The new Restylane Kysse: A revolutionary time for your lips!

By on July 10, 2020 under Plastic Surgery

Having beautiful lips can enhance the appearance of the entire face. 

The lips are a focal point of the beautiful face

William Shakespeare  mentions lips 156 times in his works. In Sonnet 145 he mentions “Those lips that love’s own hand did make”

And in A Midsummer night’s dream

“O, how ripe in show

Thy lips, those kissing cherries, tempting grow”


In the book by Joni Wilson, The Voice of Success: A Woman’s Guide to a Powerful and Persuasive Voice

Lips are…a big part of a woman’s facial expression.  We paint them red to attract attention to them, pout them when we are unhappy and spread them wide when we are happy.  Our lips tell everyone who we are and how we feel”

The science of beautiful lips

We all recognize beauty when we see it.  I have been treating lips in my practice for more than 30 years. As a Plastic surgeon we are trained to use our mathematical eye to create this beauty,  The golden ratio is found throughout art, architecture  and the beautiful face and is represented by the Greek letter phi, where it is 1.618.  Beautiful lips also fit the Phi ratio and a balance of 1:1.6 of the upper to the lower lip is a frequent ideal for the height of beautiful caucasian lips.  Ideal Asian or African lips are often closer to a ratio of 1:1.

From a side view the esthetic plane is often called the “Ricketts line” , after an orthodontist from the 1950’s, Dr. Robert Ricketts, who  showed that the upper lip and lower lip should sit along a line drawn from the tip of the nose to the tip of the chin, with the upper lip being 2 mm behind this line and the lower lip 4 mm behind this line with variations for patients of different  ethnic backgrounds.


Before your treatment we will assess your lips with you and discuss your treatment goals for volume, proportion and symmetry.  We will evaluate your face as a whole and make sure that the lips and the area around the lips will fit and look natural in context.

Some patients are bothered by a gummy smile and find that after Restyane Kysse treatment to the upper lip can reduce the show of the upper gums and improve the “gummy smile”, but still move naturally.

Restylane Kysse

Nonsurgical lip augmentation is becoming increasingly popular for women of all ages.  Patents in their 20’s and 30’s often want beautification of  their lips  by adding volume and  shape.  Patients in their 40’s want rejuvenation of subtle age related changes to the lips. Patients who are 50 and  older have lost more volume through aging and want to restore  the volume of the lips and the area around the lips. Treating  the lips  is done  using injectable dermal filler products.

Non Animal Stabilized Hyaluronic Acid ( NASHA) products are the choice in my practice, because they are reversible in the rare instance of a problem. The first NASHA filler, Restylane, was introduced in the US by Galderma in December of 2003.   Allergan followed with Juvederm in June of 2006.  I have used both since they were introduced.  They worked well in the “white roll” of the lip, but would swell significantly after treatment and take a week or more for patients to be comfortable with their appearance.  They were also too firm to enhance the vermillion of the lip without leaving “jelly fish” bumps.  My patients want to have their own lips but accentuated. Whether enhancing or restoring or both, they  do not want the  unnatural “duck lip” or “trout pout” appearance of a reality tv star!  There are many walking examples of bad treatment. My patients often say that they do not want anyone to know that they have had their lips done – but just like other examples of plastic surgery,  you don’t notice the lips that look natural and good.   In addition to looking natural, my patients also want their lips to be soft and natural to feel.  The lip is a challenging area to treat because the filler needs to be soft and flexible so it moves naturally with the lip, but also lasting in duration.  I am very excited now to be able to offer Restylane Kysse, an injectable filler specifically designed for the lips. The company has named it “Kysse” because the lips stay soft and kissable after treatment.

What is Restylane Kysse?

Kysse is a new injectable filler product in the Restylane line.  It has been used in Canada since 2015 and was just approved for use in the US May 6, 2020 for lip augmentation and the correction for upper perioral rhytids (wrinkles of the white portion of the upper lip).

Like Restylane and Juvederm, its primary ingredient is hyaluronic acid, a naturally-occurring substance which increases fullness within the skin.

Kysse was designed specifically for use in the lips as a nonsurgical lip augmentation method. It is the first lip filler formulated with XpresHAn technology and is between Restylane Refyne and
Restylane Defyne in flexibility and softness.  It is  a unique consistency that is a “Goldilocks” filler for the lips:  not too soft and not too firm.  It is flexible  to move with the lips but also gets incorporated by and molds with the tissues.  This gives the product a more natural look and feel compared to other injectable fillers. The lips are soft and “kissable” according to patients and their partners who were surveyed in the recent study.   It allows us to craft fuller,  beautiful lips and needs 20% less volume to achieve these results than Juvederm Volbella.  It is uniquely soft and flexible enough to enhance the vermillion of the lips, giving a beautiful, softer fullness and improvement in the texture of the lip lines.  The vermilion lines of aging are smoothed out giving a shinier,  “lip gloss”  effect.

Will my lips still be soft?

In the recent study with 270 patients at 14 sites in the US, the company surveyed patients and their partners.   They both agreed that the lips were natural in appearance and soft and “kissable” in feel. This is the first lip study to survey the partners impression.

