Perlane and Restylane

James J. Romano, MD

Perlane is a very pure and stabilized form of hyaluronic acid. It is a clear, transparent, viscous gel-like material that has been used as an implant for over 20 years. It is completely organic and not made from any animal products. Hyaluronic acid is a constituent of all connective tissues in humans and most vertebrates. It is a naturally occurring polysaccharide—an important structural element of all connective tissues in the body, which includes the skin, connective, joint fluid, and subcutaneous tissues. Hyaluronic acid belongs to a group of substances that are similar in all living organisms. It is a relative of GAG (glucose amino glycan). Therefore, in its pure form, it is extremely biocompatible and safe. The stabilized form of hyaluronic acid is designed to last a very long time and undergoes degradation only very slowly over the course of about a year.

Perlane has its effect by adding volume to the tissues in accordance with the amount of material injected. It integrates into the tissues and between the cells and in time undergoes very slow degradation. It is used for fine or deep skin textural wrinkles, some mild acne scars, and minor skin depressions.

There are very few reactions or complications. There have been rare reports of reactions and sensitivity at the injection site. There is minimal pain and some mild swelling after injection. Rare allergic reactions can take the form of localized redness, itching, swelling, firmness, necrosis, or scarring. Infection is very rare and when present is usually slight redness that is self-limiting. Patients with facial herpes may have recurrences. Vascular side effects like tissue necrosis, scabbing, and scarring can occur. It is extraordinarily rare, but it can cause blindness if injected near the eyes. Some lumpiness, firmness, or irregularity may occur at the injection sites for short periods of time. Bruising may occur at the injection sites, especially if you are using aspirin or other medicines that interfere with clotting. Skin inflammation such as rashes, hives, pimples, acne, cysts, or eruptions are rare but can occur.

Perlane, Restylane, and Restylane Fine Line are all related products. They are produced in Sweden and used extensively throughout Europe, Canada and South America.

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