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

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.

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.

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.

 

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.

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

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.

You need to go back to your surgeon and look at the before pictures to see the results. If you are not happy with 2 cc of the fillers, you may need face lift and or fat grafting. For the patients that have lost a lot of soft tissue , fat grafting works better.

Sometimes the results are so subtle and natural appearing that many patients forget what they looked like before.  Other times, there is not enough product placed to see a noticeable result.  Generally after 2-3 days, there is swelling from the physiology of the fillers that settles within the next few weeks.  You may need additional Restylane injected.  Please consult with your injector as to how best to proceed at this point.

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

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