Will my lips be really swollen after my treatment?

Most patients report some minor swelling and bruising for the first 7-10 days but typically feel that their lips looked good right away-

How many syringes will I need?

Most patients in their 20’s-40’s get the full correction that they want with one syringe.  Patients in their 50’s or older may have enough age related volume loss around the lips to benefit from 2 syringes of Restylane Kysse

Am I a Good Candidate for Restylane Kysse?

Restylane Kysse is a suitable treatment for many patients. There are few risks involved, as the procedure is minimally invasive.

Kysse is FDA-approved for patients over the age of  21 years old. It is recommended for patients in their 20s – 30s who are seeking a non-surgical lip beautification with additional shape and volume.  It is also recommended   for patients in their 40’s who want to rejuvenate subtle age related changes of the  lips, and  for those in their 50s – 60s who are  interested in restoring lost volume to the lips and any upper lip lines.

There are a few medical conditions that would disqualify a patient from Restylane Kysse treatment. Dr. Hall will conduct a thorough consultation and determine whether you are suited to the treatment.

How long do results last?

While some lip fillers last just three to six months, Restylane Kysse has been shown to last up to a year after injection. It is the longest lasting lip filler in the Galderma product line.  In the recent US study for FDA approval,  at 48 weeks 82% of patient’s were still satisfied with the shape of the lower lip, 70% with the shape of the upper lip, 69% with the size of the lips and 76% with “how nice your lips look when you smile”.  That makes it a cost-effective option compared to other products, and saves time because of fewer appointments to maintain your results.

What can I do to prepare for Restylane Kysse?

Before your Restylane Kysse appointment, it’s best to avoid taking medications such as aspirin or ibuprofen as well as supplements like fish oil and omega oils for 10-14 days so you can more easily avoid bruising. Consultations and injections are usually completed in the same appointment, and we typically arrange your appointment fo have enough time for treatment.  It helps to  have a decent understanding of the procedure and product as well as your goals before you arrive. You may ask any questions you have during this appointment or via email before your arrive  as well. If you have ever had a cold sore please tell us and we will give you a prescription for an antiviral medication,  Valtrex,  to take by mouth three times a day  for 5 days after your treatment.   Just like with a sunburn, a lip injection can cause a cold sore to break out again if not treated prophylactically.

Does the treatment hurt?

After cleansing the lips with an antiseptic I place a topical anesthetic cream for 10 minutes.  Most patients tell me they have only minor discomfort with the small injections along the lip but not enough for them to want nerve blocks like going to the dentist. They greatly prefer the minor discomfort to the intense numbness of dental nerve block.


What should I expect after the treatment?

Nearly all “treatment associated adverse effects” or TEAE were mild in the study.  61% of patients did not report any issues.  7.6% reported some bruising, 10.3 % some swelling and 5.4% a temporary nodule at the site of injection.  In Canada where it has been used since 2015, the doctors have not seen delayed onset of nodules with Restylane Kysse which have been seen with another companies fillers.  My patients are mainly seeing some mild bruising at the injection sites that seems to have resolved by 2 weeks.  The lips continue to soften and improve for up to a month as the product becomes incorporated into the lips but most patients report that they “looked good right away” and all patients who have had other lip fillers reported dramatically less swelling with the Restylane Kysse.  So you can expect some temporary bruising, redness, mild swelling, and mild pain or tenderness.


What steps should I follow after my treatment?

We recommend that you reduce facial expression/lip pursing for 48 hours

You should avoid sun exposure until any bruising is gone-sun on a bruise can lead to brown discoloration ( “post inflammatory hyperpigmentation”),  especially in patients who tan more easily. Arnica Montana supplements are available at Whole Foods and health food stores as well as on Amazon and can help bruising to resolve more quickly.

If you have any soreness or tenderness you can apply cool compresses to the injection site (gently and without firm pressure) for 5 minutes 4x a day

Avoid massaging the area after your treatment.  We recommend that you wait 3-4 days to let the lips settle.  If you do have any bumps after his point you can press them gently between the fingers.  It is normal to feel a little bump early on but these are settled by 2 weeks.

No hard exercise for 24 hours

Stay hydrated

Wait 6 hours to apply your lipstick-you can put at thin layer of Aquaphor on your lips right away.

In summary, the new Restylane Kysse is a revolutionary new filler for the lips that allows us to craft beautiful lips that look natural, move naturally, and feel soft and natural to the touch.  I am personally excited that for the first time we can improve the texture and volume of the vermillion of the lips with a product that lasts but is soft and flexible enough to move with the lips and not cause bumps.  And as an added bonus patients no longer need to hide out for a week after their lip treatment: there is dramatically less swelling and recovery than with other older lip fillers, with most patients reporting  that their lips looked good right away.

View Patient Testimonials for Restylane Kysse

View our Restylane Kysse Patient Gallery Here

Schedule a Consultation

If you’re interested in enhancing your lips with Restylane Kysse, schedule an appointment with Dr. Jonathan Hall in the Boston area. Call our office at (781) 279-7930 or request a consultation online.


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