Dermacare medical

Restylane, Hylaform, Captique

Restylane

Restylane® is a safe and natural cosmetic dermal filler that restores volume and fullness to the skin to correct facial wrinkles and folds, such as nasolabial folds.

Restylane is cosmetic dermal filler made of hyaluronic acid, a natural substance that already exists in the human body. The hyaluronic acid in Restylane is a crystal-clear gel called NASHA™ or Non-Animal Stabilized Hyaluronic Acid. NASHA is completely biocompatible with human hyaluronic acid.

Restylane maintains its shape using the body's own moisture. The hyaluronic acid in Restylane is hydrophilic or "water loving." As hyaluronic acid gradually degrades, each molecule binds to more water and over time, the same volume can be maintained with less hyaluronic acid. This ability of hyaluronic acid to bind to water is what helps provide lasting results.

After your treatment, you might have some redness or swelling. This will normally last less than seven days. Sunbathing and cold outdoor activities should be avoided until any redness or swelling disappears.

Doctor Yagudin uses several different dermal fillers such as Restylane, Hylaform and Captique. He will suggest which filler is best for your particular situation during your initial evaluation.

Frequently asked questions

What are Dermal (skin) fillers?

Dermal fillers are substances that are injected just below the surface of the skin temporarily adding volume, thereby filling lines, wrinkles and folds from the inside out. Dermal fillers can temporarily restore a smoother appearance.

Where Restylane can be used?

Restylane® has been used in more than 3 million treatments in over 70 countries to correct a variety of wrinkles and to enhance the appearance of the lip border. It is currently approved in the U.S. for the treatment of facial wrinkles and folds, such as nasolabial folds, which are the lines from the nose to the corners of the mouth.

How long does Restylane last?

Restylane® is proven to deliver long-lasting results. Studies have shown that Restylane effects generally last for about six months. The unique NASHA™ technology helps maintain the cosmetic effect until the injected material is nearly gone.

Follow-up treatments are typically scheduled at six-month intervals. (Individual results may vary.)

What can I expect?

You should take a few precautions before being treated with Restylane®. One week prior to treatment with Restylane, avoid taking St. John's Wort, high doses of Vitamin E supplements, aspirin, and other non-steroidal anti-inflammatory medications, such as ibuprofen. These agents may increase bruising and bleeding at the injection site. Also, if you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another recurrence.

Restylane is injected directly into the skin in tiny amounts by an ultra fine needle, resulting in minimal discomfort. The procedure is simple and convenient and results are practically instantaneous. To optimize your comfort during the short procedure, your physician may decide to numb the treatment area.

Is Restylane safe?

Since 1996, over 3 million Restylane® treatments have been safely administered by dermatologists and plastic surgeons in more than 70 countries. This innovative treatment is now approved in the U.S. for the treatment of facial wrinkles and folds.

Restylane has a highly favorable safety profile. It's composed of Non-Animal Stabilized hyaluronic acid. Hyaluronic acid is a substance found naturally in the human body. Restylane is fully biocompatible. There is limited risk of animal-based disease transmission or development of allergic reactions to animal proteins. No allergy testing is required before use.

Based on clinical studies, Restylane treatments produce a low occurrence of adverse events. The most commonly reported side effects were temporary redness and swelling at the injection site. These effects typically resolve in less than seven days.

Precautions:
The safety of Restylane for use during pregnancy, in breastfeeding females or in patients under 18 years has not been established.

The safety of Restylane in patients with increased susceptibility to keloid formation and hypertrophic scarring has not been studied. Restylane should not be used in patients with known susceptibility to keloid formation or hypertrophic scarring.
The patient should be informed that he or she should minimize exposure of the treated area to excessive sun and UV lamp exposure and extreme cold weather until any initial swelling and redness has resolved.
If laser treatment, chemical peeling or any other procedure based on active dermal response is considered after treatment with Restylane there is a possible risk of eliciting an inflammatory reaction at the implant site. This also applies if Restylane is administered before the skin has healed completely after such a procedure.

