As a healthcare practitioner, it is essential to have a deep understanding of the products and procedures you use to ensure the safety and satisfaction of your patients. One such product that has gained popularity in the field of cosmetic dermatology is Restylane, an injectable gel composed of hyaluronic acid. In this comprehensive guide, we will explore the proper administration of Restylane, including indications, contraindications, precautions, and injection techniques. So let’s dive in!

Understanding Restylane

Restylane is a hyaluronic acid-based dermal filler that is used to correct moderate to severe wrinkles and creases, including the nasolabial folds. It is composed of hyaluronic acid, which is cross-linked using BDDE and suspended in a phosphate-buffered saline solution with a pH of 7 and a concentration of 20 mg/mL].

Indications for Restylane

Restylane is approved for implantation in the mid-to-deep layers of the skin to correct moderate to severe wrinkles and creases, including the nasolabial folds. It provides an effective solution for patients seeking facial rejuvenation and enhancement.

Contraindications to Restylane

Before administering Restylane, it is crucial to identify contraindications to ensure patient safety. Restylane is contraindicated for individuals with severe allergies or a history of anaphylaxis, allergies to gram-positive bacterial proteins, bleeding disorders, or for implantation in other anatomical spaces than the dermis or submucosal implantation for lip augmentation. Additionally, caution should be exercised in areas with active inflammation or infection, as injection site reactions such as swelling, redness, tenderness, pain, bruising, itching, and extreme swelling of the face or lips have been observed.

Precautions for Restylane Administration

While Restylane is generally safe and well-tolerated, precautions should be taken to ensure optimal outcomes. Restylane should only be used by knowledgeable and experienced healthcare practitioners who are familiar with the anatomy of the treatment area. The safety and effectiveness of Restylane for other anatomical regions have not been established. It is important to discuss potential risks with patients, and they should be aware of the signs of complications.

Pre-Treatment Guidelines

Before the treatment procedure, it is important to instruct patients not to take aspirin, nonsteroidal anti-inflammatory medications, St. John’s Wort, or high doses of Vitamin E, as these agents could potentially cause increased bruising or bleeding at the injection site. Proper pre-treatment guidelines can help minimize potential risks and ensure optimal results.

Assembly of Restylane Syringe and Needle

Proper assembly of the Restylane syringe and needle is crucial to ensure a safe and effective administration. The needle should be firmly affixed to the syringe barrel and luer-lock adapter using a clockwise rotational direction. It is important to avoid improper assembly, as it may result in separation of the needle and syringe during implantation.

Injection Techniques for Restylane

The method of injection for Restylane may vary depending on the doctor’s experience, patient characteristics, and desired outcomes. Several injection techniques can be used, including serial puncture, linear threading, push-ahead, serial threading, and cross-hatching.

  • Serial Puncture: This technique involves making multiple closely spaced injections along wrinkles or folds. However, it may result in multiple puncture wounds.
  • Linear Threading: Linear threading entails inserting the needle into the center of a wrinkle or fold and injecting filler as it is withdrawn. Push-ahead technique can also be used in linear threading.
  • Serial Threading: Serial threading combines aspects of both serial puncture and linear threading.
  • Cross-hatching: In cross-hatching, parallel linear threads are injected at intervals, and then a second set of threads is injected at a right angle to form a grid.

Choosing the appropriate injection technique is crucial to achieving the desired outcome while minimizing the risk of complications. It is recommended to change needles for each new treatment region to maintain sterility and prevent cross-contamination.

Dosage Recommendations for Restylane

The recommended dosage of Restylane may vary depending on the treatment area. Based on clinical studies, patients should not receive more than 6.0 mL per patient per treatment in wrinkles and folds such as the nasolabial folds and 1.5 mL per lip per treatment. Overcorrection should be avoided, and the desired effect should be corrected to 100%.

Post-Treatment Care and Follow-Up

After administering Restylane, it is important to provide post-treatment care instructions to patients for optimal recovery and results. Patients may experience mild to moderate injection site reactions, which typically resolve within seven days in the nasolabial folds and fourteen days in the lips. It is recommended to avoid exposure of the treated area to sun, UV lamps, or extreme cold weather until any swelling or redness has resolved. Patients should limit exposure to potential irritants and follow-up appointments should be scheduled to monitor the progress and address any concerns.

Storage and Disposal of Restylane

Restylane should be stored at temperatures up to 25° C (77° F) and should not be frozen or exposed to sunlight. If the package is damaged, the expiration date or lot number is missing or illegible, it should be discarded. Proper disposal of used syringes and needles is essential to avoid injuries and ensure compliance with medical practice and regulatory requirements.


As a healthcare practitioner, your expertise in administering Restylane safely is crucial for the satisfaction and safety of your patients. Understanding the indications, contraindications, precautions, and proper injection techniques is essential to achieving optimal results. By following the guidelines outlined in this comprehensive guide, you can confidently administer Restylane and provide your patients with the facial rejuvenation they desire while prioritizing their safety and well-being.

Remember, always stay up-to-date with the latest research and guidelines in the field of cosmetic dermatology to enhance your knowledge and skills in administering Restylane safely and effectively.

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