Restylane side effects - Can Restylane be combined with other fillers to lessen side effects?

There have been cases of angioedema after injections with dermal fillers.  This is an abnormal swelling, not just the usual minor swelling one gets after HA dermal fillers.  The cause is usually unknow, but frequently it's related to someone taking an ACE inhibitor antihypertensive (usually the medication name ends in -ace).  It doesn't always happen to a person who has had it before and it only very rarely will occur in someone taking ACE inhibitors.  It can also run in families.  There are measures you can take to help prevent it in the future like taking steroids before and after. 

To have an actual allergy to HAs is extremely rare.

If you suspect angioedema is the problem, this should be worked up by your internist. 

Restylane (and other hyaluronic acid fillers) work in 2 ways:

1. They fill the area with the actual volume that is injected.
2. They absorb fluid to create even more fullness.

If you have severe swelling after Restylane injections, it is remotely possible that you have a true allergy to the Restylane.

More likely is that the Restylane is absorbing fluid and giving you more fullness in addition to the actual volume that was injected. You will be more susceptible to this under the eyes where the thin eyelid skin does not conceal swelling.

When I inject Restylane, especially under the eyes, I under-correct due to this tendency to absorb fluid. Then, after 2 weeks, if you still need more, we can always add more.

Juvederm tends to cause more swelling than Restylane, possibly because of the stronger cross-linking.