Hyaluronic Acid Injections

Hyaluronic acid is a natural gel (polysaccharide) that can be used as a soft tissue filler. The hyaluronic acid products are natural substances, without animal products, and pose no need for prior allergy testing. The gel is a resilient chemical and can easily adjust and mold to the facial contours. It is now commercially available in a variety of product including Restylane®, Juvederm® and Perlane®. These are widely used for the management of wrinkles, facial lines, contour deformities, and deficiencies of face, cheeks, and lips associated with aging, developmental anomalies, and certain diseases. They have been FDA approved as fillers to treat wrinkles but their use to augment lips is considered an “off label” use of the products. They are all very similar microscopically and in how long they last. Your treating physician or nurse will have specific recommendations on product based on where you would like to have it injected, based on product molecule size and other factors.

Technique

Hyaluronic acid gels are usually injected in an office setting. The areas of the skin to be treated can be first coated with a topical anesthetic, which is usually sufficient for patient comfort, although a nerve block may be preferable for some patients. Hyaluronic acid is a hydrophilic agent, which means that it attracts water, much like a sponge. This subsequent expansion contributes to the final volume that is achieved. Therefore, underfilling is necessary, and many patients will benefit from a touchup session in about three weeks after the first treatment. It is important that you understand that syringes, once opened, cannot be saved for subsequent use and that all secondary or “touch up” procedures will result in a normal injection fee. Overfilling can lead to bumps and irregularities which, although rare, can represent a small, temporary cosmetic problem. Most patients can expect the improvement to last for about three months. It is especially effective for the nasolabial folds, lip augmentation, and areas of contour deformities, for example along the lower lids to treat tear trough deformities. It is also an ideal adjunct for BOTOX® treatments and is frequently used in conjunction with BOTOX® to correct lines and creases that are not ideal for BOTOX® injections alone.

Benefits

1. A natural substance that does not require pre-testing for allergic reactions
2. Treatment is reversible within several months
3. Injections can last for up to six months, less in the lips
4. Minimal discomfort
5. Very few side effects
6. Can apply makeup immediately and return to normal activities

Side Effects:

1. Bruising and swelling can occur
2. Small bumps are infrequently visible but often palpable
3. After about three weeks, repeat injections may be desirable to achieve an ideal result