Facial Fine Line Removal: Juvederm, Restylane, Perlane & Belotero
Acid may not be the first thing you think of when it comes to creating a more youthful look. But hyaluronic acid (HA) can do just that. HA is found in all living things. It’s actually a sugar—a complex sugar that retains water. Because of its ability to absorb water – it can retain more than 1,000 times its weight! – it can be used to add volume to the skin. HA occurs naturally in our bodies. It:
- helps our eyes keep their shape
- maintains the volume of the eye
- lubricates the joints
- moves nutrients to our cells by binding with collagen and elastin
- works to keep skin lubricated
- maintains the volume of skin (texture) by combining with collagen and elastin
Over time, the level of natural HA in our system decreases. This is because cells stop producing HA due to aging and exposure to pollutants and UV rays. When this happens, all of the benefits above begin to diminish. The skin forms wrinkles and lines as a result.
Dermal fillers to fill facial fine lines*
While our bodies produce less natural HA, we have ways to replace it. Dermal fillers with HA are used to improve the volume and smoothness of the skin. Some examples of these products include Restylane, Perlane (made by the same company), and Juvederm (made by a different company). These are used in the form of a gel. It is clear and biodegradable. These treatments have been used successfully in over 60 countries. More than a million treatments have been given.
These types of fillers use HA, which already naturally occurs in the body. As such, the enhancements created with dermal fillers look natural. The increase in volume they produce looks healthy and is firm.
These fillers can be injected into different parts of the face. They can be injected at varying depths to create different results. Each product’s features determine what it is best used for. How thick the product is will determine how deep it can be used. For example, a thin consistency is needed to treat fine lines at the surface. The thinness ensures that the filler will not cause ridges under the skin. Thicker versions are used to improve volume and are injected deeper under the surface. These results last longer.
Several companies sell HA products worldwide. Their main product lines are discussed below. Restylane and Perlane are made by one company, and Juvéderm is made by another.
The Difference between Restylane and Perlane
Both Restylane and Perlane are HA treatments. They differ in the thickness, as described above. Restylane has a thin consistency and is used near the skin surface to reduce very fine lines. It is a gel that is injected with a fine needle.
Perlane has larger particles—it is thicker. It is used to improve volume. It can be injected below the facial folds to make them less visible. Due to the thickness of the product, it is not well-suited to be used close to the skin surface.
In fact, there are three versions:
- The first one we discussed is actually “Restylane Fine Line” – to be used as the name implies. It gets injected with a very fine needle, in very small amounts. The filler works by filling out the area under the wrinkles, which allows them to smooth out. You can see the results right away, and there are no traces of the treatment.
- The next is simply “Restylane” – which can be used both to make fuller lips and to treat wrinkles that are deeper than fine lines.
- Finally there is “Restylane Perlane” – which can be used, as we noted, for deeper facial folds and improving volume. It is also used for fuller lips. It can even be used to give a fuller shape to the chin. This is an area where more volume can really impact your look. Restylane Perlane is the version that changes facial volume and the shape of the facial contours. It works by adding volume under the skin, which in turn lifts up deep folds. It can be used on the cheeks as well, giving a whole new face shape. It can make your face fuller, restoring a youthful look.
Where may Restylane and Perlane be used?
Restylane and Perlane may be used for treating facial wrinkles or folds, and enhancing facial features using volume. Restylane is best injected into the skin in tiny amounts using a very fine needle technique. The injected gel produces natural volume under the wrinkle, this lifts up and smooths out. The results of the injection can be seen immediately. Treating wrinkles is fast and safe. It leaves no scars or other traces of the treatment.
Many people are looking for a slightly fuller shape for their chin. Just a touch of additional volume with Restylane is best and may make a drastic difference. This will give your face a fuller, more defined appearance. Perlane is specifically designed for shaping facial contours. Perlane works by volume augmentation. Injected into the face, it corrects deep folds and lifts up the skin from cheeks and chin, giving a new facial shape.
The body breaks down the filler after it is injected. However, it lasts a long time because it binds with water from your body as it breaks down. In fact, even more water can bind to it as it breaks down than before.
The speed of this process of breaking down the gel depends on:
- How mobile the area is. (More mobility means the filler will be broken down faster). For example, injections in the lips will break down much faster (around six months) than injections in the cheeks (around two years). It also matters how much muscle activity occurs in the area, which varies by person.
- Your age. How supple your skin is will make a difference.
- Your skin type.
- The placement and technique used during the injection.
