Hyaluronic acid is a natural sugar that gives skin fullness and elasticity. It does this because its molecules are “water loving.” In other words, the molecules are attracted to water molecules in the skin, binding and swelling to several times their own weight. As you age, your skin loses much of its own hyaluronic acid and thus much of its volume. As a result, it begins to sag, wrinkle and fold.
Commercial hyaluronic acids—Restylane, Perlane, Juvederm and Radiesse—can revitalize and plump up aging skin. All these products contain non-animal, hypoallergenic hyaluronic acids. You do not need a skin test before you receive treatment.
What are hyaluronic acid injections like?
Hyaluronic acid dermal filler procedures are usually quick (less than 30 minutes) and are done in your doctor’s office under a local anesthetic and with an ultra-fine needle. You can return to your daily activities immediately afterward. Side effects are minor. You may experience mild swelling, bruising and perhaps some redness, but such symptoms disappear within a few days. In rare cases, patients develop red bumps, which may require antibiotics. Always call your doctor if you have side effects.
What can I expect from the injections?
Be patient! It usually takes several weeks for the hyaluronic acid to fully plump up the skin—and to create significant changes in your appearance.
Hyaluronic acids are biodegradable, so they’re not a permanent solution to wrinkles and folds. You’ll need maintenance treatments every few months—how often will depend on such factors as the treatment area on your face, your age and your lifestyle.
Restylane
Restylane is a crystal-clear hyaluronic acid gel that is most commonly used to smooth out wrinkles and folds around the lower portion of the face, such as the thin “smoker’s lines” around the mouth and the wider nasolabial folds that run from the edges of the nose to the corners of the lips. It’s also used to shape the cheeks and chin, reduce forehead lines, and rejuvenate the back of the hands. And it’s very popular for increasing the size of lips, giving them a fuller, more enhanced appearance.
Restylane’s results typically last from 6 to 12 months on the face and from 3 to 6 months in the lips.
Perlane
Perlane is essentially the same hyaluronic acid gel as Restylane, but its particles are slightly larger, a factor that makes Perlane more useful for reducing deep, large wrinkles, such as nasolabial folds, forehead “worry” lines, and the “marionette lines” that run from the corners of the mouth to the chin. Other common uses include lip enhancement, chin and cheek augmentation, and the softening of acne and other facial scars. Perlane is also sometimes used to fill in hollows under the eyes and to give the eyebrows a temporary lift.
Results vary, but last on average from 6 to 8 months. Most people need a maintenance treatment about once a year. (Often, Restylane’s smaller-molecule (and, thus, less expensive) formulation is used for the maintenance treatments.)
Juvederm
There are two types of Juvederm: Juverderm Ultra, which is used to correct moderate to severe wrinkles on the face and to add fullness to the lips; and Juvederm Ultra Plus, which has a denser formulation and, thus, is used to improve the appearance of deeper wrinkles. Juvederm is the first hyaluronic acid dermal filler with published studies on its safety and effectiveness in people of color. Those studies showed that it doesn’t increase the risk of hyperpigmentation or hypertrophic scarring in people with darker skin tones.
Results tend to last from 6 to 12 months.
Radiesse
This dermal filler is composed of calcium hydroxylapatatite (CaHA) particles suspended in a hyaluronic acid gel. Over time, the CaHA particles create a “scaffold” that gives your skin greater shape and fullness; the particles also stimulate your skin to produce new collagen in the treated area. This process, called neocollagenesis, provides your skin with even more volume and contour.
Radiesse is particularly useful in addressing the unsightly problem of folds and creases around the nose and mouth. It’s also used to raise the depressions of acne scars to an even level with the rest of the skin. In addition, it’s been used to help treat HIV-associated facial lipoatrophy, the loss of facial fat that often accompanies that illness.
Results typically last about 1 year.
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