How much Restylane cost?

Restylane® is injected in a customized procedure based on your specific needs, so the cost will vary from patient to patient. In general, the cost of Restylane treatment is comparable to the cost of similar procedures. In our office the price may range from $500 and up depending on area of injection and amount of medication used. However, Restylane's lasting properties often prove to be very economical over the long term. Please consult your physician to determine the best recommendation for your particular needs.

What are the advantages of Restylane?

Restylane® is different from Botox®.

Restylane is natural, cosmetic filler. Botox is a drug that blocks nerve transmission and relaxes the underlying muscles. Many patients have been very pleased after receiving treatment with both products.

Restylane is different than other hyaluronic acid-based products and bovine collagen.

Unlike rooster-derived hyaluronic acids and bovine collagen products, Restylane is free from animal proteins. This limits any risk of animal-based disease transmissions or development of allergic reactions to animal proteins. Bovine collagen is derived from cowhide and requires an allergy test. Restylane can be administered without pretesting, so no waiting is required.

What are my Restylane post-treatment instructions?

Your healthcare professional should discuss what to do after your treatment. However, be sure to review the information below and discuss any concerns with them.
Post-Treatment Checklist

Please observe the following after treatment with Restylane®.

After your treatment, you might have some redness or swelling. This will normally last less than seven days. Sunbathing and cold outdoor activities should be avoided until any redness or swelling disappears. If you are pregnant, breastfeeding, or under 18, you shouldn't use Restylane.
Avoid touching the treated area within six hours following treatment. After that, the area can be gently washed.
Sunbathing and cold outdoor activities should be avoided until any redness or swelling disappears.
If you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another recurrence. Speak to your physician about medications that may minimize a recurrence.
Avoid exercise and alcohol for six hours after your treatment.
Having a follow-up treatment before the product has fully dissipated may enhance the lasting effect. Please be sure to consult your physician about recommendations for touch-up or follow-up treatments.
One week prior to your next treatment with Restylane, avoid taking St. John's Wort, high doses of Vitamin E supplements, aspirin, and other non-steroidal anti-inflammatory medications, such as ibuprofen. These agents may increase bruising and bleeding at the injection site.

Hylaform

Hylaform (Hylan-B gel) has been described as one of the best instant solutions for facial lines, wrinkles and contouring. In April 2004, the U.S. Food & Drug Administration approved Hylaform for use as an injectable wrinkle filler for those who seek to disguise the effects of aging. With this approval, it can now be used for the treatment of moderate to severe facial wrinkles and folds.

Hylaform was the fourth injectable wrinkle treatment to gain FDA approval, following the prior approvals of Restylane, Botox (botulinum toxin) and Collagen. Hylaform does compare favorably with these treatments in a number of areas. For example, unlike Collagen injections, no pre-treatment skin allergy tests are required with Hylaform injections.

What is Hylaform?

Hyaluronic acid is a naturally occurring substance that is found in human skin and throughout the body. Hylaform is dermal filler that is made from a highly purified form of hyaluronic acid which mimics the effects of natural hyaluronic acid. This highly purified form of hyaluronic acid actually comes from the combs of specially bred roosters.

Hylaform Advantages

Hylaform is made from Hyaluronic acid which is a naturally occurring substance that is found in human skin and throughout the body.

The patient can have immediate treatment. No pre-treatment skin test is required.
Results are immediate. Patients can walk away with the results clearly visible on their face.
In terms of adverse post-treatment responses, there are typically only a few such as redness, bruising and swelling.
While there is no scientific proof to confirm this, the effects of a Hylaform treatment are generally felt to be longer lasting than that of a collagen treatment.
The Hylaform injection procedure itself is very simple and takes less than half an hour. Realistically, a patient could get their Hylaform treatment on a lunch break, and return to work afterwards without any feelings of embarrassment or otherwise. Little or no recovery time is required.
Because of Hylaform's natural components, it will gradually break down and be naturally absorbed by the patient's body. Thus, again, there are no major fears of unnatural item residue in the body as time passes.

