Dermal fillers are used to correct volume loss in the face. We can use these in cheeks, lips, tear troughs, temples, nasolabial folds, jaw line, ear lobes,chin… almost everywhere really. When injecting dermal fillers, there are several guidelines I like to share with my patients to help them to achieve their best possible outcome.
First, I like to advise patients how to prepare to receive the injections. I suggest that you discontinue the use of Aspirin, Fish Oil, and Vitamin E supplements 10 days prior. This does not mean you can’t have filler if you took Aspirin that day or the night before. It simply means you may experience some bruising associated with the blood thinning effect of these products. I would also recommend taking Arnica (homeopathic for bruising) and Bromelain (homeopathic for inflammation) tablets 3 days prior (continue for 7 days after). Again, if you don’t, it is not a deal breaker. You just may experience more bruising and swelling.
Next, I like to give my patients a realistic idea of what to expect. Many fillers are temporary hyaluronic acids that your body will eventually absorb naturally between 6-12 months. Initial treatments, may require a ‘touch-up’ in 4-6 months to prolong results and/or increase volume for best results. This also depends on which product and how much product you choose initially. The initial volume with Sculptra (polylactic acid) will diminish after the first 3-5 days. PLLA particles will then work to stimulate your own collagen to replenish lost volume. It is then important to follow up every 6-8 weeks until you achieve ‘FULL correction’ with this product. I stress that it is common to have swelling, redness, and even bruising after treatment. Following the instructions above and icing the area can help diminish one’s chance of experiencing these undesirable side effects.
Lastly, I recommend that you avoid direct exposure to heat and sunlight, excessive manipulation and rubbing of the treated area(s) for 48 hours, chemical peels and laser treatments immediately after. Apply ice to the treated area(s) for the first 48 hours as well as Arnica cream and continue taking your Bromelain. I also recommend drinking plenty of water for the next 5 days as this will help hyaluronic acid to ‘hydrate’.
I welcome my patients to call me if they have any questions post procedure. This will help me when administering your next treatment.
Basically, Fillers are injectable treatments that we use to help restore facial volume. If you are in your mid 30’s or above age wise, and you are at a normal weight, you are probably noticing that your face looks a bit thinner each year. A full face is associated with youth. Look at the Victoria Secret supermodels that are plastered everywhere, they are all about 6’0″ tall and 120 lbs but they all have these beautiful round, full faces. That’s because they are all in their teens and 20’s.
So, we use filler to help restore the volume to your face to help you look younger. Now, today’s fillers are an evolution from the Collagen injections of days gone by. The problem with collagen was that some people were allergic to it so you had to skin test them, then wait several days or weeks, then inject, but you had to over inject them because some was going to go away almost immediately so you never really knew what your result would be, and in the end the stuff went away in 3 months or so. And it was expensive. Bad combo.
Today’s most commonly used fillers are made of Hyaluronic Acid (HA). The two most common trade names for these fillers are Juvederm® and Restylane® which you can find in almost any plastic surgeons offices. These are FDA approved products to help fill deeper facial lines and restore facial volume. HA is what is known as a GAG, a gylcosaminoglycan and is already found throughout the body in your connective tissues. So it is already a part of your person and very safe to use. The companies that produce these products all of varying claims of their longevity but what we see is that most people seem to get about 15 to 18 months out of these fillers. The HA fillers are reversible as well so if the patient does not like the result they produce the product can be dissolved. We love them and their popularity amongst our patients and nationally increases every year.
There are more sophiticated fillers like Radiesse and Scuptra. These last much longer, are irreversible and tend to be more expensive. These products are typically used for patients who have had the HA products a couple of times, know they like the results, and want a longer lasting product.
If you have filler questions contact us and schedule a consultation via e mail at firstname.lastname@example.org or 502.721.0330.
Lee Corbett, MD
Medical Director Corbett Cosmetic Aesthetic Surgery and MediSpa.
