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
marionette lines and
lip lines. Restylane is also used effectively in
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
Because of the thickness of
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
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.
– FDA Approved for use of thin superficial lines – comes supplied in a .50
ml syringe for single use with a 30 gauge needle.
– 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.
– 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.
– 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
- 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.
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.
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.