Dermal Filler FAQs
For more than a century, various substances have been injected into skin to plump lips and wrinkles. Everything from wax to fat to plastic has been injected into facial tissues, with some fillers proving reactive or dangerous.
For the past 25 years, only one choice in our country was FDA approved and that was collagen. Collagen was manufactured from cows, and because it was an animal product, it required allergy testing. Patients would have to undergo an allergy test and then wait a month for the actual treatment. The other problem with older fillers such as collagen was the fact that they just did not last long. Some patients retained the collagen fillers for only a few weeks, or several months at best.
A virtual revolution is now occurring with the development of dermal fillers. Several different products have been used safely and effectively for many years in Europe, Canada, and Australia. These fillers have been passing FDA scrutiny and many have been cleared for use in the USA. Each coming year will bring the introduction of new products for filling lines and wrinkles.
There is no easy answer for this question as each filler has different advantages and disadvantages. At Aesthetic Med Studio, we use multiple fillers to assist the various problems associated with facial aging. It is rare that we use only a single filler for a patient.
Many patients misunderstand fillers and sometime confuse them with Botox. Fillers are substances that are injected under the skin or lips to plump up the tissues. For the lips, fillers can increase lip size and enhance lip definition. They can also plump out “lipstick lines” that develop in many female patients. For skin wrinkling, fillers are usually used for nasolabial folds (laugh lines) or bigger, deeper wrinkles. Fillers can also be used to augment facial anatomy by increasing chin or cheek size, or to fill in defects and scars.
It is important to separate the marketing and media hype from the true clinical science of injectable facial fillers. It seems that each time a new filler is FDA approved, it is hyped as “the best and longest lasting filler in history” — that is, until the next month when the next filler is introduced. In reality, they are all good for specific indications. Sometimes they are made of the same ingredients and do the same thing. Some patients or injectors simply like one better than the other.
There is no definitive answer to this question as each patient metabolizes fillers differently. Research has shown fillers such as Restylane and Juvederm last up to 12 months. Radiesse has been shown to last more than a year; silicone and Artefil are permanent. Fillers may not last as long in areas of increased movement, such as around the mouth. Different fillers will last for different periods of time in different patients. As filler science progresses, the longevity of fillers is increasing.
Although we want long-lasting results, sometimes it is better if results are not permanent. What looks good or is in style today may not look good or be in style in 5 years. Due to this, fillers that will eventually be absorbed by the body may be preferable.
Fillers are injected through small needles. While many injectors at other facilities do not take the time to properly numb their patients, Aesthetic Med Studio goes to great lengths to make this procedure painless. We have had many patients switch to our practice because of our painless injection technique. All patients are first treated with numbing cream on the areas to be injected, then several small injections of local anesthetic are given to totally numb the area for a truly painless procedure.
The filler is then injected in the lips, wrinkles or folds. The actual injection takes only minutes. Ice is placed on the treated area immediately after the injections. After lip injections, the lips generally swell somewhat but most patients are able to return to work the next day. Rarely, some patients experience more significant swelling. For this reason, a first-time filler patient may want to be treated on a Friday. It is also a good idea to refrain from aspirin or drugs that delay clotting for 1 to 2 weeks to decrease bruising when using fillers.
Occasionally a touch-up fill may be performed at the follow-up appointment. It is important to view filler injection as a sculpting process; in some cases, multiple appointments are required to provide the special result that the patient desires
In the lips, the filler is used to enhance the natural lip outline and regain the definition that is lost with aging. It is also used to plump the lips to actually make them bigger and to show more of the red lip area. Our careful attention to detail results in a very natural enhancement. Patients who have been “over-filled” are quite obvious. Many factors go into making an aesthetically pleasing lip — just making lips bigger is not the answer and can look fake. For most patients, a single syringe of filler is adequate to plump both lips.
For nasolabial folds (laugh lines), the filler is injected to plump the fold. Fillers won’t make nasolabial folds disappear, but will improve the appearance of the lines and folds. In fact, adults would look unnatural without any smile lines. Instead of being eliminated, the fold is blunted. Nasolabial folds are actually valleys within tissue; the product fills in the valleys, making them less pronounced.
To get an idea of what to expect when injecting the folds with a filler, place your index finger above the fold and press on the skin. This will cause the fold to plump out, similar to the result that the filler produces. Younger patients may need only a single syringe of filler for both folds, but patients with deeper folds will more than likely require a syringe of filler for each side. The biggest problem with nasolabial folds is under-treatment, or not using enough filler. It is usually better to save up for two syringes than to under-treat the folds with a single syringe.
From time to time, all injectors will over-correct an area or experience an asymmetry. With the common hyaluronic acid fillers such as Juvederm and Restylane, it is possible to reverse or dissolve the unwanted filler with a product called hyaluronidase. This product is marketed as Amphidase or Vitrase and is a safe and effective way to dissolve unwanted filler in 24 to 48 hours. Aesthetic Med Studio has treated numerous patients from other offices who have either received too much filler or filler in a place they did not want it. These corrections are simple and the effect is rapid, usually occurring in 1 to 2 days. There are no significant risks and no recovery time.
At Aesthetic Med Studio, we enjoy helping our clients improve their appearance with the latest in anti-aging and aesthetic treatments. Schedule your complimentary consultation today to discuss the types of dermal fillers available and which ones will offer you the best results.