Duck Lips with Restylane or Juvederm??

Hi, I have been having restylane injections on my lips for a number of years now and have been happy with the results - only problem has been that the left side of my upper lip always looks thinner than the other. So, this time, my Doctor tried injecting some juvederm into the lip and also used this to outline the top lip. When the swelling settled, it did in fact plump up that stubborn top left side, BUT it also had the unwanted result of causing large and very deep creases in the area between my nose and mouth - they are there all the time (my friends call me 'Granny mouth') and are worse when I speak. It has been about 5 weeks now and my Doctor has tried injecting some other filler just under the nose hoping that this would help release the tension ... but it hasnt done anything. I have a virtually wrinkle free face and the creases are very noticeable ... can you help?? Ulla Secher

It sounds like you are describing a phenomenon with Restylane/Juvederm where the edges of the lips are overfilled resulting in an exaggerated roll up of the lip (usually the upper).  Which then sort of pinches the area between the lip and the nose. Only in your case it just happened on one side! 

I think you have two choices now.  You can either ask your doctor to remove the excess with a few drops of the enzyme hyaluronidase injected into the troubled area. The only down side to this is that  it may deflate back to where it was, but at least you won’t have the lines.  The other option is to just live with it as it slowly wears off over the next 4-6 months. 

I’m sure this is frustrating.  It sounds like your doctor was trying to correct your natural asymmetry which can be tricky to do depending on the situation.  The key to this is to determine the cause of the asymmetry. For example, is it the volume of the lip itself on the two sides that’s different? Are the muscles that pull the upper lip up more or less active on one side?  Is the length of upper lip different side to side and so on.

Dr. Brandith Irwin, MD

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