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    Restylane Already Available Outside U.S.; Full Approval Expected

    New Wrinkle Filler Gets FDA Panel Nod

    Fewer Allergic Reactions

    Before getting a collagen injection, a patient must undergo skin tests to make sure there won't be an allergic reaction. This test isn't needed with the new hyaluronic acid gel fillers, says plastic surgeon Wayne Perron, MD, past president of the Canadian Society for Aesthetic Plastic Surgery. Restylane and Hylaform have been available in Canada for years.

    "With collagen, there's been some concern over years about allergic reactions," Perron tells WebMD. "But collagen is still a good product, it won't go away. But it has to be refrigerated or it will spoil. Restylane doesn't need refrigeration. We use it more because of these advantages. Hylaform we have used very little, but they are all good products."

    Making Botox Better

    Rohrich says the new fillers aren't, as some have claimed, the "new Botox." They're better than that, he says.

    "You can used them in combination with Botox," he says. "We'll use Botox to relax the muscles underneath wrinkles. Then we'll fill in the area with Restylane or Hylaform."

    Bottom Line: Technique

    Rohrich and Perron warn that the new products aren't a substitute for a skilled doctor.

    "The biggest factor in all these things is technique," Perron says. "You can have the best products in bad hands, and you will have problems. Difficult products in the right hands can yield wonderful results. Basically it is technique. You probably will see a few problems as doctors get used to using the new fillers -- there is a learning cure. But experienced injectors, who have used collagen before, will not have problems."

    And where will people be getting the new filler injected?

    "The number one use will be to plump up the lips," Rohrich says. "Also a big use will be to plump up those little creases that run from the sides of the nose to the lips and get deeper with age. And we'll use it on a lot of forehead and frown lines, too."

    Editor's note: After this article was published, the FDA advisory committee voted 6-3 to recommend full approval of Hylaform. That approval comes with important restrictions.

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