Restylane-L®

What is Restylane-L?

Restylane-L is a crystal-clear, biodegradable NASHA (Non-Animal Stabilized Hyaluronic Acid) gel that contains soothing lidocaine and is FDA approved for injection into the skin in tiny amounts with a very fine needle. Since this is made from safe, naturally occurring non-animal material, there is minimal risk of an allergy. Those who are allergic to lidocaine, however, should not use Restylane-L.

How long does it last?

• Restylane-L usually lasts from 6 to 12 months.
• The length of time the effect lasts is highly individual. It depends on many factors, such as the structure of the skin, lifestyle and age, as well as on the degree of perfection demanded by the individual.
• Unlike permanent treatments or implants, Restylane-L always offers the chance to re-evaluate the need when the initial effect has worn off.
• A follow-up treatment can be performed at any time after the previous treatment. In general, a follow-up treatment is required after 6 to 12 months.
• Clinical experience indicates that regular follow-up treatments add to the duration.

Who is a candidate for this procedure?

• Those with a desire to enhance lips or fill in depressions or wrinkles.
• Men and women with no lidocaine allergies.

Intended Results:

• Immediate results, producing a long-lasting, natural enhancement, gentle and safe to the skin.
• For patients who desire fuller or more well-defined lips.
• For patients who desire to correct thin lips and/or the wrinkles around the mouth for a more normal appearance.
• For patients who desire softening of scars, depressions or wrinkles.

Procedure Description:

• The area is prepped and cleaned. Then, using a very small needle, the Restylane-L is introduced into the dermal layer of the skin. Because Restylane-L contains a numbing agent, most patients do not require a topical anesthetic.

Featured Cases

Click thumbnails below for larger view or click here for more Restylane® / Perlane® cases.

Case Number 18:		Case Number 17:
Before	After	Before	After

The before and after pictures above depict ACTUAL PATIENTS of Naples Plastic Surgeon Kent V. Hasen, M.D. Your results may vary.

Recuperation and Healing

• After the injections, the areas remain red and slightly swollen for several hours.
• The areas treated may feel firm to touch, but this is usually not visible.

Restylane-L Frequently Asked Questions

What is Restylane-L?

Restylane-L is a gel that is injected into the skin in order to add volume to lips and lift up wrinkles and folds. Restylane consists of hyaluronic acid, which is a natural substance already present in your body, and contains the pain-relieving agent lidocaine. Once in the skin, Restylane-L works by creating volume. Some dermal fillers are derived from animal substances. The hyaluronic acid in Restylane-L is non-animal.

Do I need to have a skin test?

No.

What is hyaluronic acid?

Hyaluronic acid is a natural substance that is found throughout your body. It gives volume to the skin, lubricates the joints and gives the eyes their shape. The hyaluronic acid in Restylane is stabilized for long duration and is not of animal or human origin.

How was Restylane-L developed?

After many years of research, Dr. Bengt Ågerup and the company Q-Med in Uppsala, Sweden, succeeded in developing a way of using a Non-Animal, Stabilized Hyaluronic Acid to replace the loss of volume in the skin. The first application, Restylane, was launched in 1996. Before this, only collagen made from cowhide and hyaluronic acid made from rooster combs had been available.

Restylane-L was developed to reduce discomfort during injection. It received FDA-approval in 2010 and is now widely used.

How is a treatment performed?

During treatment, the crystal-clear Restylane-L gel is injected into the skin in tiny amounts with a very fine needle. The gel produces volume under the wrinkle, which is lifted up and smoothed out. When enhancing lips or facial contours, Restylane-L adds volume and shape to the treated area.

How long will the treatment session take?

Treatment with Restylane-L is a very quick and easy process. As no pre-test is needed, the treatment can be carried out immediately. A treatment generally takes 30 minutes. The time differs somewhat, depending on the correction you wish to have performed.

What can be treated?

