Restylane® is a hyaluronic acid based dermal filler that can be used to safely add facial volume to treat deep wrinkles and folds, enhance fullness in the lips, and can also round out gaunt hollows under the eyes. The effects are long lasting, remaining from six to nine months. In areas of the face where there is the most movement, such as the mouth, the effects may only last six months. On the forehead or under the eyes, Restylane® may produce visual benefits for nine to twelve months. Since its initial 2003 FDA approval of Restylane®, the makers of Restylane® have come out with an entire product line of fillers that can treat a unique subset of facial concerns.
Ideal Candidate for Restylane®
Good Candidates for Restylane® Injections
- Lips: Desire to increase lip volume and/or reduce the appearance of vertical lip lines
- Midface/Cheeks: Have sunken or flattened cheeks either through genetics or with aging
- Wrinkles/Fine Lines: Desire to smoothen the appearance of wrinkles and fine lines
- Tear Troughs/Under eyes: Want to fill in under eye hollowness which is creating dark circles and “tired” appearance
- Facial Rejuvenation: Seek to rejuvenate their appearance by adding volume to areas of the face to restore fullness and volume
- Nose: Are unhappy with the appearance of their nose and would like to seek non-surgical rhinoplasty correction
- Hands: Are showing signs of aging hands that have lost collagen and fat volume with time
- Have realistic expectations of what improvements can be made with fillers
- Are not on medications that can prolong bleeding
Restylane® Treatment Techniques
Dermal filler injection results depend on both the type of filler used as well as the injection technique of the experienced provider. The same syringe of filler in two different hands will have two different results, there is both a science as well as an art to performing filler injections. At The Naderi Center, we only allow plastic surgeons or dermatologist to perform filler injections.
Factors that Affect Dermal Filler Results
- Type of Filler
- Number of Syringes
- Injected Area
- Injection Technique: fanning, micro-droplet, cone, cannula, fern, threading, crosshatch, depot, etc.
Dr. Naderi performs lip injections on Ms. Virginia pageant candidate using Restylane-L
FILLER TYPE: Which type of Restylane ®is right for me?
Depending on what results you are trying to achieve, your medical provider will advise you on the ideal Restylane® product for your face. Restylane® filler products can differ mainly based on which type of hyaluronic acid technology they are using.
The Restylane® line of products is formulated to act like your body’s own naturally occurring hyaluronic acid, restoring volume to your skin.1,4,5
Restylane® Silk, Restylane®, and Restylane® Lyft are manufactured using NASHA (Non-animal stabilized hyaluronic acid) technology. The raw ingredients used to manufacture these products are from non-animal origins. Hyaluronic acid molecules are cross-linked together to form a firm and smooth gel.
Restylane® Refyne, Restylane® Defyne, and Restylane® Kysse are made using XpresHAn Technology which a different technique with cross-linking hyaluronic acid (HA) molecules. Customized HA cross-linking allows each dermal filler to have a unique level of support, firmness, and flexbility. Which Restylane® product is injected will depend on the level of firmness, support, and flexibility that is required in that facial region.
Restylane® is FDA approved for lip augmentation as well as correction of moderate to severe facial wrinkles and folds. Many expert injectors also use Restylane® for a variety of off -label injection sites such as non-surgical rhinoplasty and tear trough injections.
Restylane® Lyft has been FDA approved to use in the mid-face to add fullness to the cheeks, replenish lost volume, and improve appearance of moderate to deep facial folds. This product contains a small amount of the local anesthetic, Lidocaine, to ease any discomfort with injection.
Restylane® Silk is FDA-approved specifically for a natural lip augmentation and diminishing appearence of wrinkles around the mouth.
Restylane® Refyne was developed with the intention to smoothen lines along the corners of the mouth, more specifically the “marionette” lines that come down the corners of the lips and the smile lines that run from the corner of the nose to the outer corner of the lips.
Restylane® Defyne is similar to Restylane® Refyne in that it can also treat expression lines around the mouth, including nasolabial folds and marionette lines. Injection with Restylane® Defyne still allows you to maintain natural facial expressions and not appear “over-injected.”
