Using Teoxane Teosyal RHA ®1 to treat the tricky perioral area

Dr Jeremy Isaac, medical director of Wish Skin Clinic and Teoxane UK educational faculty member, explains how the high stretch capabilities of Teosyal RHA ®1 can help treat barcode and smoker’s lines

‘Barcode’ or ‘smoker’s lines’ are a common aesthetic concern, especially for women who tend to have thinner skin, thicker superficial fat, less muscle mass, and fewer hair follicles in the perioral area. Despite the name, these lines are not only due to lifestyle factors like smoking; they’re also a prevalent sign of skin ageing, with lines forming where the skin continuously moves without significant muscular support. It’s this dynamic movement, however, that has conventionally made the perioral area more difficult to treat with HA dermal filler.

“Traditionally, the industry has relied on using short chains of hyaluronic acid with lots of crosslinking, which creates a static product,” reveals Dr Isaac. “That means when you place it above the SMAS, you can get dumbing down of movement. Patients look fine when static, but as soon as they animate, you can tell that something is going wrong.”

Teoxane Teosyal RHA®(Resilient Hyaluronic Acid) offers a solution - anew generation of dynamic premium fillers modelled on the dynamism of natural HA. Indicated for the treatment of dynamic wrinkles and folds, the HA dermal filler range is adapted specifically to the mobile regions of the face. In the case of RHA ®1, the product’s high stretch capabilities also allow it to be injected into the perioral area without puffiness or lumpiness.

Unlike the modified HA traditionally found in dermal fillers, the HA chains in RHA®1 have been kept long, with less rigid crosslinks and preservation of natural dynamic bonds that enable movement of the HA network. This leads to increased suppleness, giving the product a dynamism that encourages both natural and long-lasting results. Indeed, Dr Isaac recommends the product for blanching – a technique that fills fine lines without increasing volume.

“Teoxane’s Resilient Hyaluronic Acid mimics the dynamism of natural hyaluronic acid, which is a massive differentiation from other products,” says Dr Isaac. “Having something that’s got much greater structural integrity, through the means of stretch and strength, means that it’s more resilient to the amplitude and frequency of facial movement. Consequently, when a patient moves their face, the product animates much more naturally than with a static hyaluronic acid.”

Simultaneously, RHA®1’s ability to move in tandem with facial expressions means it doesn’t break down as easily. This not only limits the swelling that can occur as broken-down HA fragments pull more water into the skin, but also improves the treatment’s longevity.

For the best results for the perioral area, Dr Isaac injects RHA®1 into both the superficial fat and the skin, using the multi-layering technique that Teoxane pioneered. The method involves using a cannula to place RHA ®1 into the fibrous fatty layer of the face, using a subcision technique to break down the fascia tethering that attaches the skin to the SMAS’ superficial layer. Then, the same product is used over the top more superficially to fill in the barcodes by etching out the little vertical lines.

An economical approach can produce efficacious results in a broad range of patients, including older patients seeking restoration around the whole perioral area, and for lip patients of any age. It’s a testament to the product’s versatility that Dr Isaac also uses it globally throughout the face for fine lines and creases, as well as for volumising the forehead.

You can view his impressive results in the accompanying before and after photographs – captured three weeks apart, using a specialised 3D camera. They showcase not only RHA®1’s effect on the visible perioral area, but also the improvements on the paradigms of ageing in the skin’s deeper layers.

Contact: Teoxane UK Ltd uk_ info@teoxane.com | www.teoxane.com/en