A. Perlane is sold by Medicis, the company that also sells the more well known hyaluronic acid filler, Restylane. Perlane is a large particle HA filler that is best used for deeper folds, rather than fine or etched lines. If Perlane is injected too superficially, it causes a blue lump, but it can easily be dissolved with hyaluronidase or the skin can be nicked with a lancet and the excess, superficial material can be gently milked out. Go see an experienced injector and stop suffering with this easily reversible complication.
Q. I have systemic lupus erythematosus. It has never affected my face or skin. I have sun sensitivity, a history of joint pains (now controlled on Plaquenil™)and sometimes some breathing difficulties. I started a new very low carbohydrate diet that I think is really helping my lupus, but I have lost weight in my face and I now look much older (I am 45 and Caucasian). Can I have Restylane injected into my face? Is it safe in patients with lupus?
A. There have been no clinical trials done in order to evaluate the safety and efficacy of fillers in patients with autoimmune conditions. There is a theoretical risk that you would be at increased risk of infection and that the filler would not last as long, but hyaluronic acid fillers such as Restylane/ Perlane or Juvederm would be the relative best choice for injection into patients like you. I have done Restylane in autoimmune patients and can anecdotally report I have seen no complications. I would discuss it with your primary care physician and your dermatologist, but I think it is reasonably safe. By the way, very low carbohydrate diets are anti-inflammatory so I am not surprised your lupus might have improved. Good luck and keep me posted.
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