Steve Fallek (Plastic Surgeon and Medical Director, Face Focus Medical Spa) gives expert video advice on: On what part of my body can Restylane be used?; Is a Restylane injection painful?; Will weather affect my Restylane treatment? and more...
What is "Restylane"?
Restylane is a hyaluronic acid substrate. It was one of the first hyaluronic acids available in this country, and it is a dermal filler which helps fill up both static and dynamic wrinkles. It works in the dermal layer, that's the thick area of the skin, and it's safe, effective, and works quite well. It's been used in Europe for many years and has been available in this country for about two or three years. It's injected primarily in the nasolabial fold, in the upper and lower lips, and also in what's called the puppet or marionette lines. We've also started to use it in the upper face area, sometimes in the cheek and in the eye, and it's also sometimes used in the glabellar area, which is the area between the eyebrows.
How is Restylane different from other dermal fillers?
Restylane was the first hyaluronic acid that was available in this country. What was great about Restylane is because hyaluronic acid is part of the normal body, there was no pre-testing that was required. Therefore Restylane has been very valuable in our practice because patients could come in and just get the Restylane injections right away.
How is a Restylane treatment performed?
Restylane is usually performed in a doctor's office or in a medispa. It's a small syringe using a tiny needle which is injected into the appropriate areas. Usually, a local anesthetic will be used, either something such as a topical anaesthetic such as EMLA, or such as an injection with lidocaine, which is a local anaesthetic.
Who can administer a Restylane injection?
I think if you're going to a medispa and they're offering Restylane, it's important that a doctor performs the injection. This is certainly on the medical end of the medispa treatments. In medispas sometimes a physician assistant or a nurse practitioner will do the injections, but I firmly believe that the doctor at the medispa should be doing the injections.
On what part of my body can Restylane be used?
Restylane is primarily used in the facial area. Initially, it was used in the nasal labial folds. Those are the lines that run from your nose down to your mouth area and that's where most of the treatment was performed. Subsequently, we've started to inject it in the upper and lower lips, in the marionette or puppet lines. Those are these lines here and within the last year or two, we have been injecting it in the upper face, specifically around the eye area, the lower lid area. Sometimes it can be injected in the cheek area, in the crowsfeet area and also in the globella area. That's the area between your eyebrows. Restylane works and it's safe and effective.
Is a Restylane injection painful?
Restylane injections are generally not painful. The needle is a very tiny needle, almost like an acupuncture needle. It's threaded right into the skin, so no it's not painful. For most patients we apply a topical anesthetic agent, which will numb the area. Some other doctors like to use a local anesthetic, which is an injection in that area. I wouldn't suggest having the Restylane without either a topical or a local anesthetic agent. However, I do have patients who will have no anesthetic agent. In general though the injections are not that painful.
Who should not receive a Restylane treatment?
There are almost no patients that can't get a Restylane injection. Obviously, patients that are pregnant should not have this treatment as it is considered a cosmetic treatment. There are certain people that may have a reaction to the Restylane, but that would be extremely rare. For the most part, patients that don't have wrinkles or are hoping to prevent wrinkles are patients that probably shouldn't get Restylane. If there's no wrinkles than the Restylane is not really going to help too much.
What results can I expect after receiving a Restylane injection?
What's great about Restylane is you'll see an immediate result. The wrinkles will fill up by the time you're out of the office. What I like to do is I have patients come back in about two or three weeks after the initial injections to see if there are other areas that need to be treated again. What happens is many times patients will say they don't want to be overfilled the first time, they don't want to look like a chipmunk, to use their expression, so I will have them come back in about two or three weeks.
What should I be aware of after my Restylane treatment?
What I love about Restylane is you'll see immediate results. I hand patients a mirror right away and they can see those lines have either disappeared or been dramatically reduced. So for me I love it. I think it really works quite well and patients are very happy with it. In terms of any side effects or complications, really the only issue is at the injection site there can be some bleeding, which is rather minimal and goes away pretty quickly. The majority of my patients have been extremely happy with Restylane.
How much time should I allot after receiving a Restylane injection?
There's really no downtime associated with a Restylane injection. If you're at a Medi-Spa I would suggest having a facial or any other facial treatment prior to using Restylane or any dermal fillers. Am I erring on the side of caution? Sure. But I'd rather not have that material being pushed around. But in general patients are very happy with Restylane. And there's almost no down time associated with it.
Will weather affect my Restylane treatment?
There have been no studies that I've seen that show either cold or warm weather have any effect on either Restylane or any of the other treatments.
Is it possible to receive too many Restylane injections?
What I love about Restylane is that it works, and it takes care of wrinkles. I think if it changes your appearance and doesn't improve the way you look, and makes you look different or makes you look worse, then yes, I would say that there is such a thing as too many Restylane injections.
What happens to the Restylane once it is in my body?
Restylane is safe and effective, and because it's a naturally-occurring part of our body, what happens is eventually the body will just absorb that material in a local fashion. It won't go anywhere else in your body. Around nine months most of that material will be absorbed and will be gone. That's part of the reason that you need further injections.
Can I receive other cosmetic fillers after getting a Restylane injection?
There's no reason you can't have Restylane or any of the other dermal fillers at the same time or within the next week or two. Many of them work in a similar fashion, so yes, I and other plastic surgeons do combine many of these fillers.
How long does Restylane last?
Restylane should last anywhere from 6 to 9 months. Restylane is patient dependent and it can also be injection dependent, depending on where the material is put. If it is put in the right area it should last about 9 months. For some patients they start to see the material resolve after a Restylane injection so they come back in earlier for injections. Other patients may wait a year until all that material is gone before they come back for another Restylane injection.
Will Restylane correct all of my wrinkles?
There's no dermal filler that will correct all of your wrinkles. Specifically, there are two types of wrinkles: there are static wrinkles and dynamic wrinkles. Restylane will work very effectively on the static wrinkles. Those are the ones that are at rest. For some of the other wrinkles, such as the dynamic wrinkles that we get around our mouth, the Restylane will improve those wrinkles but probably won't get rid of them entirely.
How much will a Restylane treatment cost?
Restylane can vary anywhere from five hundred dollars up to fifteen hundred dollars. A lot of it depends on what part of the country you are, whether or not you're in a big city, and some of it depends on the spa settings. If, in fact, it is cheaper than five hundred dollars, I would be quite concerned that it's not the actual material. As I said though, the prices do vary, again, depending on the doctor and the location.