Hylaform versus Restylane

The effects of these fillers are very similar. The main difference is how they are derived. Hylaform gel, manufactured by Inamed Aesthetics, is a form of cross linked hyaluronic acid (5.5 mg/ml) derived from the rooster combs of domestic fowl. Inamed states that Hylaform Plus® has larger hyaluronic gel acid particles than their original product, Hylaform®. Restylane®, manufactured by Medicis Aesthetics, is made from streptococcal bacterial fermentation and does not require an animal source. At 20 mg/ml, Restylane® has a higher concentration of hyaluronic acid than Hylaform gel.

Both fillers have been proven safe as dermal fillers. Hylaform® was approved in April 2004 by the FDA. Restylane® was approved in December 2003. In addition, both fillers have been used to augment the lips; however, the FDA has not approved them for this purpose.

Hyaluronic Acid is a glycosoaminoglycan, (a huge molecule consisting of repeating chains of sugars) which occurs naturally in the skin as "ground substance", by support its collagen and elastin fibers, and binding water to give skin it's characteristic "feel". Chemical modified by connecting, or "cross-linking" the molecules produces a gel suitable for injection as a filler material. Both Restylane and Hylaform are synthetically modified hyaluronic acid, although the details of preparation and their composition differ somewhat.

Restylane is somewhat thicker and "stiffer" than Hylaform, partly because of the increased concentration (20mg/ml vs. 5mg/ml) of hyaluronic acid, and because of more cross linking of the HA molecules. The HA molecules in Hylaform are somewhat longer than those in Restylane, allowing increase water binding compared to an equal volume of Restylane. As a rule, Hylaform is somewhat "thinner" with a softer feel and less of a tendency to "bead" or "clump" than Restylane, albeit with a somewhat shorter persistence in soft tissue.

Although generally well tolerated, there have been very rare (1:2000) cases of granulomatous inflammation ("idiosyncratic reactions") and sterile abscesses after injection, which may persist for up to a year or until the injected material is fully resorbed.

Captique™

Captique™ Injectable is the newest FDA-approved non-animal stabilized Hyaluronic acid dermal filler.

The way your skin looks is directly related to the way your skin is supported. As we age, the natural support layers in the skin break down resulting in the formation of wrinkles. Captique, a clear gel containing a purified form of Hyaluronic acid, adds volume lost during the aging process by temporarily smoothing out facial lines and wrinkles. Captique is injected just under the skin’s surface in order to temporarily correct wrinkles.

What is Captique made of?

Captique is made of FDA-approved non-animal stabilized Hyaluronic acid dermal filler. Hyaluronic acid is a naturally occurring sugar. It is found in the human body in the skin, cartilage, joints and the eye.

In skin tissue, Hyaluronic acid fills the space between collagen and elastin fibers. The role of Hyaluronic in skin is to deliver nutrients, hydrate the skin by holding in water, and to act as a cushioning agent.

What is Captique Gel used for?

The gel is injected into skin tissue for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds).

Where does Captique Gel come from?

The gel is produced from materials of bacterial origin and contains extremely small amounts of bacterial protein. Because of this, you should speak to your physician and you should not use Captique gel if you have any known allergies to bacterial protein.

How does Captique Gel work?

Captique gel is injected just beneath the skin surface temporarily adding volume to the layers of the skin that have deteriorated due to age and other factors. The gel, when injected, is used to raise depressions in the skin, providing temporary correction of wrinkles and folds.

What is involved in Captique Gel treatment?

In general there are three steps: a consultation with your physician, a series of treatments (injections), and periodic touch-up treatments.

Is Captique safe?

