Should I be seeing a significant "wearing off" of Perlane injections after only 6 weeks? Had it done for lines on both sides of my mouth and also lines around upper lip. It looked great first couple of weeks but then started wearing off. Now I am starting to see lines around my mouth again. Should it have last longer, or should maybe I have tried a different product like Juvederm? I am 53 years old.
Should I Be Seeing a Significant "Wearing Off" of Perlane Injections After Only 6 Weeks?
Doctor Answers (10)
Perlane and longevity
Without first viewing a photo of your issue or seeing you in person, it is very difficult to answer your question. Dependent upon proper technique and placement, Perlane should last several months.
6 Weeks after Perlane
It's difficult to say without seeing you, before your Perlane treatment and now, what may be going on, but often times there is some residual swelling for a few weeks after injections. Once the swelling resolves completely it may look like the Perlane has worn off or that the lines are back. Often, it's just more Perlane (or whatever filler) that's required. Fillers in general do tend to break down in dynamic areas (especially ones that move and where the muscles contract a great deal, like the mouth/peri-oral area) more quickly than in thicker areas with less movement. You may also consider a small amount of Botox in the upper lip area to diminish the strength of the contraction of the muscles..this could help extend the life of the filler in that area as well as improve your results. Best to go back to the office where you were injected and see what their thoughts are. Chances are, they will recommend more filler now that the initial injections have settled in.
Dr. Grant Stevens
Typically Perlane will last at least 6 months in non dynamic folds. In dynamic folds and around the mouth it usually lasts less. Absorption varies by where injected, technique and by individual patient. Six weeks is shorter than usual.
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Perlane wearing off after 6 weeks
What you may be noticing is the post-injection swelling resolving. Usually, the swelling goes down after a couple of weeks, but it could last longer. It is likely that you just needed more filler, so you may want to go see your injecting physician again. I don't think it is related to the type of filler you were treated with.
Perlane "wearing off" around mouth may be due to movement.
Whenever fillers are used in areas of increased facial animation such as lines around the mouth, or fine lines of the lip, even "perfect" placement can be affected by movement of the recipient area, and can result in reduction of the effective degree of "fill." You may need more frequent injections (though 6 weeks is faster than I usually see), or a different filler. Realize that no filler can take the place of properly-performed facial cosmetic surgery when you become a candidate for that!
The deeper nasolabial and subcommissural folds (below the corners of the mouth) may require facelift, which will also help jowls and loose skin under the chin, and the fine lines around your lips can be treated by laser resurfacing, chemical peels, or localized dermabrasion. All of these options give long-lasting improvement, but of course require surgery and a period for recovery.
Perlane is on of the popular hyaluronic acid fillers. They usually last about six months, give or take. The problem is that the body reabsorbs/dissolves it gradually over time and once about 50% is gone it may seem like there is none left. Six weeks is a little on the short side but people are different in reabsorption rate and certainly you may fall into that end of the Bell curve.
Perlane and lips
Perlane lasts for 9 months or longer. The changes you may be seeing may be the result of swelling disappearing. You just may need more product?
Perlane should last longer than six weeks
Perlane, Restylane or Juvederm, or Radiesse should all provide a longer duration of effectiveness than six weeks. The filler might have been injected more within the fat layer than the dermis/subcutaneous interface and it might be displaced or dissolved faster. It might be worth retreating in a slighlty more superficial plane, but not too superficial as it is designed to be placed deeper than Restylane or Juvederm. The Restylane or Juvederm also can be placed at time over the Perlane and this layering technique is helpful in some patients. If it still does not produce a long term effect, then just Restylane or Juvederm Ultra or Juvederm Ultra Plus can be tried. If that still doesn't work, then Radiesse can be tried.
Perlane injection "wearing off" in 6 weeks is not common
I agree that Perlane injection lasting only 6 weeks is pretty rare. While the exact plane of the injection (i. e. upper dermis, deep dermis, upper subcutaneous, above muscle, etc) affects the longevity of the filler effects, it in general should still last more than couple of months. I suspect that the initial result you saw was exaggerated by the local swelling immediately after injection. However, it is wise to try something different next time.
Next time, try another product
Your experience of having Perlane last only 6 weeks is rare, but not unheard of. I usually suggest a different product the next time to see if the different method of production results in better duration in you. Everyone is different. I have found that both Juvederm and Restylane are more durable than Perlane in most patients. But 6 weeks is REALLY short duration. Maybe a tiny touch of Botox in those perioral muscles would improve duration. Be sure your doctor knows how to do this trick.