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Fillers, Juvederm® & Restylane ®

Fillers, Juvederm® & Restylane ®


What are Restylane™ and Perlane?
Restylane™ and Perlane are injectable forms of hyaluronic acid (HA) used for lip augmentation, wrinkle and deep fold correction.

What’s the difference between them?
The gel particle size differs.  Perlane is best for shaping facial contours and correcting deep folds such as the smile lines.  It is also most useful for adding volume to lips for lip augmentation.
Restylane™ is useful for shallower wrinkles, defining lip borders and layering on top of Perlane for a more even look. Restylane™ fine lines is best for thin superficial lines especially around the eyes and mouth.

What is Hyaluronic Acid? Is it safe?
HA occurs naturally in your body and is responsible for holding water, which gives young skin its full supple appearance.  As we age HA levels in the skin drop.  By injecting HA it restores the youthful appearance. Since it is naturally present anyway, and Restylane™ and Perlane are not animal derived, it is very safe.  It has been used in over 1.5 million treatments in over 60 countries and has a great safety and efficacy track record.

How long does it last?
For wrinkles and folds usually 6-12 months.  For lip augmentation usually 6 months.

How will I look after treatment? Can I do this before a dinner party?
There is usually some swelling and a bit of bruising for 2-3 days after.  You would want to do it at least 1 week prior to any social function.

What are the common side effects?

It is fairly common to have a little bit of swelling for a couple of days.  Bruising is always possible and can be reduced by following the instructions on the pre and post treatment page.

What is the difference between Botox™ and Restylane™?
Botox™ works on dynamic wrinkles (wrinkles that are produced with movement) by weakening the muscles that cause the wrinkle.  Restylane™ works by filling in volume and has no effect on muscle movement.  A general rule of thumb is Botox™ is used for the  upper half of the face (frown lines/crows feet) and Restylane™ is used for the lower half of the face.


Pre-treatment instructions:
It is good to pamper yourself on treatment day! If you have a nice big breakfast or lunch, and an extra glass of water, you will be more comfortable. Many patients like to take a couple of plain Tylenol™ an hour or two before  to prevent discomfort.  The chance of bruising can be reduced by not taking any Aspirin, Advil or Vitamin E or drinking alcohol (specifically red wine) for 3 days prior to treatment.

Please wear no makeup, or makeup that is easy to remove, so that the area to be treated can be clearly seen. You can bring makeup with you, and you may apply your makeup immediately after treatment.

Post-treatment instructions:
After Perlane™ & Restylane™ treatment, there is occasionally some pain, swelling, bruising, itching or redness at the site of injection — similar to what you could experience after any injection. You may take a couple of plain Tylenol 3 times a day to reduce swelling and discomfort. ASA (Aspirin) should be avoided as it may increase bruising at the site of injection. Cold compresses or ice packs can also be used to reduce any swelling, itching or discomfort. Redness may last for 1 — 2 days, occasionally longer in some patients. Swelling in the lips can last for a week, and the lips may appear somewhat uneven until the swelling subsides.

In order to allow the implant to stabilize, try to avoid excessive movement of your facial muscles for the next few days, and in particular during the first 6 hours after your Perlane™ or Restylane™ treatment.  Do not engage in exaggerated facial expressions for the first 2-3 days after treatment to reduce the chance of moving the material.

Until the initial swelling and redness have resolved, do not expose the treated area to intense heat (e.g. hot packs and sunbathing) or extreme cold.

Coming Soon

As we age we develop two different kinds of facial wrinkles, dynamic and static. Dynamic wrinkles occur during facial expression while static wrinkles are present even at rest. 

