Effects on Skin After Restylane Resorbs

Question

Hello, please advise on what happens to facial skin after restylane has resorbed. (or any other filler or fat injection for that matter.) I have read that sagging effects on the skin are unlikely and also that natural collagen production may be enhanced after filler or injected fat has resorbed, however I have yet to come across any negative effects. Assuming a successful injection, could any layer of the skin be left worse off once the filler has resorbed?

Kenneth D. Steinsapir, MD · Answer

OK now for some reality.  What will happen when the Restylane in the skin wears off?  The answer is that the skin will be one or two years older than it is now.  Does that mean that your skin will look younger and fresher?  No.  WIll it look significantly worse than it did before the service?  No not so much.  However, Restylane works by filling.  Once it is gone, it is no longer providing a cosmetic benefit.  It is very likely that having had one or two years of benefit, you are not going to like what this looks like once the filler has gone, and provided you can afford more treatment, then it is likely you will want to top off your prior treatment.

	The effect of fat can be variable.  Unfortunately, these treatments cause scaring in the skin where they are placed.  How these age is any ones guess.  However, the produce much more wear and tear in the tissues than the hyaluronic acid fillers.

Ron Shelton, MD · Answer

I have never been aware of any patient whose lines looked worse after filler dissolved than before treatment. Yes, there may be more collagen produced naturally, by the body, in the dermis as a response to the fillers. Furthermore, there is no damage to the host tissue by Restylane, Juvederm and Perlane.

Monika Kiripolsky, MD · Answer

Hi Nexus,

	  You raise a good question.

	  After you have a hyaluronic acid filler (like Restylane, Juvederm, Voluma, etc.) injected, and your body breaks down the product over months, you skin will not look more "saggy." Anytime your skin cells that produce collagen and elastin ("fibroblasts") are stretched - for example, with the placement of Restylane - they are stimulated to produce MORE collagen. So, the overall residual effect of a filler like Restylane is beneficial to the overall appearance and elasticity of your skin (even after the filler is eventually broken down by your body).

	  Hope this helps! MK

Harold J. Kaplan, MD · Answer

Hi Nexus.  The skin should look much the same (if not better) after the effects of a Restylane injection have worn off.  After the product has dissolved, it is possible that you will look slightly better than before you started with injection procedures if you have been using the product over an extended period of time.

	The reason is that there are studies that show that early use of dermal filler products like Restylane stimulate the production of fibroblasts which in turn creates new collagen.

Grant Stevens, MD · Answer

Greetings Nexus~

	After a patient has fillers, I have not had any patients say that they feel their skin is worse than before treatment.  Some patients are concerned about their skin stretching after fillers but this is definitely not something to be concerned about.  Collagen production is stimulated in the skin by injectable fillers which is really an added bonus to having the plumping effects from the filler. So, to summarize, no layer or aspect of the skin is made worse by having injections done.

	Good luck~

David A. Bray, Sr., MD · Answer

I have never heard of any long term effects on the skin. Although the product is intended to fill. The actual amount of skin stretching is small.

George J. Beraka, MD (retired) · Answer

Hi.

	1)  There is a huge amount of research on Restylane and other hyaluronic acid fillers, and the evidence is that they are very, very safe,

	2)  The only problems that we have ever seen were related to poor injection technique, or wrong placement, or wrong amount.  Other than transient bruising, we have seen no problems due to do the material itself.

	3)  You see the effect of Restylane injections right away.  If you look in the mirror after one side is treated and before the other side is treated, you will be amazed at the difference.

	4)  The effect lasts about six months around the mouth, and about two years in the tear trough.  When it is gone, the skin returns to its previous condition.

Mitchell Schwartz, MD - Account Suspended · Answer

The question of whether or not filler treatments will increase the risk of worsening of the lines after the filler has worn off has come up frequently. In my experience, the opposite has been the case. Wrinkles made to disappear using the new hyaluronic acid fillers such as Juvederm and Restylane which give a completely natural look. These fillers can also stimulate the production of your own collagen which can give an even longer lasting result. I have never seen an instance where I felt that the treatment made things worse after it wore off. Quite to the contrary, I feel that fillers not only eliminate lines but will also prevent new ones from forming. Eventually, when all of the filler is gone, I believe you will still be much improved and will be better off than if you had no treatments at all.

Francis R. Palmer, III, MD (retired) · Answer

Any type of temporary filler like Restyalne, Juvederm, Perlane and Radiesse will not permanently stretch the skin into which it is injected.  There is some evidence to suggest that the inflammation caused by the injections does cause scar tissue to build up within the tissues but this mosty likely disappears once the injections stop for a period of time allowing the skin to return to normal.

	 Fat is quite different and IMHO it is still unreliable.  Fat is living tiisue with a blood supply in and out as it exists naturally in the body.  Liquifying and removing the fat, in preparation for re-injection, disrupts the blood supply and the fat, once injected, will need blood supply to remain viable.  The problem is vessels can not be encouraged to grow into the injected fat that quickly.  IMHO, fat is still not reliable enough to replace off the shelf fillers that are very predictable and reliable.

Effects on Skin After Restylane Resorbs

Answers (9)

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