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Top Lip Swollen And Burning, On Restylane. Steroid Injections Recommended?
Dear XXXXXXX
Thank you for your query.
You may be suffering from a foreign body reaction rather than allergy. Restylane is hypo-allergic, however some contaminant or component such as hyaluronic acid may be the culprit. Restylane usually does not last this long in the lip area but it does depend on the exact depth of injection.
I seriously doubt whether oral steroids will help after 18 months. You may try local steroid injections. Take a trial of anti-allergic and anti-leukotriene. An attempt can be made to dissolve any residual Restylane. You may also attempt a ultraSonoGraphy (USG) of the upper lip skin, and compare with the lower lip; blood investigations to rule out a tendency for autoimmune reactions.
The burning pain is due to the involvement of the infraorbital branch of the Trigeminal Nerve. A nerve block will have unacceptably high loss of sensation of the cheek and lower eyelid. A local moisturising lip balm and lignocaine jelly may provide temporary relief. You may try amitriptyline (Tryptomer) or carbamazepine (Tegretol) or Gabapentin for relief of the burning pain, under the supervision of your doctor.
You should avoid any further use of Restylane. You may consider Radiesse instead or preferably none at all. Consider speaking to your doctor about the medicines above. He will certainly advice you on them.
Hope I have answered your query. If you have any follow up queries I will be available to answer them.
Regards.
Thank you for your query.
You may be suffering from a foreign body reaction rather than allergy. Restylane is hypo-allergic, however some contaminant or component such as hyaluronic acid may be the culprit. Restylane usually does not last this long in the lip area but it does depend on the exact depth of injection.
I seriously doubt whether oral steroids will help after 18 months. You may try local steroid injections. Take a trial of anti-allergic and anti-leukotriene. An attempt can be made to dissolve any residual Restylane. You may also attempt a ultraSonoGraphy (USG) of the upper lip skin, and compare with the lower lip; blood investigations to rule out a tendency for autoimmune reactions.
The burning pain is due to the involvement of the infraorbital branch of the Trigeminal Nerve. A nerve block will have unacceptably high loss of sensation of the cheek and lower eyelid. A local moisturising lip balm and lignocaine jelly may provide temporary relief. You may try amitriptyline (Tryptomer) or carbamazepine (Tegretol) or Gabapentin for relief of the burning pain, under the supervision of your doctor.
You should avoid any further use of Restylane. You may consider Radiesse instead or preferably none at all. Consider speaking to your doctor about the medicines above. He will certainly advice you on them.
Hope I have answered your query. If you have any follow up queries I will be available to answer them.
Regards.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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