What is Wrong if I See No Result 4 Days After Restylane ?

I had two syringes of Restylane four days ago, why do I see no results? The injecter suggested that I have one syringe in the upper check area on both sides hoping to lift up and out because I have lost weight in my face. I shared that I wanted my checks to look fuller and I was concerned about the lines on both side of my mouth. I could hear and feel the injection into my upper check bone. I was bruised from the inside but with ice no sign of any bruising on the outside. What do I do?

Doctor Answers 12

Restylane - What is Wrong if I See No Result 4 Days After Restylane ?

It is hard to give an answer without being able to see you but the general considerations are how much should be injected, which areas, and by whom.  Two syringes should generally be enough to see the result, although if significant volume is required that may not be enough.  The other issues though, are just as important.  It's possible that it was injected too deeply (just speculating) but, either way, selecting the other two criteria are critical.  I would suggest that you discuss this with your physician and, for the future, consider consultations with other MDs...sorry...

Dr. E

New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Seeing no results from Restylane or Juvederm fillers after you paid a lot of money.

Unfortunately, it is not totally uncommon to feel like you invested so much time and discomfort, and got not much out of it. The treatments when done by a well-qualified, safe physician injector are not cheap (you get what you pay for to some degree... so this is valid), and it can be surprising to patients to spend several hundred dollars and not feel "totally fixed". This has to do with expectations being set by the physician, and expectations brought to the treatment by the patient. It is unfortunately true that everyone has different facial structure, tissue density, and volume loss that needs correction. Patients also have different expectations of what they are hoping for when they come in. Some people truly do need two, three, or even rarely four full syringes of filler. This is just fact. Patients who can't afford to or don't want to spend a lot, may negotiate with the doctor to do only one syringe... and then end up disappointed or feel like "nothing changed". It's important to have a realistic conversation before you start, and then to remember that conversation after the initial swelling has reduced and it may be time for a little additional filler. Yes, expensive. Yes, likely worth it, with the right doctor.


Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

The amount of Restylane needed depends on the patient

Aging, and volume loss in the face, is a dynamic process and begins to occur around age 30.  If you have lost weight, you may have experienced even more volume loss in the face.  A syringe of Restylane only contains about 1/5 of a tablespoon of product.  You can imagine that this would make very little difference in someone that requires more volume augmentation.  It sounds like you needed more product, or consideration of other volume producing procedures such as Sculptra or fat transfer.

Melanie D. Palm, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 23 reviews

Restylane Not Showing after 4 Days?

Hello.  The amount of product depends on the patient, but normally, we would not try to achieve a noticeable difference in the cheeks with 1 syringe of Restylane.  The same for the nasolabial folds (laugh lines).  

Normally we place 1 syringe of Radiesse or Restylane in each cheek and the same for each side of the nose and mouth.  The product is there, it's just been spread too thin.  Your injector should set this expectation beforehand so as to help you budget.  Also, you may want to consider Radiesse in these areas as it has a longer duration and a 1.5 cc syringe, vs. 1 cc for Restylane.  Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

What is Wrong if I See No Result 4 Days After Restylane ?

IMHO, Restylane is too thin a soft tissue filler for Cheek Augmentation.  I use Perlane or Radiesse for that purpose.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Restylane in face

My suspicion is that you have a result, and possibly need more filler.  I suspect that you need more product.  Speak with your doctor.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

No results 4 days after Restylane

I agree with the advice of the above experts.

To summarize:

1.-Before and after photos are essential.

2.-The quantity of the filler should be adequate to make a noticeable, but subtle difference. (You may need more than 2 syringes)

3.-The quality of the filler should address the problem at hand:  Radiesse  and/or Sculptra (or maybe   Perlane) for deep wrinkles, Restylane or Juvederm (or maybe Prevelle) for  shallow wrinkles.

4.-The quality of the operator. Always  make sure that you are being treated by an experienced, Board Certified Dermatologist or Plastic Surgeon.

Eugene Mandrea, MD
Chicago Dermatologist
4.6 out of 5 stars 5 reviews

Restylane is not very effective for volume

The problem you are describing is most likely due to the use of a superficial "wrinkle filler" in your cheeks instead of a "volume filler". When treating problems due to volume loss I will almost always use volume fillers such as Radiesse and/or Sculptra. They are injected deeper, beneath the skin, and will generate more volume to create a much better lifting effect for sagging skin. They work by stimulating your skin to produce more collagen, which is why they are so effective, and give longer-lasting results too.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Did your injector take a photograph of you before treatment?

If so, have them take a photograph now and compare the two.  If the photos do not so a difference, it is likely that your injector has poor technique or you need more volume or both.  If no photos were taken, then you are getting service in the wrong place.  It is often very difficult to remember were you started from.  Without photographs documenting the treatment, it is your memory against that of your treating physician.  This is a formula for unhappiness.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

No results after Restylane

It is impossible to evaluate your concerns without pre and post-procedure photographs. If Restylane was the correct treatment for you, there should be results. Generally, for the cheeks, I use Radiesse which produces a significant improvement and then use Restylane in the lower eyelid region. If you have a lot of cheek hollowing, filler may not produce the results you are looking forw and you may be a candidate for a surgical facelift.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

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.