Introduction
Wrinkles are one of the prime signs of aging for which patients consult the cosmetic plastic surgeon. Skin wrinkles fall into 2 types; dynamic and static.
Dynamic wrinkles occur first in younger people. They are not present with the face relaxed, but appear as a result of contractions of the delicate underlying facial muscles every time we smile, laugh or frown. Over time, dynamic wrinkles develop into permanent, static wrinkles.
Static wrinkles are present all the time and are caused by sun damage, smoking and the effects of aging; namely skin thinning, gravity and laxity.
Smoothing out these lines and wrinkles can make an enormous difference to your appearance. This can be now be achieved by the injection of a naturally occurring substance into the skin beneath the wrinkles. This has the effect of filling out wrinkles, reducing or even eliminating them.
Hyaluronic Acid
Hyaluronic acid exists naturally in all living organisms and plays a vital role in the skin where it creates volume by attracting and holding water molecules. Without hyaluronic acid, the skin would appear dry, withered and wrinkled. As we get older, the amount of hyaluronic acid in the skin diminishes and the skin therefore becomes thinner, less well hydrated and develops wrinkles.
Treating Wrinkles
When treating wrinkles or folds Restylane is injected into the skin in tiny amounts with a very thin needle. The injected gel gives natural volume under the wrinkle, which is lifted up and smoothed out. A treatment takes about 30 minutes and the results can be seen immediately. The method is fast and safe and leaves no scars or other traces on the face. As hyaluronic acid already exists in your skin, a skin allergy test is not needed and this means that you can have the treatment done immediately.
Depending on the effects desired, an initial treatment is usually maintained with occasional follow-up treatments. Together with your doctor you plan regular future visits to maintain a good result. Follow-up treatments normally require a smaller amount of the product. Most patients choose to have a follow-up treatment six to twelve months after an initial treatment of wrinkles. Clinical trials show that Restylane is effective for up to one year after the treatment of wrinkles.
Treating Lips
Water is the source of all beauty. Water gives life and creates contours of your lips. Hyaluronic acid can be injected into your lips to attract and hold water and give your mouth a more pronounced look or the lips a more sensuous form.
Lip augmentation is usually carried out in two steps, Pouting and Contouring. Often a combination of the two is used to achieve an optimal result.
Pouting: To create a more pronounced mouth and fuller lips, Restylane is injected into the inside of the upper and/or lower lip.
Contouring: The vermilion border (lip line) is highlighted and accentuated by injecting the gel along the lip line. The lines that go up to towards the nose (philtral ridges) can also be defined by injecting Restylane into the lines.
When treating the lips pain relief in the form of a local anaesthetic is often used. A treatment session can be carried out immediately and takes about 30 minutes. Restylane is biodegradable which means it will gradually be absorbed. How long the effect lasts varies with individuals, but clinical trials show that Restylane is effective for up to six months after lip augmentation.
After Treatment
After treatment you should expect some swelling, tenderness, redness and possibly an itching sensation in the treated area. This is a normal result of the injection. The inconvenience is temporary and generally disappears in a day or two
Do I need to avoid anything after a treatment?
- Avoid touching the treated area within the following 6 hours. After that, a light make-up can be applied and the area can be gently washed with soap and water.
- Until the initial swelling and redness have resolved, do not expose the treated area to intense heat (e.g. solarium and sunbathing) or extreme cold.
Possible Side-Effects
If you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another eruption of cold sores.
If you are using aspirin or any similar medication, be aware that these may increase the bruising and bleeding at the injection site.
Other types of reactions are very rare, but about one in every 2,000 treated patients have experienced localized reactions and swelling at the implant site, sometimes affecting the surrounding tissues. Redness, tenderness and rarely acne-like formations have also been reported. These reactions have either started a few days after injection or after a delay of two to four weeks and have generally been described as mild to moderate and have settled spontaneously within two weeks.
Cost of Restylane Treatment
Restylane 0.4ml £180
Restylane 0.7ml £220
Restylane
Common Questions and Answers
This is a selection of common questions and answers. If you have any further questions, please ask me during our consultation.
What does Restylane contain?
Restylane consist of stabilized hyaluronic acid 20 mg/ml and physiologic sodium chloride solution, pH 7q.s. It is a clear, transparent, viscous gel supplied in a glass syringe. The hyaluronic acid is biosynthetically produced by bacterial fermentation.
What happens if the material is not injected at the recommended level of the tissue?
To ensure satisfactory results it is important that the product is injected at the right level. If the product is injected too deeply, the gel can move in the tissue because the gel particles are too small. If the product is injected too superficially, this might lead to tissue disturbance and/or uneven results because the gel particles are too large in relation to the tissue structure at that level.
How long does the effect last?
In general follow-up treatment is needed after 6 – 12 months. Clinical trials show that RESTYLANE is effective for up to one year after the treatment of wrinkles. However, the duration of treatment depends on many factors, such as the structure of the skin, lifestyle and age, degree of perfection demanded by the patient and the injection technique of the practitioner. Clinical experience indicates that touch-up and follow-up treatments will add to the duration.
Do the products get stiffer, in for example the lips, in cold weather? What happens in the sun?
The patient should not expose the treated area to intense heat (e.g. solarium and sunbathing) or extreme cold for the first few days after the treatment. This is to avoid the risk of inflammation since the area has been disturbed by the injection procedure. However, once the products are integrated in the body they will adjust to a normal body temperature.
Why do the lips sometimes get very swollen immediately after treatment and how long does the swelling normally last?
Unfortunately, we do not yet know the cause of this but we have no reason to believe that this is an immunologic reaction. Normally, the swelling is gone within a week after injection into the lips.
Can Restylane be combined with other types of implants?
Restylane should not be used together with any other injectable implant. Nor should it be injected into an area where a permanent implant has been placed.
Is there a need for overcorrection?
No.
Can Restylane be used during pregnancy or lactation?
The safety of Restylane treatment during pregnancy or lactation has not been tested. However, as a general precaution I would advise against the use of any injectable whilst you are pregnant or breastfeeding.
Are there any known interactions with antibiotics?
There are no known interactions with any antibiotics and, furthermore, theoretically there is no basis for an interaction with commonly used antibiotics.
Can patients with different kinds of allergies be more sensitive to the products?
So far, we have seen no connection between patients with allergies and patients that report a reaction to Restylane.
If a patient has had problems with recurrent facial herpes simplex can Restylane treatment contribute to another herpes simplex eruption?
There is a risk that the injection process itself, i.e. the insertion of a needle into the skin could contribute to another herpes simplex eruption.
Should you give patients suffering from herpes “special” treatment?
If a patient is particularly susceptible to coldsores it is wise to take a course of prophylactic treatment with acyclovir.
Can the products be used for patients who have undergone laser treatment or chemical peeling?
Yes, but it is recommended that these patients wait until the treated area is totally healed (normally 4 to 6 weeks)
