I'm talking about 10-15 years down the line. I have heard from an expert user of this product that as fillers dissipate they can leave the skin looking unhealthy and crepey where it was previously OK as the fillers stretch, puff and traumatize it. This judgment was based on personal experience, not theory. Has anyone ever heard or seen this? Any doctors ever seen this happening gradually over long time patients? Thank you!
Is Prolonged Use of Restylane Safe?
Doctor Answers 8
Restylane is SAFE
"An expert is a person who avoids the small errors while sweeping on to the grand fallacy". This expert is wrong. All studies have shown that Restylane is completely safe to use both in the short and long run.
Prolonged use of Restylane, Perlane and Juvederm
The hyaluronic acid class of soft tissue fillers (restylane, juvederm, perlane) as well as the neurotoxin botox have all been around and used throughout the world for many years. While there are never been a long term, randomized, blinded trial assessing the long term tissue effects of prolonged use of soft tissue fillers and neurotoxin, like botox, there is a general feeling amongst board certified specialist, dermatologist and plastic surgeons, that prolonged and repeated use of these needle based products do not pose a long term risk to the skin, soft tissue or general health. However, you must always seek the advice of a board certified specialist skilled and experienced in the art of soft tissue injectables to ensure that any product or treatment program is safe and effective for you individual medical condition and needs.
Long term use of Restylane or Juvederm
many of my patients who have continued their fillers such as Restylane or Juvederm have had occasions where they were not able to come back for more than a year and I have never seen stretched out saggy or wrinkled skin worse than baseline before the first filler was ever injected.
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Definitely a plus with each treatment
A number of reasons for this exist.
The first is that a University of Michigan study did show that the Restylane does indeed stretch the fibroblasts, causing a mechanism in which the cells start producing collagen on their own. Thus the effect does last longer.
The second study showed that of the Restylane is injected 4 months after the first injection, its effect lasts longer.
Another most important reason why repeated injections are important is that when injected in the skin, this "trauma" that is mentioned triggers a response that makes the body make its own collagen. This has been translated in Europe by the injection of Restylane Vital or the mesotherapy version of the product, which has a tremendous effect in hydration of the superficial skin and giving a supplness to the skin. Whether it is the material that causes this or the effect of the superficial injections still remains to be seen.
Fillers will not stretch the skin or adversely affect it over time
Your "expert" doesn't sound like a true expert with fillers. In fact, this is the first time I have ever heard anyone make this comment. I have been injecting fillers for 20 years and between my experience, that of my colleagues (see Dr. Lupo's answer above) and all of the research that has been done, I can tell you without a doubt that fillers will not make the skin look crepey or unhealthy, only sun damage or perhaps normal aging will do that.
Scientific studies have proven that the recurring injection of Restylane stretches skin fibroblasts and stimulates your own collagen over time. The "expert" who said it traumatizes the skin and makes it look unhealthy should look up the data. My personal experience also agrees with the science: that Restylane improves skin over time with regular use. I have patients that look 5 years younger than when they first tried Restylane in 2003, even though they are now 7 years older. I have presented these cases at AAD and ASDS meetings. Perhaps your "expert" is trying to sell you something else.... Of course, if you totally stop fillers after several months (9-18 months), the skin may return to your natural age, which is now older than when you started. After all, you can turn the clock back, but it keeps on ticking, even if you get an expensive laser or facelift.
Continued use of hyaluronic acid fillers may actually improve your skin long term
Hyaluronic acid fillers like restylane and juvederm are actually very safe products since hyaluronic acid is normally found in your skin between cells and also in your knee and elbow joints. Recent studies have actually shown that repeated injections of hyaluronic acid actually can last up to 18 months or more. In fact, I have seen in some patients that after several years of injections they actually need less product down the road so there may be some positive building up of one's own collagen. I hope this information helps.