Thank you for your question. You are describing
your question and experience where you had Restylane in place at one point for your lips
where 1 cc was used and you had a limited amount of swelling. At another point you had
Juvederm 1/2 cc and your lips swell significantly. You’re looking for an explanation and understanding.
Well I can certainly assist you with this question. I’m a Board-certified cosmetic
surgeon practicing in Manhattan in Long Island for over 20 years. I’m also a member of
the Y Lift Network and use Juvederm a lot in areas of the face for volume improvement
or something we call structural volumizing and create like a facelift effect. I’ve
been using Restylane since the beginning when it was first approved. Certainly I’ve had
a lot of experience with both and I can give you a certain perspective on how I deal with
patients whenever we have such a similar type of situation. First of all, it’s very important to understand
that the reactions can be individual where one patient can have a tremendous amount of
swelling with one product and will do a skin test and will try figure out if there’s
an allergy trying an alternative product and have considerably less swelling. It’s worked
both ways. We have seen swelling from Juvederm. We’ve seen swelling from Restylane. It’s
maybe the same injector doing the same technique. It’s my personal bias that for finer work
along the border lips, I tend to prefer Restylane. I think that whenever we have any kind of
discussion about optimal fillers we always get into this type of heated debate about
how we work in such and such as hands. I think it’s more that it’s also but the individual
patient. In the terms of the swelling afterwards it
is probably something that your doctor is familiar with and was able to assist you with
in navigating through the swelling. We have to distinguish between just reactive swelling
from volume or I actually should say from the trauma of the treatment versus the swelling
that’s the result of the hydrophilic or the swelling from the water. Then how long
did that take to resolve. I always tell my patients that you can expect a certain amount
of swelling and we try to mitigate that during the procedure through a variety of method.
But then at the same time there’s at least a couple of weeks of letting it settle in.
We routinely see our patients in about two weeks to make sure that the contour-ship that
we saw when I did the procedure is maintained. Sometime there’s a need for enhancement,
sometimes we add a little bit more. With that being said, I think from your experience,
you may want to choose to just use the Restylane moving forward and sometimes people want to
switch from one product to another for the sake of longevity. But it has been my experience
again for doing hyaluronic acid fillers since Restylane hit the market several years ago.
I believe it was right ’05 that it is still something that you want to customize individually.
Because some people the product will last a lot longer than what the manufacturer of
the product will state for based on their FDA studies. Where they did studies to show
the FDA what their results were and that’s what they write on their information. For
our people in practice, I’ve had patients who I did Restylane for in their lips and
it effectively lasted over a year. It’s not just an absolute, there is a lot
of factors in what happens to the individual in terms of metabolization of the material.
It maybe for you a better choice to just do the Restylane moving forward if you want to
avoid this or do at least some skin test or something to try to balance that what could
potentially be a more swelling effect if you want to try Juvederm again. In my practice
I would probably advice you against then I would say just use something that is consistent
because these are supposed to be like lunch time procedures and it was about to be able
to get people back to their normal day quickly. That being said I think we have to make practical
decisions even if it means that material like Restylane may not last as long in you but
at least you can avoid the undesirable side effect of swelling disproportionate to what
you would typically expect. I hope that was helpful. I wish you the best of luck and thank
you for your question.