Restylane
Hyaluronic acid is a natural substance found in
skin and works to trap water and maintain the intercellular space
within the dermis. As our skin ages, hyaluronic acid, collagen and
elastin are gradually lost from the dermis. The end result is volume
loss, skin laxity, and wrinkles.
Restylane is a non-animal stabilized hyaluronic
acid based dermal filler. It was FDA approved for the treatment
of wrinkles in December of 2003, but has been widely used in Europe
and other parts of the world for many years.
Restylane is produced from streptococcus bacteria.
It is purified, sterilized, and then chemically stabilized into
a clear gel.
Restylane is used to replenish the dermal volume loss that allows
wrinkles to form. It is also used to enhance lips and fill in
acne scars. Because it is minimally modified, Restylane has
a low incidence of hypersensitivity reactions and requires no
skin testing prior to treatment. The chemically stabilized hyaluronic
acid found in Restylane can remain in the dermis up to one year.
This is significantly longer than the collagen based dermal
fillers.
The clear Restylane gel is injected using a fine
needle. It is injected into the dermis below the wrinkle and
lifts the wrinkle out to the desired correction. Restylane is
injected directly into and around the lip for lip
enhancements. Topical or local anesthetic is used to anesthetize
the injection sites. Mild to moderate stinging and burning is
common during the injection, while redness and swelling can
last for hours or days after the injection.
Once injected, Restylane integrates into the dermis
and binds water. The results are immediate. It does nothing to hinder
the normal metabolism and movement of nutrients and oxygen. Over
time, Restylane is gradually reabsorbed without a trace. For this
reason, follow up treatments are needed to maintain your results
at 6 to 12 month intervals.
The amount of Restylane used during your treatment
depends on the desired correction.
Side effects include redness, swelling, and injection
site pain that may last for up to one week. Lip swelling and discomfort
can be significant and asymmetry may be noted during the first one
to two weeks. Also, small bumps of Restylane may be palpated at
the site of injection. These bumps are not usually visible, but
can remain for several weeks or months after injection before gradually
blending into the dermis.
Hypersensitivity to Restylane occurs in 1 in 2000
individuals. A rare but more severe inflammatory reaction known
as a granuloma can form in response to Restylane injections and
may require surgical management for treatment.
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All photos courtesy of S. Zimmet, MD and P. Bitter Jr., MD
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