Home » Blog » Dr. Dean Kane FAQ

Dr. Dean Kane FAQ

Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Restylane Silk

Q. The Restylane Silk was used to correct the hollow indents I was left with after another provider used 3 syringes of Radiesse in the mid-face area approximately 3 weeks before. I went to a walk-in clinic about the swelling and was prescribed steroids, Zantac and an anti-histamine, to reduce swelling.

A. This is quite helpful. Other than the crescent shaped swellings in each cheek, it appears that Restylane Silk has accomplished your desired goals.

Restylane (hyaluronic acid, HA) is a relatively “new” type of filler as compared to prior bovine or human collagen and calcium hydroxyapatite (Radiesse).

Each provide a structural lattice made of human like molecules to provide a structural support to the skin and soft tissues underneath.
Restylane and Juvederm, similar HA’s made by different companies, is additionally linked together and cleaved or filtered to achieve their particular virtues, ie., strength, projection, volume or fluidity and smoothness.
Lyft and Voluma have the greatest “R” value and therefore have the greatest number of links (similar to the rungs of a ladder) and molecule length, similar to the length of the ladder to provide support and projection.
Restylane and Juvederm Ultra lend some support but attract water (think water balloons attached to the ladder) due to the amount of exposed polarity of the molecule to create volume that has been lost in aging, disease or trauma.
Silk has the least number of links and shortest molecules further exposing more polar sites and therefore attracts more water. It is therefore more fluid and smoothening.

Based only on what I interpret from your photo, you have thin and draping skin. There is a poorly understood tissue in the upper cheek which swells particularly with allergies and crying. These festoons attract water as well and swell.

Silk with a high polarity to attract water will exacerbate a festoon. The medications you were placed on are the best option to reduce the swelling without using hyaluronidase to enzymatically degrade the injected filler.
Radiesse is the basic material of bone mineral. While it too creates a lattice structural support (I place it along the bone of the orbit, cheek, nose and jaw), it does not attract water to the extent of an HA filler and therefore much less “swelling”. . It may cause increased circulation with visible telangiectasia in some  patients.


I hope this explanation is helpful.
So sorry for your troubles. I hope you get better soon.


This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.
« »