Restylane® and Perlane® are gels that are injected into the skin with an ultra-fine needle to lift and add volume to the areas being treated. Similar to one of the body’s own natural substances (hyaluronic acid), both products have been proven to be safe. The hyaluronic acid in Restylane® and Perlane® simply supplements the body’s age-depleted hyaluronic acid to plump-up the lip or to raise the skin and ‘fill in’ the particular wrinkle being treated. Instantaneously wrinkles can be smoothed, lips can be sculpted and facial contours can be shaped.

Restylane® and Perlane® are classified as cosmetic fillers.   While there are numerous injectable fillers on the market today, many of them have their drawbacks ranging from allergic reactions to short life spans. Restylane® and Perlane® are safe and natural.

RESTYLANE® - is intended for wrinkle correction and lip enhancements
RESTYLANE® FINE LINES - is used for correcting thin superficial lines, for example around the mouth, forehead lines and smile lines
PERLANE® - can be used for shaping facial contours, such as cheeks and chin, correcting deep folds, and for volume augmentation of the lips.

In 1996, the biotechnology company Q-Med of Sweden created a genetically engineered version of hyaluronic acid (Restylane® and Perlane®). Hyaluronic acid is a polysaccharide, or natural sugar, that is found largely in the skin. Its primary function is to provide volume and pliability to the skin. The unique characteristic of hyaluronic acid is its ability to bind with water up to 1000 times its volume. This property makes it ideal as a filler agent, for even while hyaluronic acid filler is being naturally degraded it continues to attract more water to it. This characteristic allows it to hold its shape even longer.

Restylane® and Perlane® Applications:
Wrinkle correction
Lip augmentation
Correcting nasolabial and other folds
Shaping the cheeks and chin for facial contour

Restylane® and Perlane® Benefits:
No skin test is necessary. Allergic reactions are almost non-existent
Lasts up to 60% longer than collagen fillers
Clinical trials show that Restylane® and Perlane® are effective for up to six months after lip augmentation

JUVÉDERM™/JUVÉDERM PLUS™

Juvéderm™ injectable gel is a colorless hyaluronic acid gel that is injected into facial tissue to smooth wrinkles and folds, especially around the nose and mouth.  Hyaluronic acid is a naturally occurring sugar found in the human body.  The role of hyaluronic acid in the skin is to deliver nutrients, hydrate the skin by holding in water, and to act as a cushioning agent. 

In its natural form unbound hyaluronic acid forms a liquid made of highly-hydrated individual polymers (chains) that are metabolized in the body in just 12 hours.  The liquid hyaluronic acid is transformed into a soft solid, or "gel" by a process known as cross-linking wherein the individual chains of hyaluronic acid are chemically bound together.  The firmness of the gel depends on the degree of cross-linking of the individual hyaluronic acid chains.  The body metabolizes cross-linked hyaluronic acid more slowly, resulting in a longer duration of effect when hyaluronic acid is used therapeutically.

JUVÉDERM™ dermal filler, a 'next generation' hyaluronic acid dermal filler approved by the FDA in June, 2006, contains the highest concentration of cross-linked hyaluronic acid of any dermal filler currently available.  These attributes provide optimal results with a single treatment in the majority of patients and deliver sustained results for up to 6 months or longer.  Juvéderm™ may last longer than the other available hyaluronic acid products on the market.  We are currently involved in a national investigational trial to determine if patients prefer Juvéderm to Restylane® when injected into nasolabial folds.

JUVÉDERM™ is injected into areas of facial tissue where moderate to severe facial wrinkles and folds occur.  It temporarily adds volume to the skin and restores a smoother appearance to the face.  

Side effects are mild or moderate in nature, and their duration is short lasting (7 days or less).  The most common side effects include, but are not limited to, temporary injection site reactions such as redness, pain/tenderness, firmness, swelling, lumps/bumps, bruising, itching and discoloration.  As with all skin injection procedures, there is a risk of infection. 

Radiesse™ is one of the most advanced new injectable products for facial sculpting. The advantage of this product is its longer lasting effect.

Radiesse™ consists of calcium hydroxylapatite suspended in gel (carboxymethylcellulose). Because calcium hydroxylapatite is a normal constituent of bone, it should not elicit a chronic inflammatory or immune response. Additionally, the gel carrier doesn't require allergy testing such as required with collagen.


Hydroxylapatite has been used in humans for many years in prosthetic implants in dental, facial and orthopedic surgery. The use of the injectable product in vocal chords and bladder neck areas has shown that the product remains soft without new bone formation when injected into soft tissue.

