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RESTYLANE DERMAL / LIP FILLER

 

                                  

                                            Licensed image for CosmeticSurgeryForums.com

 

Restylane has been used worldwide since 1996 was the first hyaluronic acid dermal filler approved for cosmetic use in United States. It has been used in over 1.4 million treatments in the United States and 4 million worldwide.

Restylane is a dermal filler or cosmetic injection made out of cross linked hyaluronic acid Restylane is FDA approved in the United States since 2003 for treatment of moderate to severe facial wrinkles and folds, such as nasolabial folds, marionette lines and lip lines. Restylane is also used effectively in lip augmentation. Restylane is made by Medicis Aesthetics and comes packaged for injection in 1.0 cc syringe of a clear gelatinous fluid.

Restylane is a cosmetic dermal filler made of hyaluronic acid, a natural substance that already exists in the human body. This allows patients to be treated without requiring an allergy test. The hyaluronic acid in Restylane is crystal clear and non animal based so it is biocompatible with human hyaluronic acid. 

Restylane holds its shape by using the body’s own moisture because hyaluronic acid is “water loving”. It is this capability that allows Restylane to offer its long lasting results. Restylane lasts about six months, however depending on where it is injected some results can last up to nine months. If the hyaluronic acid is injected into an area that gets lots of movement such as the lips, then it will last approximately three months.

Because of the thickness of regular Restylane, it normally requires either a nerve/dental block or topical anesthetic cream before the treatment.  Immediately after the treatment the treated area can be slightly swollen and red. This is a normal result of the injection, and it generally goes away in 24 hours.  

There is a new formulation of Restylane that was recently approved for use.  It is called Restylane Lidocaine.  The anesthetic lidocaine is already in the syringe with the hyaluronic acid filler (Restylane) - there is no need for a nerve or a dental block before the treatment.  Read more about Restylane Lidocaine here.

 

 

                       Restylane Molecule                               Restylane Packaging

                         

                                                      Photo images courtesy of Restylane

 

 

Restylane has seven formulations:

  • Restylane – FDA Approved – for moderate to severe facial wrinkles – comes in both .50 ml syringe and also 1.0 ml syringe for single use with a 30 gauge needle.

  • Restylane Touch – FDA Approved for use of thin superficial lines – comes supplied in a .50 ml syringe for single use with a 30 gauge needle.

  • Restylane Perlane – FDA Approved for deeper wrinkles, facial contouring (such as nasolabial folds) and lip augmentation. Particle size is larger which makes the Perlane thicker. Comes supplied in both .50 ml and 1.0 ml syringe for single use with a 27 gauge needle.

  • Restylane Lipp – recommended for use in the lips but can also be used in the vermillion border and smile lines. Comes supplied in both a .50 ml and 1.0 ml syringe with a 27 gauge needle.

  • Restylane SubQ – FDA Approved - used for moderate to severe facial wrinkles and lip augmentation. Ideal treatment to be used due to facial volume loss due to aging or HIV-related facial lipoatrophy. Comes supplied in a single use 2.0 ml syringe.

  • Restylane Vital - The Restylane Vital range is comprised of two products, each carefully designed to attend to different skin needs. Used on mature or photo-damaged skin. Long lasting results. 20 mg/ml stabilized hyaluronic acid. Three treatment sessions 4 weeks apart, with touch-up treatments every 6 months. Comes supplied with a 30 gauge needle.

  • Restylane Fine Line – not yet FDA Approved but is on the horizon.



                           

                                                 Restylane - Perlane Packaging

 

 

                             

                                                   Photo images courtesy of Restylane

The different formulations of Restylane are available in a range of "thicker" versions of hyaluronic acid. The thicker the product - the deeper the injection will be.

 

 

 

 

Medicis Aesthetics pharmaceutical company that manufactures Restylane and Perlane, announced Restylane Lidocaine and Restylane Perlane Lidocaine to their Restylane line up of dermal / lip fillers. The Restylane and Perlane fillers will have 0.3 percent of lidocaine added to the hyaluronic acid products. Having the lidocaine added to the fillers will help ease the actual treatment process. Restylane with Lidocaine eliminates the need for additional messy topical anesthetic creams or local anesthetic injections which can be as uncomfortable as the filler injections alone.
 

                        

                                                 Photo images courtesy of Restylane

 

 

 

Advantages of Restylane injections include the following:

  • Restylane is all natural and is not derived from any animal proteins

  • If a lump or a granuloma should occur - an injection of "Wytese" or hyaluronidase can be injected into the area with great success

  • Restylane lasts much longer than collagen fillers

  • Indicated for moderate wrinkles and lip enhancement

  • Seven different formulations to chose from

  • No allergy testing is required

 

Disadvantages of Restylane injections include the following:

 

DISADVANTAGES OF RESTYLANE

Bruising with facial / dermal fillers can commonly occur during injections, but generally speaking the bruising should not last anymore than five to seven days. Bruising is usually avoided or minimized by avoiding aspirin, ibuprofen or other medications that can thin the blood.


Ask your physician if using Arnica gel or Bromelian will help resolve any residual bruising from the injections.


If the bruising is not resolved on it's own, some physicians will recommend a non-invasive laser treatment (Intense Pulse Lasers - or Pulse Dye Lasers).


There is a distinct difference between normal bruising and the Tyndall Effect (which is common with hyaluronic acid fillers in the tear trough area not being injected under the muscle).

 

 

The "Tyndall Effect" occurs when a dermal filler, such as Juvederm or Restylane (or any hyaluronic acid filler), is injected too close to the surface of the skin. The Tyndall Effect causes the skin to take on a bluish tint and is often mistaken for bruising. Injecting under the muscle in the tear trough area of the eye should avoid the possibility of this from happening.

If the Tyndall Effect occurs, your physician can correct this with injecting a little hyaluronidase or "Wytase" to help dissolve the filler in this area.

 

 

 

Swelling typically lasts anywhere from seven to ten days after injection with a hyaluronic acid filler like Restylane.  If the injections were in the tear trough, swelling tends to last longer in that area.  Swelling and pain that persists pasts two weeks is not normal - and should be brought to your physician's attention immediately.

 

 

 

 

Unevenness may be due to differential swelling after the injection of Restylane.  Most physicians will want their patients to wait at least two weeks to make sure there really is an asymmetry problem.  If there is still a significant asymmetry problem after the swelling resides, then you have one of two choices to make.  Either to get more Restylane in the area that is smaller in size or to have "Wytase" (hyaluronidase) injected into the side that has more filler to help dissolve some of the product.

 

 

 

 

Granulomas from Restylane are very rare.  Sometimes a "granuloma" can be mistaken from too much residual Restylane.  It is advised by most physicians to first treat as a build up of too much Restylane with "Wytase" or hyaluronidase to help dissolve the filler first before going for injections of Kenalog.  Injections of Kenalog have a tendency causing an atrophy effect in the surrounding tissue, so it is very important to make sure it is indeed a granuloma first.

 

If it is indeed a granuloma - the following cortisone injectable solution is Kenalog (triamcinolone acetonide solution with lidocaine - at 2.5 mg/mL concentration)

 

 

 

 

When Restylane is injected too close to the surface, bumps can occur. Restylane also needs to be injected evenly - bumps or lumps can occur.  It is very important that you go to an injector with lots of experience to minimize this from happening.

 

 

 

 

 

 

 

 

 

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