STORY BYJust as Botox did a short time ago, Restylane is creeping into our esthetic vocabulary.
Restylane is one of a group of “cosmetic dermal fillers” that acts in conjunction with Botox treatments. While Botox relaxes muscles that can cause frown lines, a filler literally fills in the grooves left behind from deep expression lines or skin folds.
Hyaluronic acid, the generic name for Restylane and a few lesser-known brands, plumps up the nasolabial folds between the nose and cheek, erases brow and forehead lines, smoothes pitted chins and obscures dark under-eye circles.
Other filling agents include collagen, fat and silicone. “But, hyaluronic acid is superior to other and older fillers such as collagen, both in its application and its finished product,” says Dr. Adelaide Hebert, professor in the Department of Dermatology at The University of Texas Medical School at Houston.
Restylane is a non-animal “stabilized” hyaluronic acid, free of animal proteins, which limits the risk to patients of allergic reactions.
“Restylane has a softer, smoother look and best of all, you don't have to pre-test the skin for allergic reactions that can come from other materials,” Hebert says.
Hyaluronic acid resides naturally in the skin and body, explains dermatologist Dr. Craig Teller, adjunct professor at UT Medical School, so it interlaces with the skin's own collagen.
Collagen serves as the skin's steel pillars. Hyaluronic acid interacts with it, providing water retention as a volume enhancing component. “We find hyaluronic acid in all species, as we do collagen. However, collagen types differ among species,” Teller explains, which also accounts for some cases of hypersensitivity in people.
Hyaluronic acid has a longer-lasting effect and wears off gradually. While collagen is a worthy filling agent, it wears off more quickly—and suddenly. “By contrast, hyaluronic acid gives you instantaneous and long-lasting enhancement because it binds many times its weight in water,” he says.
Restylane is injected into lined areas at several sites. Teller says it also is effective in sculpting and enhancing lips. Not only can it make lips fuller, but also fill in the vertical lines or “lipstick bleed lines” caused by smoking, pursing lips habitually, or sun exposure.
Dark circles and sunken eyes benefit from Restylane where the facial skin is its thinnest. Veins that show through thinned skin create the shadows beneath the eyes.
Skin loses some of its elasticity with age, particularly in the cheeks, resulting in skin folds and a hollowed appearance. Fillers can augment cheeks and smooth out crevices in the chin area, as well.
Hebert says that one of the more popular sites for Restylane or other dermal fillers is at the “marionette lines—creases that extend down the face from the corners of the mouth.”
It also fills in deep frown furrows on the forehead, both vertical and horizontal.
Restylane can be a more painful injectable than other materials used as fillers, but doctors can use local anesthetic creams and/or nerve blocks to dull the pain. Teller also uses a vibrating massager next to the injection area. Since there are only so many stimuli that the brain can absorb, the vibratory sensation serves as a neural smokescreen.
Temporary bruising or swelling is common the first few days and the face needs babying for up to a week. Hebert advises not to do anything that would tug on the skin or put pressure on the face, such as deep kissing, massage, or going to the dentist.
Restylane and other fillers typically last from four to nine months, with an average of six months. Some dermatologists recommend smaller treatments more often rather than waiting until the original treatment wears off completely. “Shorter, frequent visits are less stressful on the skin, the patient and the pocketbook,” Teller says.
Although Restylane has received more brand exposure, Teller says there are several other hyaluronic acids, with more coming on the market.
The price varies depending on the number of syringes used, which come preloaded in either 1cc or 4cc measurements. Usually, patients will need 1-3cc to treat nasolabial folds, Hebert says, which can run $400-$1000 per application.
Most patients can tolerate fillers, particularly hyaluronic acid, well. “However, keloid-prone [exaggerated scarring] patients may not be candidates,” she adds.
Teller says a person who has very deep lines or significant skin sagging receives better results with Sculptra (a significant volume filler) or a face lift.
“An experienced dermatologist or plastic surgeon can make the most reliable recommendations,” Hebert says and cautions interested patients to resist claims of expertise made by spas and salons.
“As with any procedure, seek an evaluation from a board-certified dermatologist who has had extensive experience in cosmetic procedures,” Hebert says.
Last Updated: 6-07-2005Editorial Board | Legal Disclaimer | Privacy & Security | Contact Us
© 2000-2010 Office of Institutional Advancement, The University of Texas Health Science Center at Houston
Follow us on:
Dr. Adelaide Hebert is a professor in the Department of Dermatology at the UT Medical School.
See Dr. Hebert also at:
Eating healthy
reverses metabolic syndrome
Dr. Tasnime Akbaraly of University College London and her colleagues were interested if healthy eating could actually turn-the-tide and reverse metabolic syndrome, which is having 3 or more of the following risk factors: excess abdominal fat; high triglycerides, hypertension, low levels of HDL the “good” cholesterol, or type 2 diabetes. Having metabolic syndrome doubles a persons’ risk of heart disease and greatly increases the odds of developing type 2 diabetes.
The researchers studied 339 British civil servants with metabolic syndrome, and how closely the adhered to the Alternative Healthy Eating Index (AHEI) to see if it could help reverse metabolic syndrome. The AHEI is a set of published nutritional guidelines by the Harvard School of Public Health in 2002 that emphasizes whole grains, fruits, vegetables and decreased red meat consumption.
Five years into the study, nearly 50% no longer had metabolic syndrome. People who followed the AHEI guidelines the closest were nearly twice as likely to have reversed their metabolic syndrome. The results of the study were published in Diabetes Care, online July 29, 2010.
Dr. Alice Lichtenstein, an expert on diet and heart health from Tufts University in Boston who was not involved in the study said, "It's not about focusing on individual components of the diet, it's really the whole package, and that becomes important because it means that if one of the components of a healthy diet is to eat more fruits and vegetables, just buying a pill saying that there's a concentrated extract of fruits and vegetables is probably not what's going to help you."
Call and make an appointment with Wellness Coach Sam Hester, CWC, CPT, LWMC, at 713-500-3327. It's confidential and free. For more information on the wellness services provided, visit UT Counseling and WorkLife Services.
