Do I Need 2 Syringes of Restylane to Notice a Difference?

Hi @kate h. I would recommend spacing your appointments out by two weeks to prevent overfilling the lips and causing lip filler migration. Best of luck, Dr. Nima!

Without knowing what your lips were like prior, then post-treatment, it is very difficult to answer your question. I would suggest posting pictures for a better assessment.

Most patients achieve a nice, natural, and noticeable result after 1cc of hyaluronic acid filler for lip enhancement. Only five days following your treatment, I am surprised that you do not notice some difference in the appearance of your lips, even if the changes are more subtle. The filler that was injected has not disappeared in this short time frame.

Before and after photos are very important for understanding any changes that occurred as a result of treatment. No matter how good we think our memories are, appearances are relatively easily forgotten (for doctors and patients alike), especially as more time passes.

From a physician’s standpoint, the major factors that contribute to patient satisfaction with injectables are understanding patient’s desires, proper communication of anticipated results, and complete correction. It is important to take the time to thoroughly understand patient concerns and goals; and then provide adequate education regarding the anticipated results. When speaking about fillers, the quality of the result is directly related to ‘complete correction’. A specific anatomic area needs to be fully corrected (fully re-volumized) in order to provide a satisfactory and long lasting result. Full correction of many areas of the lower half of the face require more than 1cc of filler (i.e. more than one syringe). This is especially true for treatment of the nasolabial folds, cheeks, and marionette lines/perimental hollows. For many individuals the lips do not require the same degree of filling, as most patients do not want their lips to be too large or fake looking. A conservative approach is always better for the lips as more filler can always be added if a patient desires more fullness.

It sounds as if you desire fuller lips, and from your comment it also sounds as if your physician agrees that you need more filler to get the result you desire. The restylaneusa.com website shows before and after pictures of patients who were treated with 2.7cc and 3.4cc of product. But, lip enhancement is not all about volume. You will achieve better results from an injector who understands lip and perioral aesthetics.

Best wishes, Ken Dembny

Hi Kate

 Very few women need more than 1 milliliter in the lips.  To assess your concerns, a photograph would be very helpful.  Did your physician take photographs of you lips?  If not, you are getting treated in the wrong office.  Our brains are simply not organized to remember what we looked like without before and after photographs.  If you are not working off of photographs, it is very difficult to have a sense of where you are with a treatment.  I suspect this may be the issue here.  Also remember that lip treatment is very much an art form.  It is possible to have a very unartful treatment.  Good luck.

Hopefully before photos were taken so you can compare your after results.  You may feel that another syringe of Restylane will give you the result you desire.

My patients require between 1 and 2 syringes for their lips, depending upon a variety of factors.  From what you are describing, it sound like you need two.  Restylane lasts from 6 - 24 months, as a general rule.

1 syringe is generally the norm for most patient. In some rare cases, another 1/2 syringe may be need to touch up the lips.

every patient is a bit different. Often patients have one syringe in the lips and then come back for more because they feel that they are not full enough.  It is always better to start off conservatively.

The number of syringes is dependent upon the starting lip volume and the patient's expectations.  Some patients want a subtle improvement others want large lips.  Its important to listen to the patient wants and desires.  Typically, for the patient who is new to lip augmentation I will inject one syringe on the first visit and request a follow up in one week to assess the result and get feedback from the patient as to their feelings of the results.  It is always easy to add additional filler on the second visit.  Once I have experience with how the patient responds and I learn about their expectations then on subsequent visits in the future I might do more than one syringe on the visit.  As the other physicians noted it is important to take photographs before because its hard for the patient and doctor to remember what the baseline looked like even just one week later. 

Lip injections require caution.  I find it better to be conservative and retreat than to overtreat and have patients complain about having fish lips or looking like a duck.  It is quite possible that a second syringe would give you the volume that you want.  I recommend discussing your expectations with your doctor.