Fillers are very popular products used to soften lines and wrinkles as well as to replace lost facial volume which occurs with aging or weight loss. There are a number of products available with different characteristics, allowing a skilled physician or nurse to customize your treatment to your specific needs. The firmness, viscosity, particle size and composition, and longevity vary between products. Injecting fillers requires selection of the proper products as well as the amount to inject and, equally as important, the technical and artistic skill and experience needed to produce a soft, natural appearance.
Originally many of the fillers were FDA cleared for the smile lines extending from the nose to the mouth, but are now widely used off-label for many areas of the face as well as other locations such as the back of the hands or bridge of the nose. There are 3 commonly used varieties of fillers. Hyaluronic acid is a synthetic form of one of the important naturally occurring substances in the skin and is the most common filler. Hyaluronic acid is used in fillers such as Juvéderm®, Restylane®, Prevelle®, and Belotero Balance®. Hydroxyapatite also occurs naturally in the body, but not in the skin. It is used in some other fillers such as Radiesse®. Poly-L-lactic acid is another substance from nature which stimulates collagen production in the skin and is most commonly known as Sculptra®.
Juvéderm Voluma is a fairly dramatic breakthrough for restoring mid-face volume and it has become very popular in Europe, where it was been available since 2005.
There are also truly natural “fillers” such as your own fat which can be grafted from another part of your body into your face, and recently now, your skin’s own fibroblast cells. These are the cells which manufacture collagen, elastin, and hyaluronic acid. These cells can now be multiplied and injected back into your skin in treatments such as LaVív®. Technically, LaVív® and Sculptra® are not true volumizers as they do not immediately increase volume after injection, but rather stimulate the production of collagen, etc. which then replaces volume.
We are often asked about lip enhancement and there are several techniques used for this. Unfortunately, what are referred to as “duck lips” are all too common and are usually unattractive. We specialize in providing a natural look for lips which may range from subtle enhancement of the lip outline or correcting downturned corners of the mouth to restoration of the pretty arch or cupid’s bow at the top of the lips to increasing width or volume when desired-with a focus on natural lips. However, we also understand that each patient is different, as is their personal preference and appearance. We take care in listening to our patients to help them achieve their desired look—whether merely a mild correction, a natural look, or even a more pronounced one. Patient satisfaction has always been our number one goal.
Other areas such as saggy cheeks, tear troughs, acne scars and a variety of other applications can also be successfully treated with proper filler selection and administration.
Fillers are often used in conjunction with a neuromodulator such as Botox® or with fractional laser resurfacing or non-surgical skin tighteners. Many of the newer fillers have numbing medicine mixed with them so that numbing cream (rather than dental block numbing) can now be used. We also use the newer blunt tip cannulas to minimize bruising.
The hyaluronic acid fillers such as Juvéderm® and Restylane® not only come with numbing mixed in, but they also come in different size syringes and in different degrees of firmness to allow us to further design your treatment for your face, budget and comfort.
A customized treatment plan administered by a skilled physician or nurse injector is important for achieving optimal natural results.
What areas can be treated?
- Laugh/smile lines (nose to mouth folds and furrows)
- Marionette lines
- Lipstick or “barcode” lines
- Corners of the mouth
- Many other areas such as forehead or frown lines
- For selected areas to restore volume or re-contour the cheeks, tear troughs, nose or jawline.
How long does it last?
It depends on the product(s) used and other factors such as if you choose partial or full correction, but for hyaluronic acid fillers such as Juvéderm and Restylane typically range from 9 months up to a year or more. Lips may be a shorter time and Juvéderm Voluma may last 18 month or even longer.
What should patients do before treatment?
The treatment area (your face) should be cleaned before injection.
Do the injections hurt?
Individuals’ pain tolerances can vary widely. In general, the lips are the most sensitive treatment area. We offer additional topical numbing to help minimize discomfort during your procedure, and many fillers now come pre-mixed with numbing agents that will help alleviate discomfort during and after your treatment. We advise in most cases against injection of separate local anesthetics as this may alter your facial contour and this is suboptimal for the artistic component.
How much do treatments cost?
Your treatment will be customized to your needs so the costs will vary. We will give you a fee estimate before your treatment. There are also several plans to help reduce your cost:
- Brilliant Distinctions®: Interested in saving on Botox® Cosmetic, Juvéderm®, Latisse® or Vivite®? You may register at www.BotoxCosmetic.com for the Allergan Brilliant Distinctions Program where you’ll get exclusive invitations, special offers, and great savings on treatments.
- Our in-house VIP program gives additional discounts and other benefits on your next 3 treatments above and beyond any other applicable discounts (limit 1 year). Simply speak with one of our patient care coordinators or one of our nurses to learn more!
I got my filler injected somewhere else and it didn’t turn out well! Can I undo this?
We are happy to consult with you on your personal needs. There are some techniques that can be used to help restore your original appearance in some cases-especially with the hyaluronic acid fillers.