The Current Dermal Fillers:
Restylane® and Perlane®

What are dermal fillers and what do they do exactly?

  • Dermal fillers are those FDA approved substances that are injected into the dermis for the purpose of reducing deep lines and furrows around the mouth, tear troughs, nasal labial folds and lines across the cheek.
  • Originally, bovine collagen was used for years, but that had its drawbacks and 2% of the population was allergic to it, so every patient had to be skin tested.
  • This was replaced by human collagen which eliminated the need for skin testing but it was difficult to shape and mold to provide a smooth filling.

What is Restylane and Perlane and why do I use it?

  • Restylane is an entirely new compound, not made of collagen, but of gel-like hyaluronic acid. This acid is a normal component of the skin and joints and has no allergic effect.
  • It had two immediate advantages over collagen, it lasted six months instead of three, and it had twice the filling power over collagen.
  • Since its introduction I have not used any collagen but only Restylane.
  • Perlane came after and is the same compound with a 20% increase in the size of the molecule. Now this allowed for enhanced filling of deep folds, like those deep nasal labial folds.

Why do I use it?

  • I like Restylane and Perlane because it is moldable and people see instant results.
  • It lasts twice as long as collagen
  • It has twice the filling power

Where do I use it?

  • I use it in the lips to give you back the lips you use to have ten years ago.
  • Rather than nice, plump, full lips we once had, we now have that thin red line where we put our lipstick on what used to be our lips.
  • Restylane restores the volume to where it once was; not to change the shape of the lip, but to change the size.

I’ve seen people who’ve had too much and they look weird, is that going to happen?

  • Now, everyone has heard of people going too far and injecting too much so that they look like a monkey.
  • I do not do that, and I do not allow people to receive too much.
  • People want to look better, but not like they have had ‘something done’ to them.
  • We also do not try to make you look like someone else. We make you look a younger you; the effect is subtle, yet noticeable.
  • I also use it in the nasal labial folds
  • the deep furrows between the eyes
  • the tear troughs
  • ear lobes
  • deeper lines on the face.

Medication Warning

  • As with Botox, please do not take medications such as aspirin, Motrin, ibuprofen, Anaprox, Alleve, or high doses of vitamin C & E
  • These medications thin your blood and promote bruising.

How much do I need, and how much does it cost, and how long does it last?

  • People can routinely use one to four syringes depending upon their budget and inclination.
  • Each 1.0cc syringe of Restylane costs $450.
  • Each 1.0 cc syringe of Perlane costs $500.
  • It commonly lasts about six months, sometimes longer in a non-moving part of the face.

Does it hurt?

  • The lip is the most sensitive area so I use a topical anesthetic, then a local anesthetic, then an ice pack. I inject very slowly, as it is ‘uncomfortable yet tolerable’ for most people.
  • Other areas of the face are less sensitive and a simple topical anesthetic with an ice pack suffices.

What do I expect afterwards?

  • Everyone has some reactive redness and swelling that subsides within 48 hours.
  • I send you home with an ice pack to help with the mild swelling.
  • Because of this, it is good to plan ahead.

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