Overall, this means that the effects will last quite some time, but not forever. Most people plan on having their next treatments between 6 and 12 months later. Doing so will further prolong the results, of course. The other advantage is that you can decide to either continue or change your treatment at any time. You can continue to use these products indefinitely or you can opt to stop using them later if you prefer.
The reason Restylane and Perlane remains for 6 to 12 months after injection is due to its stabilization method. This method allows the volume to remain intact for a long period. As the HA in Restylane begins to break down, your body’s water takes its place. The more broken the gel becomes; the more water is able to bind to it. This is the main reason it lasts so long.
There is no prior skin test needed, the way collagen injections required. You may have the treatment at the time of your first visit. The total treatment typically takes less than thirty minutes. Most of this is in allowing the numbing medication to take effect. The actual treatment time depends on the area(s) and correction you want performed. The result is immediate.
Again, prior to your procedure, a topical anesthetic cream can be applied. You can also choose to have a local anesthetic injection similar to a dentist visit. The numbing from the injection will last less than 40 minutes and is much shorter than the dental numbing agents. For wrinkle treatments, this type of injection is not required. But it is recommended and can be arranged by request.
What to expect after the facial fine line treatment
While you can immediately resume normal activities, you may have some temporary side effects like itchiness, swelling, redness, or tenderness. This is all normal and should go away on its own within a few days. (For lip injections, the swelling may remain for up to a week, and may make the lips seem uneven for a brief time—this is also normal).
To minimize these effects after the treatment, here are some tips:
- Try not to touch your face for at least six hours.
- After six hours has passed, wash the area gently. Use soap and water.
- Protect the face from extreme temperatures (both hot and cold)
- You can wear light makeup at this point.
Besides localized effects from the treatment directly, there are risks of other reactions:
- For anyone that has had cold sores in the past, sometimes this treatment could make them return. If this is a concern, you can take antiviral medicines.
- The use of aspirin (and related medications) can cause bruising where you have the injections. Talk to Dr. Brown about stopping these types of medicines prior to the treatment.
- Spots that are similar to acne have been reported by some people.
These types of reactions might happen anywhere from a few days to a few weeks after treatment. Typically even these reactions go away on their own after about two weeks.
More information can be found at www.restylane.com
Juvéderm in Ashburn*
Juvederm is much like Restylane, but it does have some different risks. In addition to itchiness, swelling, redness, or tenderness, there may also be bruising, lumps, firmness, and pain. There is a risk of infection (which is true for any injections). Additionally, to decrease risks:
- reases bleeding risk should advise us before undergoing treatment.
- If you have a history of allergies or anaphylaxis, do not use this treatment.
- If you have allergic reactions to gram positive bacterial proteins, you also should not use this product.
Patients should notify the office if they are on any medication that may prolong bleeding. These can cause increased bruising. As with all injections, there is a risk of infection. Juvéderm injectable gel should not be used by a patient with a history of anaphylaxis or multiple severe allergies. Juvéderm should not be used with patients who have allergies to gram positive bacterial proteins.
Belotero in Ashburn*
This hyaluronic acid is also called Belotero Balance. It is the newest kid on the block. It is a much finer HA when compared to the others mentioned above. It is used in different areas for different purposes. While some of the fillers are used to rebuild deeper volume, Belotero specifically treats more superficially. In the two pictures below you can see how the filler has been placed to raise up the skin.
Juvederm treatment to nasolabial fold area*
Like Restylane, Juvederm is a dermal filler made from HA. They are also similar in the fact that they are non-animal based. The uses are similar for both products.
Juvederm has a very high concentration of HA and a very smooth consistency. This allows it to be used in a very controlled and targeted way.
In clinical trials, Juvederm was compared to collagen injections for the same patients. The Juvederm treatment results lasted longer, and prompted 88 percent of the trial participants to prefer it.
It is FDA approved for the moderate to severe etched-in lines and wrinkles, such as the lip stick bleed lines above and around the around the mouth. It works great in this area. With being placed in more superficial areas, it does tend to not last as long. To learn more visit, the Belotero website.
Although not FDA approved for any other areas, it is probably the best filler to treat the eyelid bags. This is because it can be placed more superficially with less issues.
Fine line treatment referral
Miami, Florida has a lot to offer the visitors. If you are considering having some facial fine treatments or even plastic surgery while in Miami, we recommend Dr Jhonny Salomon. He is a highly respected, board certified plastic surgeon and has a gentle touch. Visit http://www.drjsalomon.com to learn more.
George Washington University Professional Center
The Loudoun Center for Plastic Surgery
45155 Research Place, Suite 125
Ashburn, VA 20165