Dr. Palm serves as a lecturer and trainer for
. In this capacity, she instructs other physicians and injectors on the safety and use of this product. She regularly lecturers at national meetings on the use of dermal fillers for facial revolumizing.
Restylane®, and its more robust version, Perlane®, are both hyaluronic acid gel fillers used in facial volumizing. Restylane® has been FDA-approved for use since 2003 for facial folds and in 2011 received FDA-approval for lip augmentation. Both Restylane® and Perlane® are now available pre-mixed with the anesthetic lidocaine as Restylane-L® and Perlane-L®, increasing patient comfort during an injection session.
What is Hyaluronic Acid?
Hyaluronic acid is an abundant particle found in the dermis of the skin. It attracts water, imparting moisture (hydration), structure, and firmness to the skin. Hyaluronic acid is abundant in young skin, but degrades slowly over time. Loss of hyaluronic acid in aging skin leads to loss of structural support and the formation of lines and folds. Replacement of hyaluronic acid with fillers such as Perlane® and Restylane® can plump areas of the skin that have deflated with time and exposure to environmental factors such as ultraviolet light exposure.
How long does Restylane® and Perlane® last?
The Restylane® family of products are classified as temporary fillers and typically last approximately 6 to 12 months. According to the product's clinical study, initial treatment followed by a second treatment 4.5 to 9 months later can give lasting wrinkle correction for 18 months. Wrinkle correction is lasting due to hyaluronic acid filler properties of isovolumic degradation. As Restylane® or Perlane® filler dissipates, the remaining filler attracts water to the area of wrinkle correction, creating persistent wrinkle and facial fold correction.
Facial areas treated with Restylane® and Perlane®
Many areas of the face respond well to Restylane® or Perlane® treatment. These hyaluronic acid fillers are FDA-approved for the correction of moderate to severe facial wrinkles and folds including the nasolabial folds, marionette lines, vertical lip lines, and corners of the mouth. Restylane® and Perlane® are slightly firmer gel fillers than Juvedérm®
, and some physicians have a preference for area of placement as a result of these properties.
Lip Augmentation and Eye Rejuvenation using Restylane® and Perlane®
Restylane® received FDA-approval for lip augmentation in 2011. Restylane®, has smaller individual gel size particles compared to Perlane®. For this reason, Dr. Palm uses this filler in a similar manner to Juvedérm®
. Lip augmentation with Restylane® is now an FDA-approved indication and provides natural looking results. Corners of the mouth, the lip border, and the size of the lips can all be adjusted using Restylane®.
Restylane® and Perlane® can be used to rejuvenate the eye area. Tear troughs result from a loss of soft tissue support in the under eye area, creating a dividing line between the eyelid and cheek zones to the face. Either Restylane® or Perlane® can be used to add volume back to the tear trough area, creating a smooth contour from the eyelash line to the cheek. Hollows around the eyes and the brow bone can also benefit from small amounts of volume from either filler. The temple area is an underappreciated area that loses fat and soft tissue volume over time. Perlane® can be used to augment this area for more comprehensive skin rejuvenation around the eye area.
Use of Restylane® and Perlane® on the Nose & Ear
Restylane® or Perlane® can be used in often overlooked areas of the face. Small amounts of either filler can be used to create small nasal humps or asymmetry of the nose, creating a liquid rhinoplasty (nose job). Small amounts of Restylane® or Perlane® can also be placed in the earlobes to allow earrings to rest more pleasingly and upright.
Restylane® and Perlane® can be combined with other fillers or with concomitant use of Botox®
to create a liquid facelift. These fillers are safe for use with other topical measures and light and laser procedures. Overcorrection with Restylane® or Perlane® can be corrected quickly, if necessary, through the use of hyaluronidase—an enzyme that breaks down the entire hyaluronic acid family of filler products.
Safety and Side Effects of the Restylane® Family of Products
There is very little potential for reaction to hyaluronic acid fillers such as Restylane® and Perlane® unlike earlier generation, more reactive fillers such as collagen. Mild swelling and bruising are the most likely side effects following injection. These side effects can be minimized with proper injection technique.