Restylane ® ( Perlane, Lip Volume & SubQ )

NASHA hyaluronic acid technology

Product Summary

This brand has a lot of support from practitioners and is currently one of the most popular dermal fillers used in the U.K..

Since the manufacturer, Q-Med, launched Restylane® in 1996 it is estimated that over 15 million treatments have been carried out worldwide (data as at 2013). The product range has since been expanded and now consists of five different sizes of gel particle specifically designed for use in certain areas of the face.

As of 2009, some of the product range is available with the addition of 0.3% lidocaine (Restylane® Lidocaine and Restylane® Perlane Lidocaine) for improved patient comfort.


Generic name

Non-animal stabilised hyaluronic acid (NASHA) gel.


How is it made?

By bacterial fermentation from streptococci bacteria.


Is a skin test required before treatment?

No.


Is it temporary or permanent?

Hyaluronic acid is completely broken down within the skin over a period of months, eventually leaving no trace of the filler.


Licenced status

Medical device.


Treatment should be performed by

Restylane & Perlane PacksShould be used by trained members of the medical profession only.


Restylane® Product range

Restylane

This has an intermediate gel particle size that makes it suitable for moderate wrinkles and lip enhancement. It is recommended that it is injected into the middle part of the dermis (middle layer of skin).

Perlane

This has a larger gel particle size and is used for deep lines, facial contouring, and lip enhancement. It is injected into the deep layer of the dermis.

Touch

Restylane Touch pack Has the smallest gel particle size in the Q-med range and is used for the correction of very thin superficial lines. It is injected into the upper part of the dermis. This product is now discontinued in light of the Restylane Skinboosters range.

Lip Volume

This product was originally branded as Restylane Lipp but was later rebranded as Restylane Lip Volume. It has been specially designed and formulated for injecting into the lips for enhancement and contouring of thin looking lips, the cupid’s bow, or to simply add fullness. It claims to be structured to withstand the range of mouth movements and strains – like talking, smiling, laughing and kissing - that characterise the lip area and therefore last longer.

SubQ

Restylane SubQ pack It has the largest gel particle size in the range and is used to replace fat loss in the face and create or restore a more defined facial contour. The procedure requires a larger needle and deeper injections below the skin layers.

This product is promoted as an alternative to fat transfer . As a result, you will find fewer practitioners who are adequately trained to use SubQ.

Vital, Vital Light and Lip Refresh

This group of products, marketed as RESTYLANE Skinboosters is aimed at a whole new approach to skin rejuvenation, using mesotherapy, (sometimes called biorevitalisation) techniques. It is targeted at a broad range of treatment areas including the face, neck, décolletage (the area between the neck and breasts) and hands, as well as for dry lips (the Lip Refresh product); designed to replenish the hyaluronic acid lost through ageing, hence hydrating the skin and improving its elasticity and tone. For more information, please see our Restylane® Vital and Lip Refresh page.

Not to be used in

Individuals with a known hypersensitivity to hyaluronic acid.


Duration of effect

This depends upon the degree of correction required, your age and lifestyle as well as the correct placement of the product by a practitioner.

Clinical trials indicate that it is effective for six to twelve months for the treatment of wrinkles and for around six to nine months for lip augmentation.


Reported side effects

Transient erythema (redness), swelling, pain, itching, discoloration or tenderness at the implant site. Typically resolution is spontaneous, within one or two days after injection into the skin, and within a week after injection into the lips.

Additionally, temporary palpable lumpiness has been noted after injection in some patients.

Localised reactions thought to be of a hypersensitivity nature have been reported in about 1 in every 2000 treated patients. Redness, tenderness and rarely acneform papules may occur.

In addition in rare cases (in less than 1 in 15,000 treatments) granuloma, superficial necrosis and urticaria have been reported.


Costs

Again, this depends on area treated and how much is required, and the practitioner doing the treatment, but ranges are in the region of: £250 to £400 per treatment.


Before and After

Before Restylane SubQ

Before Treatment

After Restylane SubQ Subtle reshaping of the cheeks with Restylane SubQ (Images taken using MediZen`s VECTRA 3D imaging system.

Images provided courtesy of Dr David Eccleston at MediZen .



Full Face Before Treatment

Full Face After Restylane Treatment

Full Face Before Treatment

Full Face After Restylane Treatment

Left: Full face pictures prior to treatment.

Right: Full face pictures following rejuvenation using the Restylane® dermal filler range, (a combination of Restylane, Touch and Perlane) to revitalise facial appearance.

Restylane Lipp Clinical Results

Images provided courtesy of Q-med Limited.

All before and after photographs are real patients, your results may differ.


Bibliography

Olenius,M
The First Clinical Study Using A New Biodegradable Implant For The Treatment Of Lips, Wrinkles And Folds.
Aesthetic Plastic Surgery;1998:22:97-101

Duranti,F et al
Injectable Hyaluronic Acid Gel For Soft Tissue Augmentation: A Clinical And Histological Study.
Dermatologic Surgery;1998:24:1317-25

Troilius,C
Soft-tissue fillers: What options are available today?
Aesthetic Surgery Journal; 1999:19(6):502-5

Cantisano-Zilkha, M, Bosniak, S
Hyaluronic Acid Gel Injection For Facial Rejuvenation: A Three Year Clinical Experience.
Operative Techniques In Oculoplastic Orbital And Reconstructive Surgery; 1999:2(4):177-81

Bousquet, M-Th. and Ågerup, B
Lip Implantation: European Experience.
Operative Techniques In Oculoplastic Orbital And Reconstructive Surgery; 1999:4(2):172-6

Erian, A
Erian’s Original Technique Of Lip Enhancement.
International Journal Of Cosmetic Surgery And Aesthetic Dermatology; 2000:2(1):17-19

Friedman, P.M., Mafong, E.A., Kauvar, A.N., Geronemus, R.G.
Safety data of injectable nonanimal stabilized hyaluronic acid gel for soft tissue augmentation.
Dermatol Surg 2002 Jun;28(6):491-4.