Facial fillers, including Juvederm, Perlane, Radiesse, and Restylane are all administered via injection.  Typically, there is no downtime after a facial filler injection, but in some rarer cases, patients may develop transient swelling or bruising. Dr. Karamanoukian and his staff take all necessary precautions to minimize bruising and swelling after your procedure, but in some cases, it is unpredictable. The folowing guidelines serve as a reference for both clinician and patient. Adherence to these instrucitons are strongly recommended in order to maximize results and minimize any downtime.

1) Avoid aspirin, non-steroidal anti-inflammatory medications (Ibuprofen, Motrin, Aadvil, Naprosyn), St. John's Wort, or excessive doses of Vitamin E at least two weeks prior to injection.  These medications can impair the body's natural ability to stop bleeding.  Hence, taking these medications prior to the injection may increase one's ability to fend off bruises.

2) Purchase the Bruise-Pak pills from your local health food store, pharmacy, or through our website to reduce bruising and swelling during and after your injection.  We recommend two pills twice a day from the day of your injection, for a total of 5 days.

3) If you have a bleeding history or an anemic, it is recommended that you take the Bruise-Pak for 5 days prior to your procedure.  Also, we will have ice packs ready for your use immediately after injection.

4) If you have a strong history of cold sores, you will be given a prescription for Valtrex or Zovirax to reduce the onset and occurence of cold sores after injection.

5) Please provide us with enough time to perform the procedure in a meticulous fashion during your appointment.  Remember that we are a plastic surgery office and Dr. Karamanoukian and his staff are dedicated to exceptional service and patient care.  During the course of the day, we may be a little delayed, but we will make every possible effort to accomodate your schedule.

Where can Restylane be injected? Restylane has a very high safety profile on the face as it is rare to develop allergic complications, nodularity, or permanent problems from Restylane injections.  Either Restylane or Perlane can be used for volume enhancement on the face to correct deep wrinkles and volume loss. Areas that can be filled with Restylane include the eyelids, tear trough, cheeks, nasolabial folds, laugh lines, lips, and chin.  Lip augmentation is frequently performed with Restylane as is lower eyelid rejuvenation.  Some patients with very thin skin around the lower eyelids may develop residual swelling, but this subsides with time.  Another area that works well with Restylane are the corners of the mouth. Restylane injected into this area works to uplift the lips and jowls and create a more happier facial appearance at rest.

How often should I be treated with Restylane? Restylane Regimen is a new facial filler protocol that extends the life of Restylane in the body.   It is advised that patients revisit their physician at 4.5 or 9 months and have additional filler placed to augment the volume enhancement.  This method has increased the results of Restylane to up to 18 months.

How fast will I see results with Restylane injections?  Restylane or Perlane injections add instantaneous volume to the soft tissue. As such, results with either Restylane or Perlane can be seen immediately in clinic within minutes after the procedure is complete.  Restylane may cause some transient swelling which can make the results a little more noticeable than the final result.

If I can't get an appointment with Dr. Karamanoukian, is there any one else in the office who can perform Restylane injections? Yes.  Our cosmetic registered nurse is a phenomenal cosmetic practitioner who has a wealth of experience with facial fillers.  She performs all facial filler injections along with Dr. Karamanoukian in both of our offices.  She is a true master clinician on volume enhancement of the face and is known for her gentle and compassionate approach to patient care.  She is a dedicated nurse and sees patients in consultation in both of our offices.  She is available by appointment by calling (310) 998-5533.

Are there any things that would prevent me from having Restylane injections? Yes.  We do not perform facial fillers or injections during pregnancy.   If you have severe allergies to hyaluronic acid or other facial fillers, you should inform either Dr. Karamanoukian of your reaction and medical history.  Further, we advise patients to avoid aspirin, ibuprofen, or coumadin before treatment.  Please inform us if you have a previous history of excessive bleeding or have been on these medications prior to injection.

What are some common side effects or complications with Restylane? After treatment, you may experience some bruising, swelling, redness, pain, and mild tenderness along the area of injection.  Dr. Karamanoukian recommends that you take a Bruise-Pak for five days after injection. You may purchase the Bruise-Pak from your local healthfood store, pharmacy, or through our website.  You can also purchase the Bruise-Pak on the day of your injection at the office.