Restylane® injection for lip enhancement and softening facial lines & creases

Restylane® is a naturally-occurring injectable agent that is used for lip enhancement and to soften facial lines and creases. It was approved by the FDA for the treatment of lines and creases around the mouth and nose in December 2003, and Dr. Law has been using it exclusively for patients seeking temporary, reversible facial soft tissue enhancement for over two years. We have found this material to be very well tolerated, longer-lasting for most patients than collagen products, and have yet to encounter an allergic or inflammatory response to it.

Restylane injection, 1cc, upper and lower lips Lower photos taken one day post-treatment

Common signs of lower facial aging include thinning of the lips, deepening of the nasolabial folds (a crease from the outer side of the nostril to the corner of the mouth), and the development of 'marionette' lines (running vertically downward from the corners of the mouth). These features can in many cases be instantly and dramatically improved by the injection of soft tissue filling materials such as Restylane®. The injection of Restylane® can also improve some depressed scars, vertical lines around the mouth, and other facial soft tissue abnormalities.


The Restylane® Advantage

As Restylane® does not carry the risk of allergic reaction that is associated with bovine (cow) collagen, no skin test is required. It is not harvested from cadaver sources as are human injectable collagen products. Most importantly, it does NOT contain any material that does not naturally occur in soft tissues, such as hydroxyapetite or methylmethacrylate, which can result in granuloma (cyst) formation and chronic inflammation. Be VERY wary of injectable agents that contain materials that do not naturally occur in soft tissues, as the risk of these complications is often minimized to patients.

Restylane® injections take place in our medical office and require just a few minutes to perform. All injections are performed personally by Dr. Law. The aesthetic improvement is immediate, and in general we will attempt to slightly overfill the lips and overcorrect lines and folds, so that the desired effect remains once the mild initial swelling subsides (in about 24 hours). The goal is an aesthetic improvement that appears natural.

Most injections can be performed with little or no pain by administration of local anesthesia just prior to the Restylane® injection. Injection of the lips is usually completely painless, using intra-oral anesthesia that produces total numbness of the lips. For injection of lines and creases on the face, a local anesthetic solution is used that causes vasoconstriction, decreasing the likelihood of bruising following the injection. Our aim is to provide an immediate and beautiful aesthetic enhancement, with little or no discomfort and downtime.

The duration of the improvement varies from patient to patient, averaging about four to six months. Many patients that enjoy the results of their Restylane® treatments become interested in permanent soft tissue enhancement. For these patients, Dr. Law performs structural fat grafting, using autologous (the patient's own) fat. Using specialized instrumentation and technique, structural fat grafting can produce permanent improvements in facial contours.


Know what is being administered!

A number of other products are available as soft tissue fillers, but many are as yet inadequately tested, and others have been found in some cases to produce disastrous and permanently disfiguring results, such as injectable silicone. Remember, when considering the injection of a soft tissue filler, be sure that your doctor can explain to you what the substance is, why he or she has chosen it, and what side effects and potential complications can occur. Once again, be very wary of injectable agents that contain materials which do not naturally occur in soft tissues, as the risks of complications can be significant.


Other injectables and why we don't use them

At Michael Law MD / Aesthetic Plastic Surgery we put a great deal of time and effort into researching the products and devices that we use and the treatments that we offer. For a product, device or treatment to be offered in this practice, it must be scientifically sound, clinically proven, and FDA-approved. It is our opinion that, without question, non-animal hyaluronic acid (Restylane®) is currently the safest and most effective material available for non-permanent soft-tissue enhancement of the face. For permanent facial soft tissue enhancement, we offer structural fat grafting using autologous (a patient's own) fat. Many of our fat grafting patients initially come into the practice as Restylane® patients, are very pleased with the results obtained with Restylane® injection, and elect to have a permanent enhancement performed.

INJECTABLE AGENT	TRADE NAME	SOURCE	CONCERNS	FDA APPROVED?*
Bovine (cow) collagen	Zyderm, Zyplast	from cow dermis (skin)	allergic reactions, skin test required	YES
Human collagen	Cymetra	cadaver tissue	human source	YES
Human collagen	CosmoDerm, CosmoPlast	human tissue culture	human source	YES
Human collagen	Fascian	cadaver tissue	human source	NOT REQUIRED
Autologous collagen	Autologen	grown from biopsies	must harvest patient's own skin, expensive	NOT REQUIRED
Rooster hyaluronic acid	Hyalaform	rooster combs	allergic reactions, skin test required	YES
Bovine collage plus polymethylmethacrylate	Artecoll	cow dermis synthetic polymer	lumping, granulomas (cysts), infection and migration	LIMITED**
Calcium hydroxy-apatite	Radiesse, Bioform	synthetic mineral microspheres	lumping, granulomas (cysts), infection and migration	NO
Polylactic acid in microspheres	Sculptra, New Fill	synthetic absorbable material	lumping, granulomas	LIMITED***

* - for aesthetic facial soft tissue enhancement

** - contraindicated for lip enhancement due to hardness, granulomas

*** - approved only for treatment of HIV patients with facial lipodystrophy


Other hyaluronic acid products

Restylane®, the first FDA-approved non-animal hyaluronic acid product for aesthetic facial soft tissue enhancement, has an excellent track record of safety and efficacy. Recently, other non-animal hyaluronic acid products have obtained FDA approval for this indication, including Captique® and Juvederm®. Some manufacturers are producing 'cross-linked' hyaluronic acid products with the hope of achieving longer-lasting results. However, there is as yet no conclusive evidence that any one hyaluronic acid product has greater stability and durability than the others that are currently available and FDA-approved for use in the Untied States.

For more information about Restylane®, go to this link:
http://www.emediawire.com/releases/2004/9/prweb159893.htm