In December, 2006, Radiesse™ was recommended for approval by the FDA for aesthetic uses.  Dr. Eviatar has been successfully using Radiesse™ since 2001 with excellent results, and he is a principal investigator in an FDA study for the use of Radiesse™ to treat facial lipoatrophy in patients with HIV.

Whether you're longing to reverse the common signs of aging or address a health issue that otherwise would require an invasive treatment, you have more options to look and feel better with Radiesse™ because unlike fillers that need to be injected superficially into the skin, Radiesse™ can be injected into deeper tissues for facial shaping.  Radiesse™ is a new generation injectable filler that offers versatility for both cosmetic and reconstructive use without surgery.  Its unique composition provides the immediate visual improvement common with other fillers, along with the benefit of long-lasting results.  Radiesse™ particles form a scaffold through which your body's own collagen grows, and for this reason, the desired long-term effect is achieved. 

For facial contouring, Radiesse™ can be used for:

  • Nasolabial folds
  • Marionette lines
  • Cheek augmentation
  • Improvement in the appearance of lower eyelid bags
  • Lateral brow elevation
  • Non-surgical rhinoplasty
  • Enhancement
  • Improvement in facial volume loss due to aging or disease (i.e., HIV lipoatrophy)
  • Chin augmentation
  • Facial depressions from trauma

Radiesse™ offers versatility and years of testing to prove its safety and effectiveness. Any form of facial contouring with Radiesse™ is performed as a non-surgical, minimally invasive out-patient procedure in our office.  For longer lasting results in patients who could benefit from diffuse areas of facial volume augmentation, treatment with Sculptra™ may be a better option.

Results are immediate and only require a few long-lasting treatments, which means Radiesse™ is also cost-effective – saving you time and money. While treatment results may vary, results typically last months longer with Radiesse™ compared to other fillers.

HIV-related facial wasting


If you are suffering from the stigma of HIV lipoatrophy (facial wasting) due to medications, Radiesse™ is a safe and effective injectable shaper that provides immediate contour improvements and can give your face an overall healthy, full appearance with long-lasting results.  (1-1 1/2 years depending on the patient and site of injection).

ArteFill® is the first FDA-approved non-resorbable aesthetic injectable implant for the correction of nasolabial folds.  It can also be used in other facial areas for re-shaping.

ArteFill® is a unique combination of homogeneous precision-filtered microspheres suspended in a solution of purified collagen gel and 0.3% lidocaine to alleviate discomfort during injection.  ArteFill® received final approval from the FDA in October, 2006, making it the first and only non-resorbable aesthetic injectable implant to gain FDA approval.

ArteFill® is designed with dual action to correct facial wrinkles.  It does this as a result of its composition, which is a combination of precision-filtered microspheres (20% of total volume) made from polymethylmethacrylate (PMMA) and purified bovine collagen (80% of total volume).  All microspheres have a defined size of 30 to 50 microns in diameter and have a smooth, round surface.  Aesthetic results are visible immediately after injection.  PMMA is not taken up by scavenger cells (macrophages) and cannot be degraded by enzymes.  Thus, the microspheres will remain intact beneath the creases, providing a permanent support structure to support the wrinkle and to prevent further wrinkling.  As with all products using bovine collagen, a skin sensitivity test must be performed.

In contrast, FDA-approved temporary filler treatments using biological fillers to increase the thickness of the skin, such as autologous fat, bovine collagen, and hyaluronic acid (Restylane®, Hylaform®, Juvéderm®), provide only temporary effects because they are naturally absorbed by the body following implantation.  While a permanent filler such as ArteFill® is not appropriate for use in all patients, Dr. Eviatar will discuss the advantages and disadvantages of using temporary fillers versus ArteFill® depending on the type of correction that is needed.

ArteFill® Safety Features SrteFill® Safety Features

  • Precision-filtered, suspended, PMMA microspheres optimized over 3 generations
  • Purified bovine collagen gel
  • Collagen source is a closed herd in the U.S. (FDA-compliant)
  • Proprietary, non-porous syringes contain 0.8 cc and 0.4 cc ArteFill®
  • Optimized injection flow characteristics
  • Pharmaceutical-grade product manufactured in a fully dedicated cGMP facility in San Diego, CA
  • Company-sponsored Artefill® Physician Training Program; Dr. Eviatar is a physican trainer for ArteFill®

Disadvantages of ArteFill®

  • Permanent correction may not be advised in many patients
  • Long term nodules or allergic responses may occur and may be difficult to treat