What is Restylane®?

Restylane® are ready-to-use disposable hyaluronic acid syringes for the treatment of wrinkles. In 1996 Restylane® was the first hyaluronic acid available in Europe. In 2003 Restylane® was the first hyaluronic acid approved in the USA. The process of manufacturing Restylane® without animal ingredients was patented by Q-Med (Uppsala, Sweden). Q-Med was acquired by Galderma (Lausanne, Switzerland) in 2011. The production was named Non-Animal Stabilized Hyaluronic Acid, or NASHA® technology. Hyaluronic acid is produced with the help of bacteria (Streptococcus equi). The hyaluronic acid chains are crosslinked with nine to eleven percent BDDE (1,4-butanediol diglycidyl ether). The unbound proportion of BDDE is very low (Guarise C., et al., 2019, J Appl Biomater Funct Mater). With NASHA® technology, filters with different pore sizes produce hyaluronic acid particles of different sizes. Another Galderma process for the production of hyaluronan is called Optimal Balance Technology™ (other name XpresHAn Technology™). The hyaluronic acid particles produced with this process have the same size of approximately 400 micrometers. One percent of the hyaluronic acid chain components are cross-linked (Fallacara A., et al., 2017, Facial Plast Surg). The Optimal Balance Technology™ produces a softer and more flexible hyaluronic acid. The NASHA® Fillers tend to be firmer. These fillers are suitable for contouring the face, cheeks, jaw line and chin. Similar to other manufacturers, the fillers are available with or without the local anesthetic lidocaine (three milligrams/milliliter). The concentration of the following Restylane® gels is 20 milligrams per milliliter. The characteristic values listed here may differ depending on the test conditions.

 

Restylane®

Hyaluronic acid received the approval of the American health authority FDA in 2003. The filler is manufactured with NASHA® technology. The product is injected into medium deep skin layers.

Fields of application:

  • Moderate facial wrinkles
  • Raising the lateral eyebrows
  • Filling of sunken upper eyelids (A-frame deformity)
  • Rejuvenation of the hands

Important parameters:

  • Duration of action (months): 6-12 (Fallacara A., et al., 2017, Facial Plast Surg)
  • Size of the hyaluronic acid particles (micrometers): 330 to 430
  • Modulus of elasticity (G' in Pascal, at 30°Celsius and 0.7 Hertz): 565 (Sundaram H., et al., 2013, Plast Reconstr Surg)
  • Viscosity modulus (G' in Pascal, at 30°Celsius and 0.7 Hertz): 106 (Sundaram H., et al., 2013, Plast Reconstr Surg)
  • Quotient of viscosity and elasticity (Tan Delta value): 0.19
  • Water binding (millilitres per gram): 2.5-3 (Edsman K.L.M., et al., 2018, Dermatol Surg)

Restylane® Lyft™ (other name Restylane® Perlane Lidocaine)

Restylane® Lyft™ is a solid gel produced with NASHA® technology. The hyaluronic acid is suitable for the correction of deep wrinkles and for cheek enlargement. The product was approved by the American health authority FDA in 2019 for rejuvenation of the backs of the hands.

Fields of application:

  • Hand rejuvenation for wrinkles and volume loss in the back of the hand
  • Correction of volume loss in the face
  • Injection of sunken temples
  • Volume increase of the cheeks
  • Improvement of the furrow between the nostril and the corner of the mouth (nasolabial fold)
  • Lifting the corners of the mouth
  • Treatment of wrinkles between the corner of the mouth and chin (mentolabial folds, puppet wrinkles)
  • Injection of the retraction at the edge of the lower jaw between chin and drooping cheeks ("Prejowl sulcus")
  • Removing a chin furrow
  • Construction of the jaw angles ("jawline")

Important parameters:

  • duration of action (months): 12 (Narins R.S., et al., 2011, Dermatol Surg)
  • Size of the hyaluronic acid particles (micrometers): 1000
  • Modulus of elasticity (G' in Pascal, at 25°Celsius and 0.1 Hertz): 545 (Fagien S., et al., 2019, Plast Reconstr Surg)
  • Viscosity modulus (G'' in Pascal, at 25°Celsius and 0.1 Hertz): 69 (Fagien S., et al., 2019, Plast Reconstr Surg)
  • Quotient of viscosity and elasticity (Tan Delta value): 0.13
  • Water binding (millilitres per gram): 2.8 (Fagien S., et al., 2019, Plast Reconstr Surg)

Restylane® Silk™

Hyaluronic acid has been approved in the USA since 2014. The filler is produced with NASHA® technology. The viscosity of the gel is high and the ability to bind water is low. The hyaluronic acid syringe is suitable for the treatment of fine to medium wrinkles on and around the mouth.