Fillers restore volume and can be used to improve static wrinkles.  Other treatments are available for dynamic wrinkles. Hyaluronic acid fillers are used to fill wrinkles and folds, create sensual lips, improve skin hydration and lift sagging/deflating cheeks. The closest thing that people can relate it to is the olden days of collagen usage. The problem with collagen was that it caused a lot of allergic reactions since it was animal based. The great thing about current fillers such as Juvederm® and Restylane® is that they are not animal based and are stabilized forms of hyaluronic acid. Hyaluronic acid is a naturally occurring substance in the body whose job is to hold water and plump things up a bit. It provides lubrication, fullness and contributes to some of the youthful features that you see in younger skin. Unfortunately, as always happens we lose hyaluronic acid as we age so things dry out and deflate. Thankfully, we can now restore that fullness to what you used to have when you were younger. Remember, it’s all about restoring what you used to have and giving you a natural youthful look. You want to look fabulous, not fake.

In the early days, fillers were used mainly for nasolabial folds (the smile lines from the nose to the corner of the mouth) and lip augmentation. Over the years, we have come to see the versatility of fillers and added many other treatments. The most common procedure that I perform is a cheek lift. Most patients, men and women alike, don’t realize that one of the most aging features is a loss of cheek volume with a corresponding drop of the front and side aspect of the face. In fact, it’s this drop that contributes to the nasolabial fold looking so prominent. With Restylane® and Juvederm®, we can sculpt a sexy, high, model-like cheekbone, fill in a face that has sunken in from weight loss, eliminate the hollows around the temples and other areas, improve thin “party hat lines”, augment a dropping chin, reduce smoker’s lines, improve jowls and so much more. In fact, the limits are endless in terms of what you can do. With fillers you are able to sculpt and create the specific look that you want. Even more so than with Botox® the skill and artistry of the injector is crucial. You want a provider who has injected thousands of syringes with a great deal of experience.

Side effects are usually limited to occasional minor bruising and swelling. The procedure usually takes around 30-60 minutes and the results are seen right away with continued improvement over the first few weeks. Hyaluronic acid fillers usually last 6-12 months although I’ve had patients who have had over 2 years of benefit and patients in which it started to wear off in 4 months or so. The more you do, the longer it tends to last. The new Juvederm Voluma®, available only to a select group of expert physicians in Canada, lasts 12-18 months. I have been very pleased with the results of Voluma for cheek lifts especially. By coming in for maintenance treatments you can prolong the results of prior injections and require less product in the future.

One of the common questions I am asked is how hyaluronic acid fillers compare to permanent fillers. There are several reasons I prefer Restylane® and Juvederm® to permanent fillers. Permanent fillers are more inflammatory and have a higher chance of causing tissue reactions and possible granulomas (hard tender lumps in the area injected). I have never seen this happen with Restylane® or Juvederm®, although it is still possible. Permanent fillers can be associated with permanent problems that may require surgery to correct. Another reason is that I like to do age-appropriate treatment. In other words, the way that I treat the patient today may be very different than the way I treat them in 5 years. We all age, our faces change, our anatomy and structure changes and one must alter their treatment based on the way the face looks at that time. Permanent fillers are not adaptable and do not change with the patient.

By combining wrinkle treatment, Juvederm® or Restylane® and Tripollar Maximus or Bodytite™ one can achieve a “non-surgical” facelift by tightening loose skin, filling deflated cheeks and eliminating wrinkles.

LIPgloss Technique

Many of us want the appearance of smoother and more youthful lips, but avoid lip augmentation procedures because of the fear of a drastic change or looking artificial and overdone.  Let’s face it, many of us make jokes about the celebrities on TV who’s lips enter a room long before they do!  

It is so common for women to be bothered by the appearance of their lips as they get older.  In fact we commonly hear the concern about applying lipstick and having it bleed up through fine lines that develop at the edge of the lip.  The LIPgloss Technique with Restylane Fine Lines® is a beautiful new way to make your lips smooth and soft.  Your lips won’t look any larger, just younger and more hydrated.

In a nutshell, cosmetic treatments nowadays can be very natural looking and indeed I think they should be. People should not be able to tell that you’ve had something “done”; instead they should just comment on how good you look. We can help you reduce your dynamic wrinkles and Restylane and Juvederm can improve small static wrinkles, fill deeper folds, raise and restore your cheeks and so much more. The first step to take is to contact our office for a consultation in which your needs can be assessed.



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