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What are Restylane® and Perlane®?

The resilience and youthful contours of your skin, its ability to counter the effects of time, wind and weather, owes much to hyaluronic acid. Hyaluronic acid also plays an important role giving volume to the skin, shape to the eyes and elasticity to the joints. Hyaluronic acid is found naturally in your skin and other tissues. Hyaluronic acid has a chemical structure similar in some ways to sugar, and is identical in all species and in all tissue types. Perlane® & Restylane® are made from NASHA gel (Non-Animal Stabilized Hyaluronic Acid).

Each of us has good natural lines that can be emphasized and improved. Perlane® & Restylane® can be used to give you a long-lasting and natural beauty lift: smoothing wrinkles and folds, or giving your mouth a fuller, more sensuous form.

More than 27 million patients all over the world have been treated with various hyaluronic acid based products over the years. Perlane® & Restylane® are extremely safe. More than five hundred thousand men and women in all age groups around the world have been successfully treated with Perlane® & Restylane® since 1996. Studies show that the vast majority of them were so happy with their results they would be willing to have the treatment again.

Because the NASHA used in Perlane® & Restylane® is produced by fermentation, there is no risk of transmitting diseases between species, or eliciting allergic reactions in patients who are sensitized to common foods, such as beef, chickens and eggs – and Perlane® & Restylane® are acceptable to vegetarians. No skin testing is needed before Perlane® & Restylane® treatments.

The sizes of the NASHA gel particles in Perlane® & Restylane® is custom tailored to match the tissue structures in the skin being treated, and they are stabilized to form a continuous 3-dimensional molecular network. Nutrients, oxygen and hormones pass freely between the gel particles, maintaining the health and vitality of your skin. Since the body has its own system for absorbing hyaluronic acid, it slowly disappears over time without a trace.

Perlane® & Restylane® can be used in combination with each other. For example, a deep fold can first be treated with PERLANE, then Restylane® can be used at a later date if you wish to correct residual lines in that area. Restylane Fine Lines™ can be used for thin, superficial lines, for example around the eyes, around the mouth and on the forehead. Many people are looking for that slightly fuller shape for their chin, or perhaps a rounder more sensuous line along the cheeks or lips. Just a touch of additional volume can make an enormous difference to your appearance.

Unlike collagen (which lasts 3-6 months), the benefits of Perlane® & Restylane® treatment should be visible for 6-12 months, depending on the location of the treatment and the nature of your skin. For example, highly mobile areas like the lips tend to require at least a touch-up treatment after about 6 months. Areas where there is less movement may only require additional treatment after 12 months. Experience has shown that smaller amounts of Perlane® & Restylane® are often needed for maintenance than for the initial correction.

Some patients who are pleased with the results but desire a more long-lasting correction have follow up treatments with ArteSense®/ArteFill® .

In some areas (for example: the forehead and upper lip), BOTOX® injections treatments are often used to reduce unwanted muscle movement and so prolong the effect of the Perlane® & Restylane® treatments in those areas.

In summary, Perlane® & Restylane® are:

• Long-lasting, but ultimately biodegradable and non-permanent.
• Can last 6-12 months before being completely reabsorbed
• Effects can be cumulative – smaller volumes are sometimes needed for maintenance treatments
• There are no animal ingredients
• No skin test is needed

What is the difference between Perlane® or Restylane® and BOTOX® injections?

BOTOX® injections relaxes the muscles which cause many facial lines and unwanted facial expressions.
Fillers like Perlane® and Restylane®, collagen (Zyplast™ and Zyderm®), ArteSense®/ArteFill® and other products fill creases, lips, cheekbones, and also defects like acne scars. Sometimes BOTOX® injections is used in combination with Perlane® and Restylane® when treating certain areas where permanent deep lines have resulted from overactivity of the muscles, for example some frown lines on the lower forehead or wrinkles around the lips.

1. Common uses for Restylane® and Perlane®
2. Other uses for Restylane® and Perlane®
3. How much do Restylane® and Perlane® cost?
4. What does Restylane® and Perlane® treatment feel like?
5. Who should not have Restylane® or Perlane® treatments?
6. Can a face-lift or other surgery be performed after Restylane®; or Perlane® treatment?
7. Can Restylane® or Perlane® be used during pregnancy?
8. Am I "vain"?
9. Pre-treatment instructions
10. Post-treatment instructions

Common uses for Restylane® and Perlane®

Common uses for Restylane® and Perlane® include:

• correcting folds and wrinkles of the face
• acne scars
• nasolabial folds (between your nose, mouth and cheeks)
• horizontal (upper forehead) frown lines
• glabellar (lower forehead) frown lines
• chin augmentation
• depressed corners of the mouth, also known as marionette lines
• lip enhancement, including treatment of the edges of the lips and wrinkles around the lips to stop lipstick from leaking from your lips onto the surrounding skin

Other uses for Restylane® and Perlane®

Other uses for Restylane® and Perlane® include:

• filling subcutaneous skin defects
• filling of orbits of the eyes
• augmentation of cheek bones, chin or bridge of the nose
• correcting some irregularities of the nose
• filling small facial bone or hand bone defects
• augmentation of the nipples

How much do Restylane® and Perlane® cost?