Restylane® Kysse is the newest and longer lasting lip filler that has joined the Restylane® family of dermal fillers. The most exciting news is that not only does Restylane® Kysse last up to one year in clinical studies, it has also been shown to require less overall volume of filler injection to achieve comparable results as some of its counterparts.
VOLUME: How may syringes of Restylane® will I need?
Volume or number of syringes of dermal filler injected makes a difference in terms of whether a subtle result or a more dramatic result is achieved. Additionally, the more filler that is injected the longer the results will last and the less frequently the injections need to be repeated. Our physicians will always advise you on the number of syringes they recommend in order to achieve a “full correction” dose. “FULL CORRECTION” is an important concept in determining the longevity of the filler results. Full correction refers to fully correcting the problem with the necessary amount of filler. However, we also realize that for a variety of reasons, including limited budget or concerns about too drastic of change too fast, patients may not want to achieve “full correction.” Regardless of whether a full correction is achieved, our doctors will always want you to leave with a noticeable improvement.
LOCATION: Where can Restylane® be injected?
Today the variety of facial corrections that can be safely achieved with dermal fillers is way beyond their original FDA indications. However, the provider should know the risks and potential complications that are associated with certain facial anatomical regions. These same injection providers should be experienced and knowledgeable in treating potential complications that can arise from filler injections. Many people do not know that one of the most common complications of filler injections is vascular occlusions, this is when a small amount of the filler is injected into a superficial vessel and it can potentially lead to death of the surrounding tissue. Vascular occlusions must be quickly identified and treated by melting the filler. Many people are comfortable with going to a medspa for Botox injections, but when it comes to fillers, they want to make sure they are in experienced and well trained hands.
TECHNIQUE: What are the different Restylane® injection techniques?
Restylane® can be injected using either a sharp needle or a blunt cannula. Sharp needles results in finer tuned injections, however bruising can be more common after sharp needle injection. Cannula’s minimize chances of an intra-vascular injection, however they restrict the ability of the provider to more evenly spread the filler. Our physicians use a variety of dermal filler injection techniques depending on the anatomy of the patient as well the location for the filler placement.
Often times dermal fillers may be combined with Botox or Dysport injections to enhance the effect of the fillers. The patient below achieved a more rested and youthful appearance by combining both neurotoxins (Dysport) and dermal fillers. Dysport was injected into the forehead (glabella) along with Restylane® Defyne and Restylane® Refyne into the nasolabial folds and marionette lines.
Restylane® Before and Afters
Click here to see more before and after images of patients treated with the Restylane® family of fillers.
Preparing for Restylane® Filler Injections
Proper dermal filler preparation is important when it comes to minimizing recovery and increasing safety of injections. Prior to your appointment it is important to be off of certain supplements and medications as well as to minimize consumption of certain foods that are high in Omega-3 and Omega 6. All of our patients are advised to view our list of “Things to Avoid” prior to injections or surgery.
2 Weeks Before Injections
Follow our dietary restrictions.
- For 2 weeks before your appointment avoid nuts, seeds, fish, fish oil, NSAIDs, supplements, and anything that prolongs bleeding. This will significantly help minimize bruising, bleeding, and swelling after your injections. Read our Guidelines on Foods and Medications to Avoid Prior to Injections.
- You can start Arnica supplements a week prior to injections to help with post injection bruises. Arnica helps to speed up the fading away of bruises, and can be found in most health supplement isles at your local Whole Foods, GMC or CVS, as well as purchased from The Naderi Center.
Stopping Medications and Supplements
- Talk to your primary care doctor or physician specialist. If you are on blood thinners you may need to stop these a few days to weeks prior to your injection treatment. Speak to your prescribing physician regarding if it is safe to stop these medications as well as to obtain instructions about when to stop and restart the medication. We do not recommend patients that are on life saving medications stop their medications in order to have any cosmetic procedures performed.
