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.