Restylane Arrives

Instant and Longer-Lasting Wrinkle Correction

Paul Van Camp MD for CBN

In January 2004 Restylane was given final approved by the FDA for treatment of facial contours and wrinkles. This is a major step forward in non-surgical cosmetic medicine.

Beyond Collagen
For years, collagen (brand names: Zyplast and Zyderm and others) has been the standard for cosmetic filler treatments. This is the injecting of a substance to "fill" depressed areas such as deep wrinkles, facial folds and depressed scars. It is also used to restore volume to the lips that have become thinner through aging. This can provide instant and often dramatic improvement in facial appearance.

Collagen products do provide fairly good cosmetic improvement in the majority of patients. Our staff refers to it as "instant gratification" because of the immediate improvement in the appearance of thin lips that have been restored to their youthful fullness. It is similarly good for hollowness beneath the corners of the mouth (called "marionette lines"), deep folds between the cheeks and mouth (naso-labial folds), and depressed scars. However, collagen carries some significant drawbacks.

A common disappointment with collagen is that it does not last long enough. Most patients need to have it replenished every six months to maintain the cosmetic improvement. A more serious problem is collagen allergy. Since Zyplast and Zyderm collagen are proteins derived from animal tissues, there is a chance of developing allergic reactions. Thus a two-stage skin test is required before treatment. And still there is a small remaining risk of developing allergy despite a negative test. Newer types of collagen (Cosmoplast and Cosmoderm ) use human-type collagen grown in a lab. These do not carry the risk of allergy. However, these double the price of treatments and last no longer.

Enter Restylane: A New Solution
Restylane has been available in Europe and elsewhere for several years. They are not made from proteins and have no known potential for allergic reactions. So no skin test is needed. Furthermore, they are not made from animal tissues, which is very reassuring. They are cosmetically elegant products that have compelling advantages over collagen. Not the least of which is the durability: Restylane lasts about twice as long as collagen.

Restylane is made from non-animal, stabilized "hyaluronic acid". Hyaluronic acid is a natural non-protein structural component of our skin. It helps to form the three-dimensional "fabric" of our skin and other tissues. It is a safe and natural cosmetic dermal filler to restore tissue volume. It comes as a sterile crystal-clear gel ready for treatments.

The texture is more soft and smooth with Restylane. After treatment the Restylane absorbs water molecules that makes it "fluff-up" and expand. Thus a smaller amount can provide more correction than a similar amount of collagen. The water content also gives it a softer, more natural texture without a tendency to feel lumpy. As the Restylane is slowly and gradually reabsorbed, it holds this water content. So the cosmetic correction persists until the last of the Restylane is nearly gone. This is typically about twice as long as compared to collagen. Longevity varies with the individual, but is typically at least six months and may be as long as one year.

Nasolabial Folds Before Treatment	Nasolabial Folds After Treatment

Safety and Side-Effects
Restylane® has been used safely by cosmetic surgeons and dermatologist worldwide since 1996. Because it is non-animal based and fully biologically compatible, there is no risk of animal-based disease transmission and allergy testing is not needed.

Side effects typically include some redness and mild swelling at the injection sites. This typically resolves in one to three days. To avoid bruising from injection, patients should avoid aspirin products and NSAIDs (like ibuprofen) or high doses of vitamin E for one week before treatment. Persons who are subject to frequent cold-sores may choose to take a preventive medicine since injections near the lips could trigger an outbreak.

Restylane® injections can sting (like most injections do). So we often provide a numbing topical cream or a local anesthetic to make treatment more comfortable. The cost of Restylane® is comparable to that of collagen when the duration and amount needed for treatment are compared.

Our patients have invariably been very happy with the results of their Restylane treatments. Dr. Van Camp and Dr. Teng are very careful not to over-correct with Restylane, since no one wants an unnatural appearance from excessive or inappropriate uses of Restylane. You will receive full information and a careful assessment at your consultation before deciding upon treatment.