Restylane-L can be used for smoothing out folds and wrinkles, lip enhancements and shaping facial contours. The most common areas are the glabellar lines (between the eyebrows), the nasolabial folds (from the root of the nose to the angle of the mouth) and the lips, although other sites can also be treated. Very superficial or very deep wrinkles may be difficult to correct.

Does it hurt?

Thanks to the addition of lidocaine in Restylane-L, most people find the injections relatively painless. A mild pinch may be felt, however, this is usually well-tolerated. If you like, an additional topical anesthetic can be applied to the area being treated prior to your procedure.

How soon will I see the results?

The results can be seen immediately.

How long does the effect of a Restylane-L treatment last?

The length of time the effect of a Restylane-L treatment lasts is very individual and depends on many factors, such as the structure of your skin, lifestyle, age, the degree of perfection demanded and the injection technique of the practitioner. Experience indicates that touch-up and follow-up treatments will add to the duration. Most of Dr. Hasen's patients choose to have a new treatment within a year after the treatment of wrinkles and folds and about six months after a lip enhancement.

What will I look like after the treatment?

Immediately after the treatment, you can expect slight redness, swelling, tenderness or an itching sensation in the treated area. This is a normal result of the injection. The discomfort is temporary and generally disappears in a few days. After a lip treatment, the lips may become swollen and look somewhat uneven. This can persist for a few days or up to a week. If the discomfort continues, please contact Dr. Hasen.

How will my skin look without follow-up treatments?

The correction will gradually disappear until your skin looks like it did before the treatment. Follow-up injections will help you maintain the correction.

What should I bear in mind after my treatment with Restylane-L?

During the first 48 hours after your treatment, do not massage or rub the treated area. If you have had a lip enhancement, avoid puckering your lips for the first two days after the treatment. Until the initial swelling and redness is gone, do not expose the treated area to intense heat (e.g. in a solarium or by sunbathing) or extreme cold.

Are there any side-effects?

The rate of reactions to Restylane-L is very low. However, after the treatment, some common injection-related reactions may occur, such as swelling, redness, pain, itching, discoloration and tenderness at the injection site. These typically resolve within a few days after injection into the skin and within a week after the injection into the lips. Other types of reactions are very rare, but about 1 in 2000 treated patients have experienced localized reactions thought to be of a hypersensitive nature. These have usually consisted of swelling at the injection site, sometimes affecting the surrounding tissues. Redness, tenderness and rarely acne-like formations have been reported. These reactions have either started a few days after the injection or after a delay of two to four weeks, and have generally been described as mild to moderate and self-limiting with an average duration of two weeks. This text does not contain all the information known about these products.

Can patients with allergies of different kinds be more sensitive to Restylane-L?

Unless the patient is allergic to lidocaine, Restylane-L should not cause an allergic reaction. However, all known allergies and drug reactions should be discussed with the doctor prior to treatment.

Why do the lips sometimes become very swollen immediately after a Restylane-L treatment?

The cause of this is not known, but there is no reason to believe that this is an immunological reaction. Normally, the swelling is gone within a week after injection into the lips.

Can Restylane-L be removed?

No. However, Restylane-L dissolves naturally with time. If you feel uncertain about the desired result, you can choose to have the treatment done in small steps.

Can Restylane-L replace surgical procedures?

No, but Restylane-L can be used in conjunction with surgery to fill out wrinkles that cannot be removed by surgery.

Can Restylane-L be used if I have undergone laser treatment or chemical peeling?

If you have recently had some other kind of facial treatment, it is recommended that you wait until the treated area is totally healed and the skin has normalized (usually 4 to 6 weeks) before you undergo a Restylane-L treatment.

Does Restylane-L get stiffer in cold weather? What happens in the sun?

You should not expose the treated area to intense heat (e.g. in a solarium or by sunbathing) or extreme cold for the first few days after the treatment in order to avoid the risk of inflammation. However, once Restylane-L has integrated into the body, it will adjust to your normal body temperature.

What should I think about before I have a Restylane-L treatment?

Look at yourself in the mirror and think about the result you are expecting. Try to convey your expectations to Dr. Hasen before the treatment and ask him if it is possible.