In Canada, Restylane® and Perlane® are not expensive; however there is a cost involved. Many cosmetic treatments were once considered a luxury item only for those who had a high disposable income. Restylane® and Perlane® are very affordable even for those with modest incomes, but some people need to budget for these treatments, just as they would for buying accessories like shoes and having their hair styled.

Having successful cosmetic treatments for your face is not expensive, it is priceless.

Treatment of the lips or nasolabial folds would usually consume one or two 0.7 ml syringes of Restylane® or Perlane®, costing $475 for the first syringe, with a $75 discount for addition syringes used on the same day. Syringes of Restylane® or Restylane® Fine Lines containing about 0.4 ml cost $275 each, and are often used for outlining the lips or treating fine lines around the lips and on other parts of the face.

What does Restylane® and Perlane® treatment feel like?

Dr. Smith has pioneered the use of ice to prevent discomfort when doing Restylane® and Perlane® treatments, and has taught this technique to other physicians at meetings across Canada and in the United States. Patients are very pleased that Dr. Smith can take good care of them without having to administer local anesthetic.

Some people find it helpful to take a couple of plain Tylenol™ and/or Advil™ an hour or two before treatment to prevent discomfort.

Who should not have Restylane® or Perlane® treatments?

• People who have thin, loose skin in the area to be treated
• People who have unrealistic expectations (as with any treatment, you need to have an accurate understanding of the likely benefits and risks of Restylane® and Perlane® treatment.

Can a face-lift or other surgery be performed after Restylane® or Perlane® treatment?

Yes. A face-lift can be performed after Restylane® and Perlane® treatment. The skin on the face is thick enough to prevent the implants from becoming visible after a face-lift. Restylane® and Perlane® treatments can sometimes reduce or eliminate the need for a facelift or other surgery, or can delay the need for repeated surgery.

Can Restylane® or Perlane® be used during pregnancy?

There is no technical or medical reason why Restylane® and Perlane® should not be used during pregnancy.

Am I "vain"?

Many people at some time before Restylane® and Perlane® treatment for wrinkles, lip augmentation or scarring have fears and doubts. A common concern is that they are being vain. My experience has been that just about all patients who have Restylane®, Perlane®, ArteSense®/ArteFill® , laser hair removal, BOTOX® injections treatment, and other procedures to maintain their appearance and comfort are no more vain than anyone else. What does distinguish these individuals is a desire to get the most out of life, and to look as good as they feel.

Looking after our appearance is not a fault. After all, would you leave your house with broken gutters or peeling paint? Why do less for your body? I think you should feel proud of yourself for having the will and the ability to change something that you find unacceptable. I emphasize that you should only have Restylane® & Perlane® and other treatments if it is for you. It is a big mistake to do these things if it is just for somebody else.

The same self-esteem that makes our patients successful in their chosen fields, precise in their consultation questions, well groomed and dressed, and often careful in their diet, exercise, and other aspects of health maintenance leads many of our patients to seek help for their wrinkles and frown lines. These individuals are normal healthy people, and the same degree of self-interest that prompts them to exercise, be selective in what they eat and drink, and protect themselves from sun damage leads them to explore the benefits of Restylane® and Perlane®. Our patients simply want to look their best.

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™ and/or Advil™ an hour or two before treatment (similar to what you might do before having a flu shot) to prevent discomfort. As a practical matter, bruising is seldom a major problem after Restylane® and Perlane® treatment. The chance of bruising can be reduced by minimizing your consumption of ASA, alcohol and Vitamin E for 3 days before Perlane® & Restylane® 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, 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.

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.

Restylane® and Perlane® For correction of wrinkles and scars in men & women.

Please call Toll Free: 1-866 760 1000 if you have any questions about Restylane® and Perlane®, and to arrange for prompt, confidential consultation and treatment.

• No referral is needed. Treatment can be done the same day as the consultation, if you wish.
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• Our staff can take the time to discuss your wishes and options, and answer your questions.

Niagara Falls Dermatology & Skin Care Centre Limited
Kevin Smith, MD, FRCPC Dermatologist
Licensed and inspected by the College of Physicians and Surgeons of Ontario

Fellow of the Royal College of Physicians and Surgeons of Canada
Board Certified in the United States by the American Board of Dermatology
Suite 201, 6453 Morrison Street, Niagara Falls, Ontario
Call Toll Free: 1-866-707-3222