Restylane® versus Juvederm® for the lips.

Restylane® has been the most successful dermal filler for lip augmentation over the years. The results are predictable and last between 4 to 6 months. With time, the hyaluronic acid product diminishes and is absorbed harmlessly into the body. Restylane® is injected along the borders of the lip, the Vermilion border and the white line to nicely enhance these areas. Restylane® can be injected into the red portion of the lips to augment the overall size. Restylane® does not require skin testing before treatment. Treating the lips for augmentation entails an in-office procedure usually lasting less than 30 minutes.

Juvederm® versus Restylane® in your lips.

Juvederm® is the second most popular dermal filler, in our practice. Juvederm® is a smooth consistency gel made of cross-linked hyaluronic acid, and is a very soft dermal filler that feels more natural than Restylane® in the lips.The results are comparable to Restylane® and last between 4 to 6 months for lip augmentation. With time, the hyaluronic acid product in Juvederm® is absorbed harmlessly into the body. Juvederm is injected along the borders of the lip, the Vermilion border and the white line to nicely enhance these areas. Juvederm® can be injected into the red portion of the lips to augment the overall size. No skin testing is required before treatment. Treating the lips for augmentation entails an in-office procedure usually lasting less than 30 minutes.

Off-label use of FDA Approved products.

Use of these FDA-approved dermal fillers is considered off-label. This means that the product is used in an area not tested by the manufacturer and with no data review by the FDA. This is acceptable to do, but requires the patient’s understanding and consent before proceeding.

Dermal fillers for Rhinoplasty?

Scottsdale – Dermal fillers are not FDA approved for rhinoplasty or post-rhinoplasty correction. However, because of their potential reversibility, low risks and ease of use, these are used in the nose with high frequency, especially for correction of minor defects after rhinoplasty.

The latest issue of the Aesthetic Surgery Journal discusses the use of dermal fillers to correct post-rhinoplasty deformities in the nose. The article was published through the University of Illinois Medical Center in Chicago.

The authors point out that dermal fillers are minimally invasive and can reduce the  financial expense, anesthetic risks, or downtime associated with revision nose surgery. The researchers discussed these options and give some sound advice.

The authors like hyaluronic acid (HA) derivatives, such as Restylane and Juvederm, and calcium hydroxylapatite gel, such as Radiesse. Tips on patient selection and injection technique in the article are important, including:

1. Nasal injection includes sub-SMAS placement to reduce visible or palpable nodules.

2. Restricting the use of fillers to the nasal dorsum and sidewalls.

3. Avoiding injections to the tip and alae, which carry more adverse risks with injections.

4. Radiesse is an acceptable treatment for post-rhinoplasty deformities, but patients must be carefully selected to minimize risks.

5. Avoid silicone altogether because of severe granulomatous reactions, infection, thinning of the skin, and necrosis.

I found the article to be quite useful. I do agree with the authors, patients who are treated with dermal fillers must be followed closely for complications. The use of any soft tissue filler must be carefully considered by the patient. An explanation of the risks and the off-label use must be clearly explained to patients before any non-surgical plastic surgery procedure is administered (model used in illustration).