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Could Restylane Silk lip injection cause permanent bumps/nodules?

Dr. Dean Kane Q & A.shutterstock_66281377

Q.  Could Restylane Silk lip injection cause permanent bumps/nodules?I just had a small amount (maybe 1/4 of the syringe left from Nasolabial folds ) of Restylane Silk injected in my lips 2 days ago by a certified plastic surgeon . My upper lip was moderately swollen and lower lip bruised in the corners. I feel some bumps/nodules, some of them are visible . My question is if this is normal for this product, and should I be concerned that it’s going to be permanent? And what if anything should I be doing or applying?   A.  Restylane Silk is a new product to the US. It has been used extensively in Canada, Europe and elsewhere. It is very injector dependent! Ie., the skill level for Silk is not as easy as other gel fillers. ​ ​While it is a hyaluronic acid (HA) injectible similar in its molecular structure to the well known Restylane, Perlane and Juvederm family, it has different characteristics. “Silk” is extremely hydrophyllic or water-loving due to lesser number of links between HA molecules. Attracting more water means it will expand to a greater degree with less volume of the gel. ​ ​It should be used sparingly in any particular location and maybe compressed or massaged should there be a bump or irregularity. Like all HA’s, it will be dissolved by the body’s natural hyaluronidase, an enzyme which your injector may have for such concerns. ​ ​HA’s do not create a foreign body inflammatory response, so the likelihood or permanence is unexpected. ​ ​Thanks for sharing your photo. There appears to be some irregularity along the “cupid’s bow” vermilion white line. This may be due to bruising. ​ ​Discuss your concerns with your injector and the options for improvement. ​ ​I wish you the best!
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