Prevention of Cold Sores
- Patients prone to cold sores will need to start a prophylaxis dose of an anti-viral medication prior to their injection treatment. Your physician provider will prescribe this medication prior to your treatment.
Familiarize yourself with Risks and Benefits
- Read our filler consent prior to your visit to familiarize yourself with risks and benefits of filler injections.
Day of Injection
Eat and drink before your treatment
- It is not uncommon for patients to “pass-out” or get “vasovagal” during their injection. Most people are not fond of needles. Having a good blood sugar and being hydrated will make it less likely that you will feel queasy during your treatment.
Minimize make up and lotions
- Please minimize make-up, especially in and around areas where you would like to get injections performed. Our medical assistants will have to remove your make-up prior to the procedure. You can bring make up with you and apply it immediately after your treatment
Come in 30 minutes prior to appointment time for numbing
- We recommend numbing cream application prior to dermal filler injections. The numbing cream needs a good 20 – 30 minutes to exert its full effect, hence we ask all our filler injection patients to come a little earlier to allow for the numbing time.
Reserve your next appointment
- We love our loyal patients, and making sure that we can see you when you need your next injection is important to us. Most of our physicians can be completely booked 3 – 4 months in advance, and we prefer to never double book patients. We always recommend that you schedule your next appointment before leaving.
Recovery after Restylane® Injections
After your filler injection, it is normal to have some swelling, pinpoint bleeding, and bruising. If numbing cream was applied for your procedure, you will still feel numb for another 1-2 hours after your procedure. Please be sure to follow our post procedure instructions in order to minimize swelling, bruising, and decrease downtime.
Ice, Ice, Ice
- Use a small bag of frozen peas in a sandwich bag or crushed ice to gently ice the area. No heavy ice bags. Ice for 20 minutes on and 20 minutes off. Continue the icing for 48 hours if possible.
Minimize Strenuous Exercise
- We recommend no strenuous exercise for 48 hours in order to reduce swelling and bruising.
Do not manipulate, massage, rub, or poke the area.
- Unless specifically advised by your physician, do not massage or manipulate your face. For one week avoid facials or rough scrubbing of the face. You can wash your face gently.
Use make-up and concealer to cover up bruises.
- You can use makeup and concealer the day of your injections to cover up any bruising.
Non-surgical rhinoplasty patients should avoid glasses if they “dig into” the injection region
- Bring your glasses to your appointment to show Dr. Shervin Naderi if they would be appropriate to wear after non-surgical rhinoplasty. Additionally, if you are an avid swimmer, mention the use of swim goggles during your consultation.
Take Arnica supplements
- Arnica supplements can quickly help reduce appearance of bruises.
Eat pineapples and drink pineapple juice
- Pineapples have natural anti-inflammatory properties that help to minimize swelling after injections.
Do not over-evaluate your face the first two weeks
- For the first two weeks after injections, it is normal to have bruises, swelling, and be asymmetric. We recommend waiting two weeks for swelling and bruising to be completely gone before you can appreciate your final results.
Take Tylenol for Pain
- It is normal to experience some pain and sensitivity in the area of the injection. Most patients find that Tylenol can help relieve this post-injection pain. Avoid NSAIDs such as Motrin and ibuprofen as these can make swelling and bruising worse.
Risks, Safety, and Potential Complications of Restylane®
Common and expected side effects of dermal filler injections include the following:
- May last 1-2 weeks but bad bruises can last up to 4 weeks. That is not abnormal. Bruises can show up several days after the treatment.
- Bruising can be covered with a full coverage concealer such as Neostrata which we sell in the office or Cover Fx brand from Sephora.
- Tear troughs and lips are more likely to bruise because these areas are more vascular than other parts of the face.
- May not always be even from side to side depending on pre-existing facial asymmetry and volume of injection and bleeding at each injection site.
- Initial swelling takes 2 weeks to settle.
- Sleeping propped up and icing can minimize this side effect.
- Avoid exercise first 48 hours or longer as swelling increases when working out.
- Do not manipulate or massage area as this can aggravate swelling
- Asymmetry can be related to swelling. Wait it 2 weeks before deciding whether asymmetry is from filler differences or swelling.