Fields of application:

  • Repair of lip wrinkles (upper lip wrinkles, smoker's wrinkles)
  • get rid of pleated lines
  • Restore fullness to the lips
  • Emphasis on the Cupid's Arch
  • Correction of the corners of the mouth
  • Rejuvenation of the lips and mouth region
  • Smoothing crow's feet
  • Improvement of tear ducts ("nasojugal groove", "tear trough deformity")
  • Correction of the furrow between the nostril and the corner of the mouth (nasolabial fold)

Important parameters:

  • duration of action (months): 12 (Narins R.S., et al., 2011, Dermatol Surg)
  • Size of the hyaluronic acid particles (micrometers): 50 to 220 micrometers
  • Modulus of elasticity (G' in Pascal, at 25°Celsius and 0.1 Hertz): 344 (Fagien S., et al., 2019, Plast Reconstr Surg)
  • Viscosity modulus (G'' in Pascal, at 25°Celsius and 0.1 Hertz): 79 (Fagien S., et al., 2019, Plast Reconstr Surg)
  • Quotient of viscosity and elasticity (Tan Delta value): 0.23
  • Water binding (millilitres per gram): 2.7 (Fagien S., et al., 2019, Plast Reconstr Surg)

Restylane® Fynesse™ (other name Emervel® Touch)

The filler is relatively thin-bodied (low viscosity modulus) and elastic (low elasticity modulus). The fabric filler is produced with the Optimal Balance Technology™. It can be easily injected with very thin needles. The hyaluron gel is suitable for the treatment of fine superficial wrinkles. Hyaluronic acid is characterized by its high ability to bind water. The greatest possible effect can be seen after three weeks.

Fields of application:

  • Correction of fine superficial wrinkles
  • Lip wrinkles (upper lip wrinkles, smoker's wrinkles)
  • Contouring of the lip
  • Emphasis on the Cupid's Arch
  • Lifting the corner of the mouth
  • Reduction of nasolabial folds
  • Treatment of crow's feet

Important parameters:

  • Duration of action (months): more than 6 (Cartier H., et al., 2012, J Drugs Dermatol)
  • Modulus of elasticity (G' in Pascal, at 37°Celsius and 2 Hertz): 34.5 (Segura S., et al., 2012, J Drugs Dermatol)
  • Viscosity modulus (G'' in Pascal, at 37°Celsius and 2 Hertz): 18.6 (Segura S., et al., 2012, J Drugs Dermatol)
  • Quotient of viscosity and elasticity (Tan Delta value): 0.54
  • Water binding (millilitres per gram): 17.2 (Fagien S., et al., 2019, Plast Reconstr Surg)

Restylane® Refyne™ (other name Emervel® Classic Lidocaine)

Restylane® Refyne is CE certified since 2008. The hyaluronic acid preparation is produced with the Optimal Balance Technology™ The hyaluron treatment with Refyne is carried out in the medium to deep skin layers. The hyaluronic acid is versatile. The injected hyaluronic acid binds a lot of water. The greatest possible effect can be seen after 3 weeks.

Fields of application:

  • Improvement of the furrow between the nostril and the corner of the mouth (nasolabial fold)
  • Injecting the wrinkle between the corner of the mouth and chin (mentolabial folds, puppet wrinkles)
  • Spraying the corners of the mouth
  • Treatment of wrinkles on the cheeks
  • Lip augmentation
  • removing the frown line
  • Correction of retractions on the edge of the lower jaw between chin and drooping cheeks ("Prejowl sulcus")
  • Removal of chin folds (chin furrow)
  • Reduce crow's feet
  • Reduction of dark circles under the eyes, tear ducts ("nasojugal groove", "tear trough deformity")
  • Spraying away upper lip wrinkles

Important parameters:

  • Duration of effect (months): 6-12
  • Modulus of elasticity (G' in Pascal, at 37°Celsius and 2 Hertz): 67.7 (Segura S., et al., 2012, J Drugs Dermatol)
  • Viscosity modulus (G'' in Pascal, at 37°Celsius and 2 Hertz): 20.3 (Segura S., et al., 2012, J Drugs Dermatol)
  • Quotient of viscosity and elasticity (Tan Delta value): 0.31
  • Water binding (millilitres per gram): 9.7 (Fagien S., et al., 2019, Plast Reconstr Surg)

Restylane® Volyme™ (other name Emervel® Volume Lidocaine)

Optimal Balance Technology™ is used to produce the hyaluronic acid filler. The hyaluronic acid is characterized by high strength. The gel does not spread in the tissue. The filler is injected deep into the bone. Sunken skin areas are lifted and the tissue stabilized.

