Extreme swelling after Restylane Silk (Photo)

Question

A friend of mine recently became an injector and I asked her to even out some unevenness in my lips using restalyn silk. I have used this product serveral times before and had no problems, minimal swelling, and no bruising. She did a very small amount (.1 maybe .15) however my lip on the one side is huge, hard, and painful. It has been 24 hours of ice, massaging, and ibuprofen but I feel like it continues to get worse. Help! I have a very important event in 24 hours!

Jason Emer, MD · Answer

Severe swelling can be treated with steroids and antihistamines to calm down the inflammation. If necessary, this can be reversed with hyaluronidase. I recommend getting an evaluation with a cosmetic dermatologist. Best, Dr. Emer

J. Jason Wendel, MD, FACS · Answer

Thank you for your question in regards to Restylane Silk.Couple of things: Ibuprofen is not a product to take post injection – it can increase any bruising that you see or can’t see deeper under the skin. Some of the hyaluronic acid fillers, including Restylane Silk, can show significant swelling because they love the water that is naturally in your body. I would always plan to get filler injections a few days before a social event. Best of luck!

Matthew Richardson, MD · Answer

Asymmetric lip swelling after fillers could be a hematoma or bruising within the soft tissues of the lip or could be asymmetric placement of the fillers. Swelling is common after fillers to the lips, and typically gets worse the day after the injections are performed. NSAIDs are not recommended around the time of any injections as these may make bruising or bleeding worse. Cold packs and keeping the head elevated can be helpful, but usually the swelling just needs time to resolve. Injections should be performed by experienced and highly trained injectors.

Aldo Guerra, MD · Answer

Restylane Silk requires an experienced injector. This product is different than a lot of other injectables and is not designed to be injected deep into the muscle of the lips. New injectors will find that injecting Silk using the same technique as previous products leads to extreme swelling. Most injectables are traditionally injected into the muscles. Silk in the muscle swells a great deal more and it goes away faster when placed in the muscles, which is a double whammy for the patient because the swelling is extreme and the results short lasting! 
Silk should be injected in the more superficial locations and not the muscle. This is what I think is going on here, but if you're still having swelling and if you're developin pain, then you should be evaluated by a physician.
Next time, see an experienced injector for Silk.

Monika Soni, MD · Answer

Thank you for your question and photo. This appears to be severe swelling, which can be treated with steroids and antihistamines to calm down any inflammation. If necessary, you can have the filler dissolved with hyaluronidase. I recommend having this evaluated by an experienced injector. Best of Luck!

Hardik Soni, MD · Answer

Thank you for your question and photo. This appears to be severe swelling, which can be treated with steroids and antihistamines to calm down any inflammation. If necessary, you can have the filler dissolved with hyaluronidase. I recommend having this evaluated by an experienced injector. Best of Luck!

Kevin Cavanaugh, MD · Answer

Hi,
In our experience with Restylane Silk at our clinic we have seen significant swelling and we will give patients a dose of prednisone to be taken the night of the injection along with Zyrtec 10 mg twice daily until swelling improves. I hope this is helpful.
Kevin Cavanaugh, MD

Lenore Sikorski, MD · Answer

Restylane Silk can cause significant swelling and will resolve in time. If it is severe oral prednisone can be helpful or an antihistamine.

Drew Varano, MD · Answer

Do not use ibuprofen!! If the asymmetry is due to an underlying hematoma or bruise it will continue to make it worse.

Robert Whitfield, MD · Answer

Maybe the addition of an antihistamine will be of some help.  This will resolve.  Sorry that you are having such a difficult time.

Extreme swelling after Restylane Silk (Photo)

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