simplest thing to do is wait until you stop.  I will say that it is unlikely that it would be found in your breast milk.

You are absolutely right on both accounts:

1. There are no studies that determine whether there is harm in injecting Restylane while breastfeeding.  So we have no idea, even though logically it seems it should do no harm.  Yet, we have no data.  The recommendation is not to have injectables while breastfeeding.

2. You are also right that breastfeeding moms want to maintain their youthful looks. It is hard to recommend injectables to a pregnant or breastfeeding woman if we do not have data showing that it is safe for the baby. 

Occasionally, we do use medications and treatments in pregnant and breastfeeding women that are pregnancy category C (unknown if there is harm) when the health, well-being or life of the mother or baby are at stake.  But, fortunately, that is not the case with cosmetic procedures.

The best thing to do is to use gentle skin care and an excellent broad spectrum sunscreen to care for your face while breastfeeding.  And I am sure your dermatologist or plastic surgeon will be happy to resume cosmetic procedures as soon as you are done.