Other Restylane-associated Issues to Watch out For?

I have lupus and keloid, as well as difficulty healing. I use acupuncture, occasional steriods and a number of Chinese, holistic mediciine including gingseng. I'd like to know more about the other issues associated with Restylane such as allergic reactions, risk of getting gram positive viruses and/or other warnings. Please explain as well as possible.

Doctor Answers 3

Restylane complications

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Restyland and other hyaluronic acid products are generally safe and effective, and have a huge part in many plastic surgery practices.

Restylane is genetically engineered. The hyaluronic acid is generated by a Streptococcus species of bacteria. Patients with severe allergies in general (such as anaphylactic reactions) should be cautious about receiving Restylane injections. Patients who have allergies to gram positive proteins should not get Restylane injections.

The majority of serious Restylane complications are due to pilot error; too much in one area, aggressive injection close to the eyes (especially tear troughs), injection in the glabella (frown area) causing skin necrosis, not allowing for recovery time after injection in patients prone to swelling,etc

The package insert for Restylane indicates Restylane should not be used in patients with tendency to keloid formation or hypertrophic scarring,

We have performed many successful surgeries in patients with lupus. Optimization of their medical condition, close communication with their immunologist and internist and great attention to detail all help in this process.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Restylane is very safe.

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Hi Patricia

Restylane is an incredibly safe product. The rate of allergic reaction to Restylane is quite small. So small that testing is not needed unlike bovine collagen. There is no evidence that active Lupus is a contraindication to having Restylane. Regarding the history of keloids, I find that many patients confuse a hypertrophic scar say on the abdomen with a keloid. They are not the same thing. I recommend that you show your treating doctor the scar that you think is a keloid and let them make up their own mind.

There is no such thing as a gram positive virus. The gram stain refers to how bacteria (not virus) appear under a microscope using staining techniques that help visualize these small organisms. Some HA products are produced by bacterial and then highly purified-there is absolutely no risk of getting a bacterial infection from these products. Having said that, bacteria do live on the skin, even sterilizing skin preps do not kill all of the bacteria. Yet there are amazingly few skin infections after a Restylane treatment.

For me, I major concern with Lupus pateints is how active is their disease. I personally don't like doing cosmetic services for someone with active lupus and it is my personal belief that cosmetic surgery should be avoided in the setting of active lupus. Others feel differently about these issues.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Restylane complications

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Restylane is a hyaluronic acid facial filler with a high safety profile.  Risks include bleeding, bruising, infection, nodularity, uneven contour, swelling, and a theoretic risk of rejection or allergy. Patients generally do very well with injection of Botox as the allergic profile is extremely low.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.