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.
Rhinoplasty/Restylane – Patient 123
A woman in her late 40’s who was bothered by a “bump” on her left mid nose. She first noticed this after being struck by a ball in the nose a few years before. On examination she has very thin skin and has a prominent cartilage bump under the skin. A surgical rhinoplasty is an option to reshape the cartilages and add a strip of fascia from her scalp under the skin to add more thickness and help to camouflage this area. I recommended that she might try a “non surgical rhinoplasty” first with the use of Restylane injected under the skin to camouflage the area. This was done in a few minutes in the office with a topical anesthetic. She is shown 2 weeks after and has a significant improvement with ½ cc of Restylane. Although this is not permanent, it typically lasts for a year or longer in this area and is easy to repeat. She is pleased with her improvement. The nose looks straighter, and the “bump” is no longer as noticeable. The side view shows an improvement in the dorsum.
Fillers – Patient 116
A woman in her late 40’s who has been through a stressful year and wants to look more rested. She has a strained look in the “11’s” due to over-activity of the corrugator supercilii muscles and has creases there at rest. She also has age-related volume loss of the mid face ( cheeks and lower eyelid area). As the cheeks have deflated, the “parentheses” (nasolabial and melolabial creases) have gotten deeper as well, and the corners of the mouth are turning down. She is shown 4 weeks after the placement of 15 units of Botox to the corrugator supercilli muscles combined with 0.5 cc of Restylane to the deep “11” lines and 3 cc of Juvederm Voluma to her cheeks. She returned 2 weeks later and had 1 more syringe of Juvederm Voluma to the cheeks and 2 cc of Restylane to the nasolabial creases and corners of the mouth. She is shown two weeks after this second treatment. Her forehead is relaxed and she no longer has a strained or angry appearance. I did not place Botox to her upper forehead because her brows are a little low and I wanted to avoid a “Mephisto” look that might occur in her case by overly dropping the medial eyebrows and overly elevating the lateral eyebrows. The volume loss of the midface is improved but not overdone. Slightly underdone looks normal but slightly overdone looks funny from across the room. She will plan to return at the 4 month mark to repeat her Botox.
Fillers – Patient 115
A woman in her mid 50’s who is bothered by a tired and aged appearance. As we analyze her face we notice a strained look in the mid forehead at rest- this can be improved with Botox and a small amount of “filler” to the deeper lines. When we examine her face she has significant volume loss with aging. The cheeks are deflated. The “marionette” lines around the mouth are prominent. She is shown before and again, just 2 weeks after 15 units of Botox to the corrugator supercilii muscles. She has 4 syringes of Juvederm Voluma to her cheeks. And 2 syringes of Restylane Lyft to her marionette line area. She feels that she looks much younger and more rested, but is happy that it is still natural in appearance.
Fillers – Patient 114
A woman in her early 60’s with deep frown lines she dubbed “the Mercedes” because of its shape. She had received
Botox 1 ½ years before in another practice but it hadn’t worked well and caused too much drooping of her medial brows.
She is shown before and again, 2 weeks after treatment with 25 units of
Botox and 1 cc of Restylane.
Discussion: She has more than normal activity of her corrugator supercilli muscles (the main “frown” muscles) , and needs a larger dose than the typical 15 units of Botox that is used here. She also has deep lines at rest- these won’t go away with weakening of the muscle activity alone, and need to be filled with the Restylane. As the forehead deflates with age ,she is more at risk for over descent of her medial brows from Botox, so I avoided the typical treatment to her upper forehead. This gives her improvement but does not cause the medial brows to drop as much. The “Mercedes” and lines of her forehead are dramatically better at rest, with maximum frown and even with smiling. Her friends ask is she has “lost weight”. When you look better in a natural way, it is difficult for others to determine why, so a typical comment is “did you have your hair done” or “did you lose weight” because you look better but people are not sure why.
So, “one key does not fit all locks”, and one treatment pattern does not fit all patients. Her case illustrates how careful analysis of her anatomy and the aging process can help to give us a good result.
Fillers – Patient 113
A woman in her early 60’s who is bothered by the appearance of her lower eyes but does not want surgery. On examination she has some of the typical volume loss with aging. She is shown before and again, 3 weeks after the placement of 2 vials of Juvederm Voluma in the office.
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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