On my mother’s side, family photos reveal mouths that shrink with age on every woman going back generations. The sides of their mouths begin falling inward, and thin lips recede to nearly invisible. Many years ago, I knew I was cursed with my maternal family’s mouth, and I vowed to fight it when the time was right.  

That time has arrived. I’m 42. My marionette lines used to show up only in certain angles or light, but now they’re a constant. If I do nothing, they’ll eventually reach the bottom of my chin. My lips are shrinking inward and look pursed even when I’m totally relaxed. I don’t want to plump them up to a new place — I want the mouth of my mid-20s back, and I want it to stay that way forever.

I had three consults. I heard about many injectable filler options for my lips, and Restylane Silk was always one. Medical providers told me that the molecules are very small in Silk, and the outcome is reliably natural-looking. It’s a safe choice to avoid “duck lips,” which some larger molecule fillers could create on lips as thin as mine. Additionally, Restylane Silk smooths fine lines, or marionette lines, around the lips.

No more feathering lipstick? I can wear my favorite red again? Sign me UP.

Regarding my marionette lines, I was told large molecules would be needed to diffuse the deep line. I was told small molecules would be good because the lines aren’t that big yet. I know I’m in a timeframe where treating them is a balance between corrective (what I’ve got already) and preventative (what’s coming if I do nothing). I was undecided.

Then Restylane’s Refyne and Defyne injectable fillers were released in the United States (they’ve been out in Europe under the name Emervel since 2010), and my choice became easy. I love the way Restylane products are designed to move with your natural expressions. I’m an expressive talker, and it’s a priority of mine to not lose any of it to vanity.


My appointment: Day 1, Monday

I heeded the internet’s advice to avoid NSAIDS (nonsteroidal anti-inflammatory drugs) and other anti-inflammatory drugs for two weeks beforehand. I also ate Arnica tabs three times a day for three days in advance. But “no alcohol two days before appointment” wasn’t taken seriously. Weekends are for wine.

I was told one syringe of Restylane Silk would be plenty on my small lips. As I was tackling the marionette lines early enough, one syringe of Restylane Defyne should cover both sides.

I paid $650 per syringe at Dr. Andrew Lyosmedical spa in Houston. I may have paid the higher end of average, but I believe I was treated by the absolute best “lip artist” in the area, and to me, that’s worth it.

The Restylane Silk in my lips should last six to nine months. Restylane Defyne in my marionettes should last up to a full year.

I told my nurse practitioner/injector Sherry Mitchell my two goals were to make a lunch on Wednesday and have zero signs of injections by Saturday.

Sherry made a few things very clear. Immediate results look amazing, but expect significant swelling soon after. New patients may panic in the first 48 hours and call in to report that they look hideous, but swelling is normal. And my weekend wine? Yesterday’s wine causes today’s bruising.


Author’s before photo

The injection session

Restylane products have a bit of lidocaine in each syringe. Sherry’s injection style was to start at the outer corner of my lips and move inward, so that she’s shooting lidocaine in the direction she’s going, making each needle poke a little more comfortable than the last. I loved this method. I only felt the outermost poke on each side.

To minimize bruising, she iced my lips for about a minute pre-injection. I’d say it worked, my lip bruising was minimal. We did not ice my marionettes, and indeed I developed bright purple bruises on both sides. “Wine yesterday…”

It’s highly recommended that you ask your provider about their injection style when it comes to your comfort.

We started on half of my upper lip, and she handed me the mirror after injection. What a thrill! Half of a brand-new lip plumped exactly how I wanted it. We proceeded with the other half of my upper lip, and finished off my syringe with a small amount in the center of my bottom lip for balance.

Filling the marionettes was a little more mysterious as I don’t quite get how that filler works. Does it puff out the corners beneath my mouth like tiny chipmunk cheeks? Does it build a small wall where the line use to be? The answer is kind of both. The thing is, a lot of what we want to correct can’t be erased, it just migrates to a different form. For me and my marionettes (now in the shape of thicker skin on each side of my smile) I prefer this new form to the old one.

Total appointment took about 15 minutes. Upon inspection right after all fillers, I was overjoyed. No marionettes at all! Cute lips!

I iced my treatment areas constantly throughout the rest of that first day but by bedtime I was crazy swollen. It hurt at the corners of my mouth to open wide enough for a forkful of dinner, and it hurt my lips to smile. The price of beauty.


Day 2, Tuesday

I woke up looking like Donatella Versace, which works famously for Donatella, but was extremely alarming for me. I resisted the impulse to call my nurse and tell her things had gone terribly wrong.

Aside from cartoonish lips, I had a big, saggy lump on one side of my face where a marionette line used to be. Again, resisted the urge to cry on my nurse’s voicemail. Wait 48 hours and then sound the alarms.

I iced my mouth constantly throughout the day, took Arnica tablets and patted Arnica cream directly onto tender, swollen bruises.


Author’s photo, day two


Day 3, Wednesday

Day of my luncheon, I woke up very swollen, but after an hour of moving around it resolved considerably. In fact, things were looking good! Bruises fading quickly at the Restylane Defyne injection point, but were still very noticeable, and the saggy lump was on its way out but still quite swollen. I continued with the Arnica cream every few hours. I still felt too heinous to venture into public, though.

Goal No. 1: Make Wednesday lunch. Fail.

Note: There are tons of makeup palettes designed specifically to cover bruises, but I have zero talent for applying makeup. Another woman with my same bruising might’ve made her Wednesday lunch no problem.


Day 6, Saturday

Bruising and swelling continued to decrease rapidly Thursday and Friday. By Saturday I had zero bruising, and if there was swelling nobody knew it but me.

Goal No. 2: No signs by Saturday. Win!


Author’s photo after one week


Final thoughts

I’m so incredibly happy with my decision to combat my marionette lines and plump my lips back to my younger years. I made it extremely clear that I wanted subtle and natural. I brought a picture of 25-year-old me to the appointment. I got exactly what I was seeking.

Most importantly, I feel outstanding when I look in the mirror, years were taken off my face with simple updates. I’ll never go back to the old, aging-mouth me. Never!