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Forever Young Part 2: Demystifying Dermal Fillers

Wrinkles and other signs of aging are inevitable!  In the quest for a more youthful appearance, women and men are seeking treatments to minimize laugh lines, crow’s feet, and forehead furrows.

The first edition of “Forever Young” focused on Neuromodulators.  In this second edition of the four-part series, Suria Plastic Surgery provides information about the various types of Dermal Fillers and the most common applications for each.

Dermal Fillers, also known as “Injectables” or “Soft-Tissue Fillers“, do as their name suggests:  Fill in the area under the skin.   Some are natural and some are synthetic.  They all work to improve the appearance of aging skin in the following ways:

  • Filling in wrinkles, fine lines and deep creases
  • Improving other imperfections, like scars
  • Filling out thin or wrinkled lips
  • Plumping up cheeks
  • Contouring the jaw line and other areas of the face

 

The American Society of Plastic Surgeons (ASPS) divides Wrinkle fillers into two categories:  Temporary and Semi-Permanent.   Temporary solutions are Human Fat, Collagen, HyaluronicAcid, Calcium Hydroxylapatite and Polylactic Acid.  The semi-permanent category is comprised of PMMA (Polymethylmethacrylate) fillers.

For a technical explanation and to learn about other applications, you can read this article by the National Center for Biotechnology Information (NCBI).

 

The following categories and descriptions of Dermal Fillers should help our patients make the most educated decisions:

I.  Temporary:

A.  Hyaluronic Acids:  They typically last 6 months to 2 years.  Depending on the area being treated and the degree of correction needed, we would recommend one of the following fillers:

  • Belotero:   BELOTERO BALANCE® has unique properties that allow it to adapt within the skin for soft and even correction.  The versatility of the product makes it strong enough to handle deep treatment areas such as smile lines around the mouth, yet soft enough to treat more delicate areas such as the thin lines that appear above the lip line.
  • Perlane:   Perlane-L is a thicker facial filler that can be used in most areas of the face. The most common uses of the product are the treatment of the nasolabial folds (the creases that run from the bottom of your nose to the corners of the mouth) and the lines of the lower face. Perlane is often used to restore the volume in the face causing a more dramatic correction. It is particularly a well-suited product for cheek augmentations and the deep folds of the lower face.
  • Restylane:   The most common uses of Restylane are the treatment of the nasolabial folds (the creases that run from the bottom of your nose to the corners of the mouth), the tear trough (dark shadows under the eyes), the lower lines of the face, and lip augmentation. It can also be used to rejuvenate the earlobes by adding volume and strength to the earlobes in order to prevent sagging and hanging when wearing earrings. It can be used to restore volume and eliminate shadows and hollowness of the face, producing a refreshed natural result.
  • Voluma:   Juvéderm® VOLUMA™ is designed to recontour the face and restore lost volume in the cheeks, cheekbones and chin.  It was developed to be smoother than other hyaluronic acid facial volumisers, making it easier to inject during the filler treatment and resulting in a smooth, natural look and feel.
  • Juvederm:   Juverderm® can be used on most areas of the face. The most common uses are for the treatment of the nasolabial folds (the creases that run from the bottom of your nose to the corners of the mouth). The thickness of Juvederm Ultra Plus allows it to treat deep wrinkles and lines adding volume and structure to the face. Whereas the Juvederm Ultra is often used for lip augmentations, its soft consistency produces a plump natural lip.

B.  Calcium hydroxylapatite:  This heaviest class of facial fillers is found naturally in human bones. 

  • Radiesse:   Radiesse is a dermal filler that is made up of calcium based microspheres and a water-based gel.   Due to the thickness of Radiesse, it is not used to treat all areas of the face; such as around the eyes or lips. It is commonly used for cheek augmentations to add volume and structure to the face. It has been FDA approved to treat moderate to severe wrinkles and nasolabial folds (the creases that run from the bottom of your nose to the corners of the mouth).
  • Silicone:   Silicone injections are permanent.  They are used for small areas, like acne scars or those fine etched lines above the lips.  The recovery time is similar to other fillers, but several treatments are recommended 6 weeks apart until you get the desired result.

C.  Polylactic acid:   As a synthetic material, it stimulates the body’s own production of collagen.

  • Sculptra:   Sculptra  replaces collagen in the skin that has been lost throughout the years.  It is not used to treat all areas of the face; such as around the eyes or lips.  Sculptra is commonly used for cheek augmentations to add volume and structure to the face.   It can also be used to help soften the lines of nasolabial folds (the creases that run from the bottom of your nose to the corners of the mouth).  Sculptra will not show results for three months.

II. Semi-Permanent

A.  PMMA (polymethylmethacrylate):  Most often used to treat medium-to-deep wrinkles, folds and furrows, particularly nasolabial folds. 

 

  • Artefill:   Typically used for the correction of smile lines, Artefill contains Collagen and is injected when there is a “negative space” or an area that needs volume.  It is known for its long-lasting wrinkle correction results.  Artefill is recommended for those patients who have had fillers in the past and liked the results, but they would like a longer or more permanent outcome.

Below are some additional factors that we consider when we make recommendations to our patients:

  • We have found that filler treatments are more effective if you are treated before the prior treatment has totally lost effectiveness.  Building on the prior base takes less material in the long term than starting over each time.
  • Fillers can also be use to augment the nose & chin.
  • All of the above procedures can be performed on the same day as your consultation.
  • We use several techniques to make the procedure more comfortable for our patients!

 

To discuss your specific Dermal Filler options, please call our office or contact us via e-mail.

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