Restylane
Restylane is a form of hyaluronic acid (the jelly-like substance found in our joints), and was developed in Sweden as a replacement for Collagen (see below). The material comes in pre-filled syringes and is injected into lips, wrinkles, and folds to smooth out surface contour irregularities and to provide fill as a temporary maneuvre which can be done easily under no or local anaesthesia only. Because it does not contain materials which might cause allergy, pre-testing is not required.

Typically, the area treated is not bruised after treatment, swells during the first two to three days after treatment, and reaches its optimal form after about three days.


Dr. Gelfant does not recommend the following injectable products:

Collagen
Collagen in skin care creams and lotions is of absolutely no value. As a large protein molecule, it cannot penetrate through the upper layers of the skin.

Purified collagen protein has been injected into fine and medium wrinkles for about twenty years. A simple office visit is required and the injection takes only a few minutes. A skin test for allergy to the collagen is required, prior to treatments. It takes several days to see the results of the test, and many doctors feel a second skin test is worthwhile, to prevent allergic reactions to the injected collagen. Collagen treatments are moderately effective but the effects are relatively brief, lasting only three to six months. Most patients want more extensive and longer–lasting improvement than collagen offers and are better waiting until they are prepared to undergo more definitive treatment.

I do not use injectable collagen to fill wrinkles and fine lines of the face. It certainly is not “replacement therapy” as described by the advertisements promoting it. It is made from animal collagen, and is broken down in human skin once injected. In fact your own collagen is in a balance, being constantly made and broken down.


Artecoll
Artecoll is another injectable which is available. Our concerns about it relate to the content. It is made up of acrylic (plastic) micro-spheres in a collagen base. Because of the microspheres, once injected, it would be difficult to remove. While this offers a hope of permanent change, it makes problems difficult to treat, and we have seen difficulties arising from the injection of silicone in the past which make a less permanent injectable more attractive. The collagen protein carrier also is something I prefer to avoid. Most plastic surgeons who were using Artecoll have stopped using it, generally for the reasons we chose not to use it in the first place. You will find it used mainly by non-plastic surgeons.


Fat injections
Fat injections have limited benefit in the treatment of fine and medium wrinkles, but recent work has shown that part of aging is the gradual loss of fat from the face and therefore the fullness of the face. In a short operation, lasting less than an hour, fat, is injected where it is needed in the face, filling out contours and plumping up the skin. It is taken by liposuction from another part of the body.