Fields of application:

  • Filling of hollow temples
  • Filling hollow sunken cheeks
  • Correct receding chin
  • Emphasis on the chin line
  • Defining the jaw angles ("jawline")
  • Correct nose without surgery
  • Injecting the furrow between the nostril and the corner of the mouth (nasolabial fold)
  • Removing the retraction at the edge of the lower jaw between chin and drooping cheeks ("Prejowl sulcus")
  • Removing a chin furrow
  • Treatment of wrinkles between the corner of the mouth and chin (mentolabial folds, puppet wrinkles)
  • Correction of sunken upper eyelids

Important parameters:

  • Duration of effect (months): more than 6 (Carruthers J, et al., 2009 J Drugs Dermatol).
  • Modulus of elasticity (G' in Pascal, at 37°Celsius and 2 Hertz): 131.6 (Segura S., et al., 2012, J Drugs Dermatol)
  • Viscosity modulus (G'' in Pascal, at 37°Celsius and 2 Hertz): 20.3 (Segura S., et al., 2012, J Drugs Dermatol)
  • Quotient of viscosity and elasticity (Tan Delta value): 0.15
  • Water binding (millilitres per gram): 7.3 (Fagien S., et al., 2019, Plast Reconstr Surg)

Restylane® Kysse™ (other name Emervel® Lips Lidocaine)

The filler is slightly more fluid than Volyme™ (viscosity modulus low) with moderate elasticity. The gel for wrinkle treatment is produced with the Optimal Balance Technology™. The hyaluronic acid is hardly distributed in the tissue and is therefore able to define the contours of the lips precisely.

Fields of application:

  • Repair of lip wrinkles
  • Reduction of the furrow between the nostril and the corner of the mouth (nasolabial fold)
  • Smoothing the wrinkles between the corner of the mouth and chin (mentolabial folds, puppet wrinkles)
  • Lifting the corners of the mouth
  • Lip augmentation
  • Lip Modelling
  • Correction of retraction at the edge of the lower jaw between chin and drooping cheeks ("Prejowl sulcus")
  • Treating the chin furrow

Important parameters:

  • Duration of effect (months): more than 6
  • Modulus of elasticity (G' in Pascal, at 25°Celsius and 0.1 Hertz): 156 (Fagien S., et al., 2019, Plast Reconstr Surg)
  • Viscosity modulus (G'' in Pascal, at 25°Celsius and 0.1 Hertz): 12 (Fagien S., et al., 2019, Plast Reconstr Surg)
  • Quotient of viscosity and elasticity (Tan Delta value): 0.07
  • Water binding (millilitres per gram): 7.2 (Fagien S., et al., 2019, Plast Reconstr Surg)

Restylane® Defyne™ (other name Emervel® Deep Lidocaine)

The skin filler (Dermal Filler) is produced with the Optimal Balance Technology™ Restylane® Defyne is CE certified since 2008. The filler is produced with a local anaesthetic. The hyaluronic acid is cross-linked to a high degree. It is characterised by its strength and long-lasting results. The hyaluron can nevertheless be injected with fine needles. The filler adds volume to the tissue and is suitable for the treatment of medium to severe facial wrinkles.

Fields of application:

  • Treatment of sunken temples
  • Volume increase of the cheeks
  • Helps to achieve natural radiance with a sunken face
  • Smoothing the wrinkles between the nostril and the corner of the mouth (nasolabial fold)
  • Combating the furrows between the corner of the mouth and the chin (mentolabial folds, puppet folds)
  • Corner of the mouth lifting
  • Reduction of dark circles under the eyes, tear ducts ("nasojugal groove", "tear trough deformity")
  • Injection of the retraction at the edge of the lower jaw between chin and drooping cheeks ("Prejowl sulcus")
  • Correction of a chin furrow
  • Contouring of the jaw angles ("jawline")

Important parameters:

  • duration of action (months): 12 (Narins R.S., et al., 2011, Dermatol Surg)
  • Modulus of elasticity (G' in Pascal, at 37°Celsius and 2 Hertz): 213.8 (Segura S., et al., 2012, J Drugs Dermatol)
  • Viscosity modulus (G'' in Pascal, at 37°Celsius and 2 Hertz): 23.3 (Segura S., et al., 2012, J Drugs Dermatol)
  • Quotient of viscosity and elasticity (Tan Delta value): 0.11
  • Water binding (millilitres per gram): 6.4 (Fagien S., et al., 2019, Plast Reconstr Surg)

Author's statement

Author: Stéphane Stahl, MD, PhD. There are no financial relationships with the pharmaceutical or medical device industries that could have influenced the above text. Any reproduction, even partial, is permitted for personal use only. All texts used on this website are protected by copyright.

 

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