What are Restylane® & Juvederm® Fillers?
Restylane® and Juvederm® in Boston and Worcester, Massachusetts are both hyaluronic acid based fillers that are used in the face. Hyaluronic acid is a substance found naturally in the human body, and does not require any allergy testing.
How do Restylane® & Juvederm® Work?
After being injected below the skin, Restylane® and Juvederm® lift and improve the appearance of wrinkles, hollow areas, and scars. This technique results in a smoother, more youthful appearance.
Where are they used?
Both Restylane® and Juvederm® can be used to add fullness to a large selection of areas on and around the face. These areas include: the cheeks to restore fullness, in the chin and jawline to soften the appearance of wrinkles, in earlobes to plump the lobe, in the nose during a rhinoplasty, in the face to treat marionette lines and wrinkles along the sides of mouth, in the upper and lower eyelids, and more.
Will injections hurt?
There is little to no discomfort associated with these fillers. A numbing medication can be applied topically to the treatment area before treatment. Additionally, there is numbing medication mixed in with both Juvederm® and Restylane® to further eliminate any discomfort.
When should I expect results?
Results from these hyaluronic fillers are immediate, and will improve after any swelling subsides.
Fillers – Patient 133
A man in his mid 50’s who is bothered by “tear trough” hollows under his eyes as well as lines of the forehead and crow’s feet lines around the eyes. He is shown before and again, 10 days after Botox to the forehead and crow’s feet lines ( lateral orbicularis) as well as the off-label use of REDENSITY to the tear trough area. REDENSITY is a Non Animal Stabilized Hyaluronic Acid Filler ( NASHA) that was recently released in this country for the treatment of active lip lines, which is the “on label” indication. It has been used “off label” in Europe for the tear trough area and I am excited that we now have it available in this country for the off-label treatment of the tear trough area. This is a challenging area to treat, because other NASHA fillers can become puffy and swollen in this area, and if this area is over corrected it looks funny. Redensity is part of the RHA line of fillers which have been in this country for almost 2 years and in Europe for almost 8 years. In Europe it is called Teoxane TEOSYAL RHA® 1
It is reversible if needed with the injection of an enzyme, hyaluronidase.
Fillers – Patient 132
A woman in her early 50’s who started to notice “smoker’s lines” or “lipstick lines” when she puckered her lips. She has stopped using a drinking straw in hopes this would help. She is not a smoker. This is typically related to subtle loss of soft tissue support with aging and is a perfect application for Redensity, the new RHA filler from Revance, and the first filler to be approved by the FDA for the treatment of active lip lines. The RHA line has been in Europe for 7 ½ years where it is known as Teoxane, and has been in this country for the last 20 months. It is a “Non Animal Stabilized Hyaluronic Acid” ( NASHA) filler. Which can be dissolved with hyaluronidase, and is very flexible but strong, so it can move with the lip but still return to shape. She is shown before and again, 11 days after treatment of the upper lip lines with one syringe. It does not add “bulk” to the lips but markedly improves the active lip lines.
Fillers – Patient 131
A woman in her early 60’s who has had significant weight loss after a gastric bypass is bothered by her deep set nasolabial creases. She is deeper on her left side. She received 2 syringes of Restylane Defyne and returned 2 weeks later for 2 more syringes. She is shown 2 weeks after the second treatment.
Discussion: The volume loss seen with aging is often made worse by significant weight loss. Proper replacement of the volume can give a significant improvement. Enough product needs to be used to correct the deficit, and this is frequently more in patients in their 60’s or older. She has a pleasing improvement
Fillers – Patient 130
A woman in her mid 70s who came in to ask about a face lift. She was not a good candidate for a facelift because of poor skin quality from prior smoking and sun exposure.
“It’s not just the tailor, it’s the fabric we are working with” is a saying that emphasizes that the expected results are impacted greatly by the quality of the skin.
She does have age related volume loss and elected instead for 4 syringes of rha 3 to the “marionette Lines” and 4 syringes of RHA 4 to the cheeks. She is shown 10 months after placement of the rha 3 and 1 month after placement of the rha 4. The resilient hyaluronic acid fillers are a new line of Non animal stabilized hyaluronic acid fillers from Switzerland that were brought to this country in November of 2020 by Revance and allow a correction in parts of the face that move without looking stiff or abnormal- they are “resilient” and move with the face. They have been used in Europe for 6 years and the doctors there report that they are lasting 22 months or so.
RHA Fillers – Patient 129
A woman in her early 60’s who is shown before and again 2 weeks after the placement of 3 syringes of the RHA-3 .
We are pleased to be one of the first practices in the United states to be able to offer the Resilient Hyaluronic Acid fillers, which are manufactured in Switzerland by Teoxane and have been used in Europe for more than 5 years. They have just been brought to the US by Revance. They are still hyaluronic acid, and therefore have the same safety profile as the Juvederm collection from Allergan and the Restylane collection from Galderma. But they differ in being more Resilient, which allows them to move naturally with the face. This is described as the difference between a steel girder bridge and the golden gate bridge. They are both strong, but one is more flexible. This now allows me to treat the nasolabial creases and areas around the mouth without bunching or moving, and they are expected to last for 18 months. Our patient here is seen at rest and smiling. The correction is significant but appears absolutely natural with movement of the face.
How long do results last?
Restylane® and Juvederm® injections will last four to six months.
What should I expect during recovery?
Downtime required varies on the areas treated, and will be determined during your consultation with Dr. Hall. Different areas of the face will have different reactions, such as bruising or swelling. However, these reactions are commonly covered with makeup after treatment. It is advised that the injection area not be massaged, rubbed, or irritated for at least one week. Bending, straining, and lifting should be avoided, and patients should sleep with their head elevated for optimal results.
Dr. Hall demonstrating a Juvederm Ultra injection at a recent Allergan Master Class for Injectables in Boston.
Cosmetic & Plastic Surgery Specialist
"I treat my patients like I would treat
- Jonathan D. Hall, MD, FACSmembers of my own family."
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