Yes, for most people. The primary ingredient in Captique gel is Hyaluronic acid (a component of skin) produced from materials of bacterial origin. By comparison, Hylaform is produced from materials of avian (bird) origin. Captique and its counterpart Hylaform have undergone extensive testing including scientific studies to establish safety and effectiveness. The gel has been approved for injection into the skin for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds) by the U.S. Food and Drug Administration (FDA).

Are there any reasons why I should not receive Captique?

Captique gel must not be injected into blood vessels; doing so could cause the blood to stop flowing in that area. A blocked vessel could result in temporary discoloration of the treated area or in tissue death leading to a scab and/or scar formation.
Captique gel must not be injected into areas where any infection or skin eruptions such as cysts, pimples, rashes, or hives, are present.
The majority of reactions to the injection are redness, bruising, swelling, and pain that begin early after the injection and last less than 7 days.

What else should I know about Captique?

Captique gel is indicated for injection into the skin for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds, the lines that run from the nose to the corner of them mouth.)
The safety and of Captique gel for use during pregnancy, in breastfeeding females or in patients under 18 years has not been studied.
Captique gel should not be used in patients with a known potential for keloid formation or hypertrophic scarring (heavy scarring) or pigmentation disorders.
Captique gel should be used with caution in patients on immunosuppressive therapy.
Patients who are using substances that can prolong bleeding, such as aspirin, non-steroidal anti-inflammatory drugs and warfarin may, as with any injection, have increased bruising or bleeding at injection sites.
After receiving injections of Captique minimize exposure of the treated areas to excessive sun, UV lamp exposure, and extreme cold weather, until any swelling and redness have disappeared.
If laser treatment, chemical peeling or similar procedure is considered before or after treatment with Captique gel, there is a possible risk of an inflammatory reaction (such as redness, swelling) at the Captique injection site.

What are the potential concerns when using Captique?

It is possible for the needle to be accidentally placed through a blood vessel during injection, which could result in a temporary change in color or in tissue death in the treated area leading to a scab and/or scar formation.

How will my skin look and feel immediately after treatment?

Most people feel comfortable in resuming their normal activities following treatment. Temporary puffiness of the treated areas, however, should be expected.

As with any injection, you may also notice temporary redness, slight bruising, and tenderness around the treatment sites. Like the puffiness, these are normal occurrences and all should clear up within a few days. Although the injected material is generally not visible through the skin, some people have reported that they were initially able to feel the outline of the injected material.

What concerns should I have after treatment?

Your physician will review with you what to expect following treatment with Captique gel. If there is swelling or redness after the injection you should minimize your exposure to sun and UV lamp. Within the first 24 hours, patients should avoid strenuous exercise, extensive sun or heat exposure and alcoholic beverages as exposure to these may cause temporary redness or swelling at injection sites. Make-up may be applied a few hours after treatment if no complications are present (e.g. open wounds, bleeding and infection).

When may I apply make-up?

Make-up may be applied a few hours after treatment if no complications are present such as open wounds, bleeding and infection.

Does the correction last forever?

No. Correction is temporary; therefore, touch-up injections as well as repeat injections are usually needed to maintain optimal correction. The need for touch-ups will be influenced by ongoing mechanical forces (such as smiling or other muscle activity) and biological changes (such as aging) that caused the original skin depressions.

How often will I require treatment?

Everyone’s skin is different. That is why the timing of any additional treatment varies from person to person. Over time Captique gel will be absorbed by your body; this is why you may want ongoing treatments. If you choose to continue with your treatment, any remaining gel is simply absorbed by your body over time and your skin gradually returns to its natural shape.

Without touch-up injections, how will my skin look?

Correction will reduce gradually until your skin looks like it did before treatment with Captique gel. Touch-up injections will help you maintain correction of the skin surface.

Legal disclaimer:

The content on this website is provided for informational purposes only, and is not intended in any way to substitute professional medical advice during an in office consultation and examination by the physician. Any photos from this web site with text “Property of Dermacare Medical PC” on them are not allowed to be copied and reprinted in any way without written permission from Dermacare Medical PC.