Is it appropriate to only inject Restylane silk into the upper lip?

I went to my dr to inquire about a treatment for vertical upper lip lines. I had researched belotero and wanted that filler bc it does not add actual volume to the lips. My dr instead felt that restylane silk would be better. I had the injection done about 6 hours ago and my upper lip is now sticking out further than my lower. I am wondering if this bad profile will last or if it is more likely due to temporary swelling. Thoughts please?

Doctor Answers 20

Silk swelling

Dear eroot41:

Restylane Silk and Belotero are FDA indicated for lines around the lips. As you pointed out, they are thinner HA (hyaluronic acid) gels which "smooth" rather than project or volumize tissues. 

There are several reasons why the lips will swell following injectables. Like the eyes, the tissue in the lips have receptors to swell or close the area to protect them from further injury like an insect sting. 
These include: histamines and IgE. Some patients may activate "cold sores" which adds to the swelling. These injectables contain lidocaine, a vasodilator agent as well. 

These smaller molecule HA's also have the propensity to attract more water molecules for the amount injected. 

About one-third of our patients who have Silk injected into the lines around the lips do swell. Elevation, ice, antihistamines such as loratidine or certidine and if necessary, a medrol dose pack has been very useful. Give yourself about 3 days or less for the swelling to subside. If you do have a history of cold sores, then take Valtrex as well as prescribed by your injector.

Should you have a rapidly progressive sense of anxiety and difficulty breathing, call 911 or proceed directly to the nearest Emergency Room as there maybe a component of the HA causing a allergic response. 

I hope this is helpful. All the best!

Baltimore Plastic Surgeon
4.8 out of 5 stars 82 reviews

Restylane Silk and Belotero

Restylane Silk is an appropriate filler for upper lip lines.  Belotero could also be used.  It is common to have swelling for several days after any injections in this area.  Wait 2 weeks and if you are concerned, please return to your doctor.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

Swelling 6 hours after lip injection

Thanks for posting your question.

The filler recommended and injected into your upper lip lines seems to be an appropriate choice as it is a small molecule product that can be delivered superficially. Swelling, sometimes significant, is not unusual after injection of Restylane Silk. Swelling should decrease after 3 days. Try to avoid overuse of ice, try not to massage the area and swelling should go down quicker. After swelling subsides, most patients are very pleased with the results. Make sure that you see your surgeon if you are unhappy with results and have an open conversation.

I hope that helps. 

Rachel Streu, MD
Portland Plastic Surgeon
5.0 out of 5 stars 26 reviews

Restylane Silk into the upper lip

Without examination before and after the treatment, we do not know if the injector made the right call and if he injected properly. Temporary swelling in the lips is common, and should have been explained to you prior to treatment. Lip augmentation is an emotional area for patients and should only be performed by experienced and expert physician injectors.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 42 reviews

Restylane silk is a good choice

Restylane silk is a good choice for lip (perioral) lines, I also recommend Belotero.  The technique for injection with Restylane silk is slightly different from other fillers.  Restylane silk is very hydrophilic (likes to attract water) and as such has a higher potential for swelling after injection.  The silk is injected in multiple small amounts in mutiple areas of the red and white portions of the upper and lower lips.  This is also a product that should not be excessively manipulated after injection - no excessive massage or prolonged icing.  The goal of Restylane silk injection is a smoothing effect not an voluminzation.  Hope that helps!

Jenifer L. Henderson, MD
Silverdale Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Restylane Silk for Upper Lip Wrinkles

Yes, Restylane is commonly used to smoothen wrinkles concentrated above the upper lip. Restylane Silk specifically is the latest and smoothest filler in the Restylane family. The injection is strategically placed in places where it is needed, and the amount of filler used is to be determined by your board certified doctor. To address your concern about the swelling and discomfort you are experiencing, rest assured that mild swelling is normal in the first couple days following a Restylane injection. The swelling is temporary and should completely subside within one week or even sooner. Should you still be experiencing swelling at this time, I would advise that you make a follow-up appointment with the doctor who performed the procedure to ensure your body is responding as it should.

Yael Halaas, MD
Manhattan Facial Plastic Surgeon
4.8 out of 5 stars 42 reviews


Restylane Silk is FDA approved to improve lines and fullness to the lips, however, it can also be used to improve fine lines in other areas of the face.

Jeffrey W. Hall, MD
Austin Plastic Surgeon
4.5 out of 5 stars 19 reviews

Restylane silk and Belotero are very similar products.

These products are very similar and are used interchangeably in my practice. I actually prefer restysilk for the lips. I think you had the correct treatment. Of course the injector is just as important and the substance injected. A bit of swelling immediately post treatment is fairly normal.

David Rankin, MD
Jupiter Plastic Surgeon
4.9 out of 5 stars 164 reviews

Lip swelling

I think that Restylane Silk is an ideal product for exactly what you described. I have identified that it does cause a bit more early swelling than previous products.  That can be explained by its chemistry. It attracts water to itself.  It should be injected very slowly.  But... the swelling will depart in the next day or so.

Ice packs, an NSAID, and antihistamines are helpful in this period. 

Mark A. Brzezienski, MS, MD, FACS
Chattanooga Plastic Surgeon
4.3 out of 5 stars 8 reviews

Restylane Silk - Upper Lip

I appreciate your question.
Both Restylane Silk and  Belotero would have been appropriate choices for the vertical lines in your upper lip.  The swelling is most definitely temporary and should resolve in the next 3-5 days.  In the meantime, you can ice your upper lip off and on as well as take some benadryl in evening (as it might make you sleepy).  For any immediate concerns, or should symptoms worsen, please call injecting doctor right away.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.

Best of luck!

Dr Schwartz

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 93 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.