The RHA (Resilient Hyaluronic Acid) Collection of fillers are the first line of facial fillers to gain an FDA approval to specifically treat dynamic facial wrinkles and folds. While these fillers have been widely used in Europe since 2015, they were approved for use in the U.S. by the FDA in 2021. These fillers were designed to treat dynamic wrinkles, those that appear in areas of the face that move repetitively. These wrinkles are often difficult to treat with fillers, since many of more viscous fillers can lead to a stiff, unnatural result during dynamic movement of the face.
The RHA fillers are formulated to simulate the molecular structure of the hyaluronic acid molecules found in the skin. This is done to enhance stability, as well as creating a more natural look. Hyaluronic acid naturally occurs in your skin to help provide moisture, volume, and structure. Over time, your skin produces less hyaluronic acid. There are four unique formulations found in the RHA Collection, which allows the injector to select a filler based on the patient’s anatomy and strategy for treatment. They are categorized and labeled according to their density and viscosity.
RHA Redensity: Redensity is the newest FDA-approved filler to be added to the RHA Collection. Being the least viscous of all of the RHA fillers, Redensity is best used in the dermis for the correction of dynamic perioral rhytids (also known as smoker’s lines). Its unique properties allow it to be injected very superficially, further enhancing its effectiveness.
RHA2: This filler is a great choice for treating mild to moderate wrinkles and around the lips and mouth.
RHA3: RHA3 is designed for treating deep wrinkles and folds, such as the nasolabial folds, the oral commissures (the corners of the mouth), and the marionette lines. It can also be used to enhance the lips and subtly contour the midface.
RHA4: The most viscous of the RHA fillers, RHA4 is designed to treat deep lines and folds. RHA4 is also an excellent choice for contouring the chin, jawline, and cheeks. Its flexibility allows it to be placed in the subcutaneous plane, rather than the deeper periosteal plane, so it can be used to layer over deeper, more structural fillers as well.
One of the primary benefits of the RHA fillers is that each possesses specific properties that are best suited in specific areas of the face. In many patients, using different RHA fillers can best achieve the most natural, balanced results. These RHA fillers are great choices for dynamic areas of the face with a lot of movement, since their elastic properties help to ensure a more natural outcome.
Dr. Greene’s specially formulated topical numbing cream is applied for 15 to 20 minutes prior to treatment. Treatment takes approximately 15 to 30 minutes to perform. The treatments involve very small needles, and comfort is enhanced due to the numbing cream and Dr. Greene’s gentle injection technique.
While initial results can be seen immediately following treatment, there is some initial swelling that may mask the final outcome. It generally takes a few days for the major swelling to subside, though evaluation of the final result takes two weeks, after the majority of the swelling has resolved. Minor bruising is to be expected, but can typically be camouflaged with makeup. More significant bruising is very uncommon, and can take 2-3 weeks for complete resolution. Avoiding certain medications and supplements, such as baby aspirin and fish oil, can minimize bruising. Patients who have bleeding tendencies may experience more visible bruising than others.
There is no downtime after treatment, though we typically recommend patients to refrain from exercise for 24 hours. Mild transient side effects may occur, such as minor swelling and bruising.
A major advantage of RHA fillers is that they are all composed of hyaluronic acid (HA). Hyaluronic acid fillers can be dissolved if necessary using a specific enzyme, hyaluronidase. Experienced injectors like Dr. Greene and Holly are often asked to dissolve filler placed by other injectors.
All facial fillers require extensive experience and an advanced understanding of anatomy in order to achieve the absolute best results. Dr. Greene has served as a national trainer for Allergan and Galderma in order to train others how to safely and properly inject facial fillers.
Most patients report only mild discomfort during treatment. We use a specially formulated numbing cream that enhances comfort for our patients. After having used a number of different numbing creams in the past, we have found a formulation that is most effective for our patients. All of the RHA fillers are also formulated with lidocaine to further enhance patient comfort.