Restylane smooths away worries about wrinkles ...

By Jan Jarvis
The New York Times <URL>
March 14, 2004

FORT WORTH, Texas -- Move over, Botox and collagen. There's a new injection to smooth out wrinkles, and aging baby boomers can't get it under their skin fast enough.

Since Restylane was approved by the Food and Drug Administration in December, more and more patients have been demanding it.

"I've been getting about three calls a day asking about it," said Dr. Raymond Faires, a Fort Worth plastic surgeon. "It's on the tip of everybody's tongue."

More precisely, it's in those annoying lines around the lips and the fold between the nose and mouth. Unlike Botox and collagen, which have raised safety concerns, Restylane has gained fame as a safe way to smooth wrinkles and reshape lips by plumping up the skin.

In the months before Restylane's approval, Dr. Rod Rohrich, chairman of plastic surgery at the University of Texas Southwestern Medical Center at Dallas, had a waiting list of 200 people.

"I think the reason why people are lining up is it has a long history of safety," said Rohrich, who is also president of the American Society of Plastic Surgeons. "It's a natural product, so you don't need a skin test, and most important, it lasts two to three times longer than collagen."

Anne Kashata, of Dallas, wanted to try Restylane because she heard it is safe and produces a natural look.

"I wanted my lips to be a little plumper and fuller," said Kashata, 33. "I didn't want to look like Melanie Griffith; I just wanted to look pretty."

Restylane is expected to catch on quickly and make a big dent in the demand for Botox treatment, which was the No. 1 cosmetic procedure performed last year. Nearly 2.3 million Botox injections were administered in 2003 to the tune of more than $560 million.

While Botox is effective on the upper face, Restylane works best on the lower face.

Unlike Botox, which is made from a toxin and relaxes muscles, Restylane is made of biodegradable nonanimal hyaluronic acid, a natural moisturizer that gives fullness to the skin. It also is safer than collagen, which is made from bovine skin and requires an allergy test about a month before an injection.

But probably the biggest advantage of Restylane is that it lasts about nine months, compared with four months for collagen and Botox. A syringe full -- enough to do the lines around the lips -- costs about $500.

Restylane pumps up the volume without creating giant, unnatural-looking lips, said Dr. Angela Bowers, a Southlake, Texas, dermatologist.

Doctors warn, however, that Restylane is not a lunch-hour procedure. The injection stings, so physicians usually numb the area first. It is more painful than Botox and collagen, Faires said.

Ice packs help, but attending a big event or having a family portrait after the injection is probably not a good idea.

"There's a little more redness overall, but you can put makeup on the next day and go about your business," Bowers said.

Three weeks after the procedure, Sheryl Maher, of Keller, Texas, said she's pleased with the results.