Facial Fillers
Injectable Fillers : Why Use Injectables?
As we age, our faces begin to show the effects of gravity, sun exposure, and years of facial muscle movement, such as smiling, chewing and squinting. The underlying tissues that keep our skin looking youthful begin to break down and atrophy. From the age of 40 onward, there is a progressive loss of fat, dermis, and bone in our faces leaving laugh lines, smile lines, sunken cheeks, and facial creases over the areas where muscle movement occurs. Smoking also causes vertical wrinkles around the lips which can be disconcerting.
Soft-tissue fillers or fat can fill in these lines and creases, temporarily restoring a smoother, more youthful-looking appearance. When injected beneath the skin, these fillers can help rectify deep facial wrinkles, fill in creases and furrows, plump up sunken cheeks, create fuller more sensuous lips, and correct skin depressions and some types of scars.
Deep folds in the face or brow caused by overactive muscles or by loose skin may be effectively treated with injectables. Injectables may also be used in combination with surgery when soft tissue hollowing is noted.
Recently, a number of great injectable facial fillers have been FDA approved. These provide a wide choice for patients and physicians allowing customized filling of the face.
Lip Augmentation
Lip augmentation is another excellent use of fillers. Fillers add fullness to the lips for a lush, attractive look. For best results around the lips, injectables should be combined with resurfacing techniques, such as chemical peel, dermabrasion or laser treatments, or a recontouring procedure such as a facelift. Please see our complete photo gallery of lip augmentation examples.
BEFORE
AFTER
Cosmoderm/ Cosmoplast—lasts 2-4 months
These are the traditional collagen fillers. They give very predictable soft natural fill to facial wrinkles and lips. Collagen is a naturally occurring protein that provides support to various parts of the human body including the skin, the joints, the bones and the ligaments. Injectable collagen received approval from the Food and Drug Administration in 1981. It is produced in various thicknesses to meet individual patient needs.
The collagen is injected using a fine needle, and it is inserted at several points along the edge of the treatment site. Local anesthesia is mixed with the collagen to make this a virtually painless process. Target sites are wrinkles, lines, and scars on the face where the collagen restores fullness and tension to the skin. Collagen implantation works best for wrinkles around the eyes and mouth; it may also be used to give lips greater fullness.
Restylane®—lasts 6 months
This hyaluronic acid filler is FDA approved for filling facial lines. We also commonly used it for lip augmentation and filling of “tear troughs” (the hollows under the eyes).
Juvederm® Ultra/ Ultra Plus—lasts 9-12 months
This newer hyaluronic acid filler has higher cross linking which increases duration of action. Great for filling lines, lips and tear troughs.
Radiesse®—lasts 12 months to 18 months
Radiesse® recently received FDA clearance for filling deep and medium depth wrinkles. Calcium Hydroxylapatite (CaHA) is the chemical name for the medication. Impressive filling is achieved. This can also be used to treat lipoatrophy associated with the treatment of HIV.
Sculptra™—lasts over 2 years
Sculptra™ is a biostimulator. When injected, it causes rebuilding and thickening of our skin through growth of our own collagen. The beauty of this product is that the augmentation of the facial soft tissues actually occurs by regrowth of one’s own collagen. This gives dramatic results which we term the “liquid facelift.”
Artefill®—permanent filler
Artefill® is FDA approved for permanent filling of naso labial lines. It is very effective at filling the lines and has an excellent safety record.
Fat Injections—permanent filler
For fat-injection, the medical term is autologous fat transplantation or microlipoinjection. This procedure entails extracting fat from an inconspicuous part of your body and reinjecting it beneath the skin at the treatment site. Fat is most often used to fill in sunken cheeks, eye sockets (tear troughs), laugh lines between the nose and mouth, skin depressions or indentations, forehead wrinkles and to enhance the lips.
After both the donor and recipient sites are cleansed and treated with a local anesthesic, the fat is withdrawn using a syringe. The fat is then purified and injected into the recipient site. Sometimes an adhesive bandage is applied over the injection site. The augmentation from fat transplantation is extremely effective in permanently filling depressions. Fat injections are a great way to augment the face, breast, or other defects on the body. There is usually an abundance of fat in the lower body for use in grafting. Fat provides a soft, natural fill to the face. Reabsorption of half of the injected fat may occur. The remainder will stay permanently where injected. "Overfilling" is necessary to account for fat reabsorption in the weeks following treatment. When fat is used to fill sunken cheeks or to correct areas on the face other than lines, this intentional overcorrection of newly injected fat may temporarily make the face appear abnormally swollen. However, after the swelling subsides, the amount of fat permanently retained produces the desired results.
Potential Risks
When qualified practitioners administer injectables, complications are infrequent, and if they occur, are usually minor such as swelling and bruising. On rare occasions, lumpiness can occur. These usually all resolve on their own. All of the Changes surgeons are board-certified plastic surgeons. These credentials help ensure the highest standards of care and your utmost safety.
Soft tissue fillers are not suitable for pregnant women, or anyone with a history of autoimmune disease.
Planning for Treatment
As with all cosmetic procedures, meeting your unique needs and preferences are paramount. That's why you’ll meet one-on-one with your board-certified plastic surgeon to discuss your hopes and expectations.
In your initial consultation, your plastic surgeon will evaluate your face and/or lips and discuss your goals. Your plastic surgeon will help you select a treatment option based on your desired results, your treatment preferences, your anatomy, and your lifestyle.
Insurance usually doesn't cover cosmetic procedures. However, if your injectable treatment is being performed to treat a scar or indentation from an accident or injury, you may be reimbursed for a portion of the cost. Check with your insurance carrier to be sure.
Treatment Facilities
Injectable treatments can be performed in our office facility.
Anesthesia Options
Your doctor may use a topical cream anesthetic or a local anesthetic or sedative drugs.
For fat transplants, both the donor and recipient sites are numbed with local anesthesia. Sedation can be used as well. If you elect to use sedation, be sure to arrange for a ride home after your treatment.
Post-Operatively
Immediately following treatment, you may notice some minor discomfort, stinging or throbbing in the injected area. Occasionally, some bruising or swelling will occur, and will last from a few days up to a couple weeks, depending on the size of the area filled. Any redness that appears in the injected site usually disappears within 24 hours. The extent of these symptoms depends upon the size and location of the treated area. In some individuals, particularly fair-skinned patients, this redness may persist for a week or more. Tiny scabs may also form over the needle-stick areas, but generally heal quickly.
No bandaging is needed and you are free to eat, drink, and wear makeup with sun block protection shortly thereafter, however it is best to stay out of the sun until the redness and bruising subsides. If any symptoms persist, contact your surgeon.
Results
The longevity of the fillers results varies depending on the patient's lifestyle and physical characteristics as well as the part of the body treated. Generally, the injected material is likely to be absorbed faster in areas that are more affected by muscle movement, such as the mouth. The duration of action of the various fillers is listed above. Regularly scheduled repeat injections may be necessary for the shorter acting fillers. Your doctor will advise you on how to maintain your results with repeat treatments.
In your one-on-one consultation with your plastic surgeon, you can discuss your desired look. Your surgeon will then recommend the procedure(s) that will best meet your preferences.
Please see our complete photo gallery of lip augmentation examples.
Patient Testimonials
"Thanks for helping to restore my youth. J I love the new me"… -Lenora
"Thank you very much-we could not be more pleased with the results! -Sincerely, Elizabeth & Steve"