Patient-preferred sites of restylane injection in periocular and facial soft-tissue augmentation.

PURPOSE: To determine patient-preferred injection sites and frequency for facial volume augmentation with nonanimal stabilized hyaluronic acid (Restylane).

METHODS: : The authors retrospectively reviewed the records of 145 consecutive patients who received 0.4 ml or 1.0 ml subcutaneous facial injections of Restylane. Location, amount, supplemental anesthetic, injection frequency, follow-up time, and use of botulinum toxin type A or other facial aesthetic interventions were reviewed. If recorded, patient satisfaction, revision rate, and any adverse reactions were also noted and analyzed.

RESULTS: Median age at time of initial injection was 54 years; median follow-up was 8 months (mean 10.4 months, range 1-37 months). A total of 309 patient injections were performed (mean, 2.14 injections/patient), with 26% of patients receiving adjunctive anesthesia. Injection site frequencies among the 145 patients were nasolabial folds (72%), melolabial folds (70%), lips (51%), infraorbital rims (24%), perioral rhytids (24%), glabella (23%), malar hollows (10%), chin (8%), and other (8%). Among the 75 patients who received repeat injections, injection intervals were > or =4 months in 56 (76%) and > or =6 months in 28 (38%). Forty-four percent of patients received Botox and Restylane injections during the same office visits. Six complications included edema (2); vasovagal reaction during injection (1); ecchymosis (2); and herpes simplex virus dermatitis (1). Three revisions were performed. One patient was dissatisfied with the procedure.

CONCLUSIONS: Patients elect to undergo Restylane injections to improve the appearance of rhytids and augment volume along infraorbital rims, malar hollows, lips, and depressed scars. Complications are minimal and easily treated.