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

Dr. Dean Kane Q & A shutterstock_66281377 Q. Is it appropriate to only inject Restylane Silk into the upper lip? I went to my doctor to inquire about a treatment for vertical upper lip lines. I had researched Belotero and wanted that filler because it does not add actual volume to the lips. My doctor 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 lip. I am wondering if this bad profile will last or if it is more likely due to temporary swelling? A. 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!
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