Restylane

Mid-Dermal Filler for Moderate to Severe Facial
Folds and Wrinkles

Perlane, approved by the FDA in May of this year, is a "mid-dermal"
hyaluronic acid filler product. As a sister product to Restylane,
Perlane is designed for more pronounced facial folds and wrinkles
such as those on the sides of the mouth.
Perlane is injected into the deep dermis to superficial layer of the
subcutis to add volume to restore surface contour in facial wrinkles
and folds. Perlane corrections maintain volume augmentation for
about six months before natural product degradation begins to lessen
the effects.

Q What is Perlane® used for?
A Perlane® is used to smooth moderate to severe facial folds and
wrinkles such as the lines from the nose to the corners of the mouth
(nasolabial folds). Perlane® generally lasts for about 6 months. It has
been found to be a safe dermal filler that restores volume and
fullness to the skin.

Q How does Perlane® work?
A Perlane® is injected into the skin with an ultrafine needle. It plumps
the skin to smooth away wrinkles and folds. Perlane®’s water-loving
nature attracts and binds water molecules to help maintain volume.

Perlane® is composed of hyaluronic acid, a natural substance that
already exists in the body. The hyaluronic acid in Perlane® is a
crystal clear gel that is chemically cross-linked (the long chemical
strands are tied together) to delay breakdown by skin enzymes.
Perlane® is non-animal-based and free from animal protein. This
quality prevents disease transmission.
Allergy pre-testing is not necessary.

Q How long does Perlane® last?
A Perlane® is proven to deliver long-lasting results. Studies have
shown that Perlane® effects generally last about six months as shown
in the following graphs. Perlane® gradually disappears.

Before Treatment                                          After Treatment

Perlane® has been used safely by dermatologists and plastic
surgeons since 2000 worldwide.

Q Who should not use Perlane® (Contraindications)?
A Perlane® should not be used by people with previous bad allergies
(particularly to certain microorganisms known as gram positive
bacteria),
to drugs that have required in-hospital treatment, or in people with
bleeding disorders. Perlane® should not be injected anywhere except
the skin or just under the skin.

Q What are some warnings to consider?
A The use of Perlane® at sites with skin sores, pimples, rashes,
hives, cysts, or infections should be postponed until healing is
complete.
Use of Perlane® in these instances could delay healing or make your
skin problems worse.
You may experience skin discoloration (bruising), swelling, redness,
tenderness, pain, itching, or small lumps in the area where you are
injected. If any of these events occur, the majority usually last less
than seven days. If
any symptom lasts longer than two weeks, call the doctor who
administered the Perlane® injection.
Inflammatory papules (red or swollen small bumps) may rarely occur.
You may need antibiotics to treat them.

Q What are some risks that may be experienced?
A As with all procedures like this, the injection of Perlane® carries a
theoretical risk of infection and formation of scar tissue.
The safety and effectiveness of Perlane® have not been established
in the treatment of lips, in nursing mothers, and in patients under 18
or over 65 years of age. Perlane® use in nursing could harm you or
the nursing child.

The use of Perlane® in African-American patients can result in
hyperpigmentation
(darkening of skin color), which may take several weeks to correct.

If you have had herpes before, an injection can cause the herpes to
come back.
The safety of Perlane® used with other skin therapies such as laser,
mechanical or chemical peeling, and hair removal has not been
established. The use of Perlane® in these skin therapies may not
work or they may damage your skin.
You should avoid exposing the area(s) treated with Perlane® to
excessive sun or
UV lamps, and extreme heat and cold until any redness or swelling
has disappeared.

Q What should patients do prior to treatment?
A Perlane® requires no pretesting, but you should take a few
precautions before being treated. Avoid using St. John’s Wort, high
doses of Vitamin E supplements, aspirin, and other non-steroidal anti-
inflammatory medications, such as ibuprofen prior to treatment,
because these may increase bruising or bleeding at the injection site.
Also, if you have previously suffered from facial cold
sores, discuss this with your physician. He or she may consider
prescribing a medication to minimize recurrence.

Q Do the injections hurt?
A Perlane® is injected directly into the skin in tiny amounts by an
ultrafine needle. To help maximize your comfort, you should discuss
the use of numbing medicines with your doctor before treatment.

Q How much do Perlane® treatments cost?
A Perlane® is a customized procedure based on your specific needs,
so the cost will vary from patient to patient. In general, the cost of
Perlane® is comparable to the cost of similar procedures. Because
Perlane® is long lasting, it may prove to be very economical over the
long term. Please ask your doctor to give you an estimate of the cost.

What Areas of the Face Can Be Treated with Perlane®?

The hyaluronic acid in Perlane® can be used to improve the contour
of facial skin and to reduce wrinkles, folds, scars, and other facial
skin depressions.
Common uses for Perlane® filler include:
•        Wrinkle correction
•        Diminishing worry lines, smile lines, crow’s feet, marionette lines
at corners of the mouth, and smoker’s lines
•        Lip enhancement
•        Reducing the severity of nasolabial folds
•        Chin augmentation
•        Filling cheek depressions
•        Redefining lip border
•        Softening acne scars
Other, less common, uses for Perlane® filler include:
•        Filling hollows under the eyes
•        Creating a temporary eyebrow lift
•        Correcting facial depressions caused by fat loss
•        Softening the appearance of jowls

Restylane® vs. Perlane® Filler
Perlane® is primarily the same product as Restylane®, but Perlane®
filler contains a larger concentration of hyaluronic acid. Because of
this higher concentration of hyaluronic acid, Perlane® is usually used
for larger folds, while Restylane® is better suited for smaller wrinkles
or to maintain the results of a previous Perlane® injection.
Because of the differing levels of hyaluronic acid, Restylane® is less
expensive than Perlane® filler.