FYI…If you are planning a Louisville cosmetic surgery in the future don’t forget that we can add in a Louisville Dysport or a Louisville Restylane treatment. And, the best part is you will already be asleep so you won’t feel a thing! It only takes a minute and the facilities do not charge you to have this done if you are in the operating room already.
Fillers have been extensively tested and are very, very safe. Most problems are actually not a result of the filler itself, rather a problem with injection technique.
Early problems are the most common ones we encounter and include redness and swelling. Bruising can occur if a small blood vessel is injured by the injection. With the exception of fat injections, an allergic reaction can occur with any filler but this is extremely rare with todays fillers.
Late problems are primarily related to granuloma formation. A granuloma is basically a scar reaction to the injected material. If this occurs it is typically 6 to 24 months after injection.
Hands and necks tend to give us away from an aging perspective.
As far as the hands are concerned, what I typically see are brown spots and a thinned, skeletonized appearance. Both problems are actually pretty easy to correct though.
I treat the dark spots with a Laser. There are a lot of lasers out there that treat pigment. It can be done in the office in just a few minutes. It is slightly uncomfortable but in 11 years I’ve never had anyone tell me it ‘hurt’. In fact, I’ve lasered myself numerous times to put a patient at ease. It’s not a big deal. Afterward, the spots will get a little red and may scab but within a week the skin will flake and your spots will be gone. The cost is very reasonable, about $300, but this is a treatment you will have to repeat, probably about once a year depending on how much sun you get.
Injectable fillers are used to add volume to the back of the hand so it doesn’t look so skeletonized. This does require a couple of needle sticks on each side so it is a little uncomfortable. It is done in the office and only takes a few minutes. There is no recovery though. The main ‘downside’ to this treatment, like all fillers, is cost and the need for repeat treatments. Costs will range from $500 to $1000, depending on how much filler is used, and most of the fillers will go away after 12 to 18 months.
Check with your Plastic Surgeon if you are interested because if you really hate your hands and your budget allows, we do have a really effective solution for you.
My preference for lip enhancement is to use injectible fillers. My two favorite fillers are Juvederm and Restylane.
I like these products because they are easy to use and they last a pretty long time, at least 1 year. Either can be placed in the office under a local dental block and it usually only takes about 15 to 20 minutes. I also like that the products give a 1:1 correction. In other words, when we inject the lip and plump it, what you see is what you get, which increases patient satisfaction. This way the patient can hold a hand mirror and make sure she gets exactly what she wants. In the past, with some of the collagens, we had to over-correct anticipating some absorption so our results were less certain.
There are permanent implantable lip plumpers but these have historically been plagued with palpability, extrusion, and infection problems. Personally, I prefer to stay away from these.
Fat is also a good filler choice. A small amount of fat can be harvested from your tummy or thigh and then re-injected. This is a very good technique and I think you will find some plastic surgeons who prefer this and others who prefer the Hyaluronic Fillers. Both are good.
It looks likes come July, Botox is going to have some competition here in the U.S. The name of the new product is Dysport. It is made by a company called Medicis, who make Restylane.
As an experienced Cosmetic Plastic Surgeon here in Louisville, KY I have performed thousands of Botox injections and am very pleased with the results, as are my patients. Point is, personally, I don’t see a need for more botox but it’s coming regardless. So, let’s check it out!
Are there any differences? I don’t know because I haven’t used Dysport yet. Supposedly, the new toxin starts to work faster, lasts slightly longer and will be slightly less expensive than botox. Whether this is true or not remains to be seen but the product does have FDA approval. In addition, the problems associated with the injections are of the same type and frequency as those found with botox, at least in the control group the FDA studied.
Look for the product around the first of July. We will run an introductory special so check your e-mail. If we don’t have your e mail please call the office and we’ll add your address to our blast list.
All posts on this blog are authored by Louisville cosmetic plastic surgeon Dr. Lee Corbett. Dr. Corbett specializes in cosmetic plastic surgery including facelifts, browlifts, blepharoplasy, Botox, Juvederm, Restylane, breast augmentation, breast lifts, breast reductions, body lifts, liposuction, and tummy tucks.