LAM FACIAL PLASTICS

Hi Dr. Lam,

Sorry if I missed this somewhere... but is Restylane SubQ on the market yet? If so, are you using it at all?

Thanks!

J.

no, it is not on the market yet in the U.S.. i actually talked to a canadian doctor and it is not very popular there according to him. his feeling is that it can migrate over time due to the weight. i get such long term results with perlane that i am hard pressed to want to switch even when it becomes available. i will have to wait to see.
best,
sml

Hi Dr Lam

I just wanted to share my experience with Restylane Sub Q. I've had regular restylane injected below the eyes and into the nasiolabial folds, which have always yielded a great result. I only need small amounts in those areas, since I'm only 30 this year.
In June 2008, I tried Restylane Sub Q to help volumize the cheeks. I developed some uniform volume loss in my cheeks last year after a period of ill health (and after IPL treatments over the cheeks, so maybe this contributed to a bit of fat loss, who knows?).
The restylane Sub Q was injected deeply - even with a local anesthetic it hurt a lot. For a couple of months it looked slightly overfilled, but balanced and even.
Then problems appeared. By December 2008, I went back to my doctor with migrating lumps. He pushed them back into place, but an uneven look remains. It took lots of pressure to move them, which left me a bit bruised & swollen under the eyes.
Also, during our very hot summer in Australia, I've experienced a puffiness about my cheeks, similar to a fluid retention look. Plus, it seems that the Sub Q has migrated down my cheeks. I now look like I have "heavy" lower anterior cheeks and yet my weight hasn't changed.
In photos, it can look lumpy. It looks like I have a ridge near my eyelid & cheek junction on my left side, which feels like restylane under the skin on palpation.
I was told that it would last 9 - 12 months. Well, I'm at 8 months and it's still an unfavourable result and is holding!
My doctor here is very experienced and has a fantastic reputation for being extremely artistic with fillers. However, I was one of his first patients to have Sub Q done. He assures me the lumps and ridge are not scar tissue, since I was afraid that the larger needle may have resulted in scar tissue.
I'm visiting the US in June 2009 for a holiday. Should I look at booking a consult with you to get it dissolved, then get Perlane after that? Or is it best to just wait and let it dissolve over time. I'm worried it will take years to go away and keep dissolving unevenly.

Sincerely
Jane

that is exactly what i heard about it from a Canadian doctor who stopped using it. i have no plans in using it until i hear any improvements with it and also when of course it becomes fda approved. my perlane in the cheek lasts a year or 2 so i would dissolve it immediately. restylane products (subq, perlane, restylane) are meant to be dissolved if you don't like it. just get rid of it. why doesn't your doc or a local guy do it? of course, i would be honored to do that but why don't you find someone where you are to do it. i am always amazed and shocked that injectors don't have hyaluronidase. i usually wait a week before reinjecting after the hyaluronidase but could go as short as 3 days if you wanted me to do it. hyaluronidase really hurts without a good dental block. make sure that you find someone that can adequately do a block for you. sounds as if you are not getting that kind of block. restylane etc. should not hurt even the slightest with the right block. and the block should not hurt at all either. also make sure you pretest the hyaluronidase for skin allergy before injecting.
best,
sml

Thanks for so much for your response Dr Lam. It's very much appreciated

Yes, for some reason it's the casual mentality over here to "just let it dissolve over time, no worries mate" (even if it looks awful !)

Thanks - I will organize myself and book well in advance to have a consult with you while I'm visiting Texas.

Kind Regards
Kendall

sounds good!
best,
sml