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Non Surgical Rejuvenation - Immediately Rejuvenating Filler

Hyaluronic acid (HA)

HA is FDA approved for the correction of facial wrinkles, folds, grooves and scars (e.g. acne and chicken pox scars).  It is commercially available as Restylane®, Hylaform®, and Perlane®.


Restylane® is a sterile, elastic-like, clear, colorless, and odorless transparent gel composed of HA.  HA is a naturally occurring chemical in human tissues, including skin. It is chemically, physically and biologically identical in the tissues of all species. HA serves as a building-block to produce collagen and skin support.

Indications and usage

HA is indicated for the correction of wrinkles, folds and scars in the skin. Hylaform® and Restylane® are less viscous (thick) than Perlane®, and are usually used in finer lines.

The procedure

Prior to your HA injection you may be given a local injection (similar to a dental block) to numb the area.  After HA has been injected, the skin will be lightly massaged to smooth to the contour of the surrounding tissue.  After the first treatment, one or more additional injections (at least 1 week apart) of HA may be necessary to achieve the desired level of correction and fullness.

To sustain correction, repeat injections over time may be necessary (i.e. after 5-12 months). The need for re-injection may vary from site to site and is dependent upon a variety of factors, including anatomic location and the root cause of the original problems. The patient is charged for each HA syringe used at each injection.


Some HA (Hylaform) is produced from materials of bird origin and contains trace amounts of avian protein.  Patients with known allergies to materials of chicken origin should not be treated with Hylaform, but may receive Restylane or Perlane, which are synthetically produced.  As in any procedure involving the skin, the injection of HA is associated with an inherent risk of infection.  HA should not be used in areas where inflammatory processes or infections are present, e.g. active acne or cold sores.

Temporary side-effects

In some patients HA injections may cause transient pain or bruising at the site of injection.  Injection sites are frequently associated with pinpoint bleeding which usually resolves soon after injection.  Patients with known bleeding and/or coagulation disorders, those who are on anticoagulant therapy or those taking the anti-inflammatory drugs listed below are at greater risk from this complication.

Anti-inflammatory drugs may thin your blood, increase bruising and bleeding.  These must be stopped four days before your treatment and for four days afterwards.  Advise the doctor if you are taking: Aspirin, Advil, Arthrotec, Bextra, Celebrex, Coumadin (warfarin), Diclofenac, Feldene, Ibuprofen, Indocin,

Motrin, Naprosyn, Orudis, Ticlid, Toradol, Voltaren or Vioxx; or herbal supplements like St. John’s Wort and garlic.  However, Vicodin (hydrocodone), Darvocet and Tylenol are permissible.

Local redness, swelling and itching may occur and are the most commonly reported side-effects. It usually resolves within two to three days. Cold compresses may be used immediately after treatment to reduce swelling.  On occasion, some patients have experienced prolonged erythema (redness).

People suffering from cold sores may be at higher risk of a recurrence from injections into the lip areas.  Also, a small group of patients have reported acne like lesions that formed at the injection site between the time of injection and up to two months after treatment.

In some patients an allergic reaction may occur — red or discolored, sometimes lumpy bumps in the skin may be seen which can last for several months and in some cases may be permanent. The exact incidence of allergy is currently being investigated.