- Please keep in mind that once you start to analyze your face, it is not rare to start to “notice” new asymmetries that have been there your entire life.
Lumps and Bumps
- The filler is going to feel firmer than your own tissue. Do not massage or manipulate the area.
- The feeling of lumps and bumps usually improves within 2 weeks as swelling resolves.
- 1 syringe of filler is the equivalent of 1/5th of a teaspoon in volume. After swelling subsides there may be a need for additional filler injections if you desire increased volume.
- Our doctors are very conservative and do not over inject patients. Our physicians prefer to add volume slowly with time to achieve patient’s desired looks.
- The first time getting injections, the results tend to go away faster. With repeat treatments results last longer as you build your own collagen around the injection sites.
- Lips will also be more dry post injections. Ice the areas and keep lips lubricated with Vaseline or Aquaphor. No more than 20 minutes of ice at a time
Possible complications after dermal filler injections
- Hypersensitivity or allergic reactions
- Cold sore or herpes simplex virus outbreak
- Acne breakout
- Skin necrosis
- Intra-vascular injection leading to skin necrosis and even blindness
- Sterile abscess
Please notify our office immediately if you feel that you may be experiencing any of the above possible complications after your filler injections.
RealSelf Most Loved Injector Awards: 2017 Winners Announced, according to patients.
Restylane® Injection Specialists at The Naderi Center for Plastic Surgery and Dermatology
Dr. Naderi is a board certified facial plastic surgeon and a National Clinical Trainer for Allergan and Medicis. He teaches other doctors how to inject Juvederm® properly. Other doctors from all over the world refer to Dr. Naderi’s instructional videos on YouTube to fine tune and improve their own filler injection techniques.
Dr. Kulak is a facial plastic surgeon with a gentle and artistic female touch. Her patients love her nearly-pain-free techniques. She focuses on facial rejuvenation with advanced minimally invasive techniques as well as more invasive face lift and eyelid lift surgeries.
Dr. Alexandra Snodgrass is a board certified dermatologist who trained with Dr. Shervin Naderi prior to joining The Naderi Center. Dr. Snodgrass is expert on a variety of filler types and injection area techniques. Dr. Snodgrass’s dermal filler injections create a noticeable yet natural rejuvenation of the face.
Dr. Erica Anderson, board certified plastic surgeon who also performs facial filler injections as well as injections on the body. Dr. Erica Anderson is known for her Sculptra® Brazillian Butt Lift. Patient’s desiring to enhance non-facial areas of the body would seek the expert opinion and guidance of Dr. Anderson.
Dr. Shervin Naderi was named as part of the “Top 25 Injectors” by the 10 million member community of RealSelf. Out of 2000 nominees, Dr. Naderi was chosen as Top 25! This is a huge honor being recognized by the national and international community of RealSelf, the most trusted and authoritative site for all unbiased plastic surgery research.
Dr. Naderi is one of only 4 winners in the South East region of the United States. Patients regularly fly and drive to The Naderi Center from all over the country for Dr. Naderi’s unique style of Botox and filler injections. Doctors all over the world regularly use his online tutorial videos to learn and enhance their own techniques.
Fillers can sometimes provide improvement in the appearance of chicken pox and acne scars. Fillers help by reducing the depth of the pit or depression in the skin, which can soften the appearance of these scars. Restylane can be injected superficially into the skin to improve depressed scars. If Restylane provides a good result, permanent fillers such as Silicone have been used for this purpose as well.
If you live in the states of Virginia or Maryland, The Naderi Center for Plastic Surgery and Dermatology offers restylane® among its services. For a full list of services, please visit our Locations page.
Schedule your Restylane® Consultation
Contact us to schedule your Restylane® injection consultation with one of our specialists at The Naderi Center. We are located in the greater Washington DC area with two locations, Chevy Chase, Maryland, 301-222-2020 or Reston, Virginia, 703-481-0002. For out of town patients we offer virtual consultation prior to your visit which can be arranged by filling out our contact us form.
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