Injections of new biodegradable gel help eliminate lines, creases

By Kevin Culen

Journal and Courier March 16, 2004

Restylane, a crystal clear, biodegradable gel, is now being used in Greater Lafayette for cosmetic procedures that fill in wrinkles and facial folds. It also makes lips fuller.

Dr. Alexander Gorup of Greater Lafayette Facial Plastic Surgery began offering Restylane this month. The produce was only recently approved for use in the United States. He says he is the first local physician to offer it.

"I think this treatment is going to fit a certain age demographic," he says, "maybe late 20s to mid 50s, patients that would rather do small things and try to maintain a youthful look rather than going to surgical correction immediately.

The gel contains hyaluronic acid, which is found naturally in skin. The acid is found in connective tissue, and it provides great volume because it binds with water, Dr. Rhonda Narins, a clinical professor of dermatology at New York University Medical Center, recently told the Los Angeles Times.

"You can not only fill with it, but you can lift with it," she says.

Restylane, developed in Sweden, was introduced in 1996 and has been used by 1 million patients in 60 countries. It was approved for use in the United States in December, with the first shipments reaching physicians offices within the last few weeks.

It is popular among baby boomers who want to eliminate laugh lines, marionette lines and other creases, mostly on the lower third of their faces.

"I think the reason why people are lining up is it has a long history of safety," said Dr. Rod Rohrich, president of the American Society of Plastic Surgeons, in a recent interview with the Fort Worth Star-Telegram. "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."

The procedure takes less than 30 minutes and costs about $700. Usually, a topical medication is applied to numb the area, and then an injection is administered on each side of the face, using a fine needle.

Often, only a single injection is needed, using a "threading" technique to deposit the gel along the line or wrinkle. Temporary redness can occur.

Gorup, formerly of Beverly Hills, Calif., moved to Lafayette recently. His brother is a physician here, specializing in spinal surgery.

Botox injections have been done in the United States for years, relaxing muscles to help reduce wrinkles. Restylane, Gorup says, "could compliment Botox."

Its main competitor is bovine collagen, a cow-based product that usually is effective for about three months. Because it is animal-based, it is more open to potential contaminants and some patients are allergic to it.

Similar treatments have been administered on a "bootleg" basis by non-physicians in other parts of this country.

This month, the American Society for Dermatologic Surgery announced plans to form a task force to write guidelines for the use of facial fillers and warned that they should be administered only by trained physicians.

Trademarked, government-approved Restylane is available only through licensed practitioners such as Gorup. It recently was featured on The Oprah Winfrey Show, and that, plus many news stories, have fueled interest.

Based on comments heard at national meetings of plastic surgeons, Gorup says, it will be embraced by many Americans.

"I know that we have been waiting for it," he says.