Question
Upper lip fuller on one side than the other after Restylane
After having Restylane in the upper lip, why does the doctor rub it, and why does one side look fuller than the other?
Answers (7)
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1
December 18, 2008
Wait a bit, then see your doctor to see if more Restylane is needed
The biggest cause for early asymmetries after filler injection into the lips is swelling or slight bleeding into the tissues. Often by 1 week post injection, this swelling has "ironed itself out". At that time, additional injections may be considered.
Restylane tends to clump a bit, so massaging the areas can smooth out the lumps immediately after injection.
Fillers do not even out asymmetries in the cupid's bow. Placing more and more filler on the low side will only result in a very plump, and lower, lip on one side. So it is nice to note any asymmetries before injection and point out to the patient that not all asymmetries will be fixed by injections.
2
December 12, 2008
If there is an asymmetry, have the doctor inject more filler to even it out
Ann Marie,
All of the filler induce swelling at the points of injection which starts almost immediately after your injection and then for a several days post-injection. You can even see the difference if you ask to see in the mirror right after your injections. If the right side was injected first, when you look in the mirror after both sides have been injected, the right side will look fuller since it has been swelling for a few more minutes than the left side. This swelling resolves over a few days. However, it is possible that you have underlying asymmetry of your lips or had more product injected in one side or the other. This is easily correctable if you are willing to have more product injected in the smaller side.
David Shafer, MD
New York City
Web reference: http://www.RealCosmeticSurgery.com
3
December 3, 2008
May just need a little more filler on one side..
I often massage immediately after injecting to distribute the filler evenly throughout the area. I'd suggest waiting a few weeks to see if the uneven result you describe is merely a result of swelling. After a few weeks, if your lips are still noticeably assymetric, you may need a bit more filler on one side.
Always research your injector prior to making an appointment. Make sure he/she has the proper training and credentials. Doing this research will make you more comfortable and confident at your appointments.
Thank you for your question!
Stephen A. Goldstein, MD, FACS
4
December 2, 2008
Fillers
Rubbing in the fillers is a way to mold it so it is smooth. There is usually asymmetry between both sides of the lip. If one is particularly larger, then I suggest you get more filler in the other side.
5
November 8, 2008
The swelling that often accompanies fillers is rarely symmetrical.
Answer by Richard Foxx, MD
After fillers are injected the body often reacts with swelling. The swelling is rarely exactly symmetrical from one side to the other. My best advice is to observe the area over several days. Usually the areas even out.
Sometimes a small bruise is present in one area that is within the tissue and cannot be seen immediately. That will cause that area to appear larger.
The doctor often appears to rub or knead the injected area. More often than not he is not really moving the product but insuring it is feathered into the surrounding area. Sometimes we do that to determine there are no skip areas.
6
October 22, 2008
Lip asymmetry after Restylane can occur for different reasons
Filler enhancement for the lips is very artistic and definitely requires more skill than say, filling of the nasolabial folds. There are subtle differences from lip to lip, and what may look great on one face may look awkward on another.
After treatment, one side of the lip can look fuller than the other because there actually may be more filler injected on that side.
Or, if the doctor performed a nerve block with anesthesia, the bolus of anesthesia may have been more on one side than the other.
Or, it may seem asymmetric because of the anesthesia causing more temporary paralysis of movement on one side than the other.
The best thing to do is let everything settle and then after 1 week reasess for symmetry. Restylane is soft, and the doctor can "mold" it so it is not lumpy or bumpy.
7
October 20, 2008
Who Kneads Lumpy, Uneven Lips?
Occasional lumpiness or un-evenness of the lips is not uncommon after Restylane or other filler injection to the lips or nasolabial folds, even with careful attention to injection technique and quantity. When this occurs, most physicians massage the lips to mold or re-distribute the filler more evenly across the intended area. When the Restylane or Juvederm has been injected into the proper tissue plane, there is some ability to "milk" it back and forth through the tissue plane, to smooth lumps or to produce better symmetry to the injected areas. If you have had a nerve block before the injection, the lips may also look abnormal and asymmetric because of the temporary paralysis, so you should trust the artistic eye and judgement of your surgeon, whose job it is to insure that your result is smooth and even.
Sometimes, our lips need to be kneaded.
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12/3/08
i recently had hydrafill for the second time in my top lip 4 days ago. the first time i had it injected, it was injected in four points (two on the sides of the mouth and under the cupids bow on either side). this time, she injected only on the sides and once in the middle. it looks more swollen on in the middle, especially the right side where she injected, and there also appears to be a bit of a gap between this lump and where the lower fill was injected. i know it has been less than a week, but is there anything i can do to reduce the prominance on the right side and make it fill the gap, like massage or something??