Restylane
Restylane is a non-animal hyaluronic acid gel that is used for the cosmetic treatment of facial creases, wrinkles, and etched lines. Restylane can be used to improve lines around the mouth, on the forehead, and to enhance the lips. When this material is injected into the skin, it fills the depressed area. This causes those creases to soften, thereby improving the appearance of the wrinkles. This filling-in is temporary, but prolonged improvement may be seen for up to 6-9 months. There is no way to guarantee specific results in individual cases.
Restylane was approved in January, 2004 by the Food and Drug Administration (FDA) for the treatment of wrinkles around the mouth. It has also been widely used for cosmetic treatment of forehead creases, crows feet, lip margins, and to enhance the fullness of the lips, although at this time treatment of these areas is considered an “off-label use”. It is not recommended for glabellar frown lines, which are best treated with a smaller particle-size collagen product (Cosmoderm) or the yet non-FDA approved smaller particle-size Restylane Fine Lines product. Options for alternative treatment to all of these areas include injection of either collagen or free-fat. There are several other filler substances that are available but are not yet FDA-approved or do not have as good a safety profile as Restylane.
The injection of the implant material does cause variable discomfort and requires pretreatment with a topical anesthetic cream about 30-45 minutes prior to the procedure. Rarely for Restylane treatments in the lip area, a dental block using injectable anesthetic is preferred for maximum comfort. This should be decided in advance of the actual treatment, as it would require 20-30 minutes of extra time. If there is a history of cold sores or lip herpes simplex episodes in the lip or nasal area, we recommend that patients inform us and premedicate with an oral anti-herpes medication the day prior and for 3-4 days following the procedure.
Hyaluronic acid occurs naturally in the body and therefore it also dissolves naturally with time. Restylane is integrated into the tissue, enhancing the ground substance support structure of the skin. Hyaluronic acid also absorbs water from the dermis, so it can maintain its volume for a longer period of time.
Significant complications or allergic reactions are extremely rare; no skin testing is required. More common local reactions include swelling, redness, pain, itching, tenderness, lumpiness at the implant site, skin discoloration, and bruising. The risk of bruising can be minimized by avoiding aspirin, aspirin-containing medications, other non-steroidal anti-inflammatory medications, warfarin (Coumadin), and other blood "thinners" (including Vitamin E, ginkgo, ginger, and ginseng supplements) for 7-10 days prior to injection of Restylane. Ice packs and head elevation are advised for the first 12-24 hours after Restylane treatment to minimize swelling, redness, and discomfort.
If you think Restylane is a treatment you may be interested in, please ask to see additional informational material that can further clarify any questions you may have. At that point, our physicians and assistant staff are willing to answer your questions and to help you decide if this treatment is right for you.
