Dermal and soft tissue fillers are second only to Botox injections in popularity, with over 2 million injections being performed in the US last year. This popularity is even more remarkable given that few of these products were even being used in this country 10 years ago. Fillers have given us a way to restore the volume losses associated with aging, particularly around the mouth, eyes, and lips. The relative ease of use, safety, and low costs of these treatments has accounted for their enormous popularity.
What we use
We utilize primarily hyaluronic acid based products (Juvederm, Restylane, Voluma, Belotero) in our practice, the most widely used injectables in the US. We have been impressed by the ease of use, effectiveness, and lack of complications we have seen we these products. We continually evaluate new products as they come on the market, and our exploring new ways to use them. However, we sometimes warn patients about being too anxious about seeking “the newest treatment they saw on TV” as we have seen some of these injectables greeted with great fanfare (and marketing budgets!) only to disappear from the market after a few years because of problems or lack of effectiveness. We want to make sure any treatment we use on our patients is proven to be both safe and effective.
How we do it
Patients interested in dermal fillers are first seen for a consultation where we will evaluate your face, take photographs, discuss the areas to be treated and the amount of improvement you can expect. If you are interested in undergoing injections, we will schedule these to be done in our office at a convenient time.
The areas to be treated will be first anesthetized with a topical anesthetic or nerve block injections. We then chill the area with a cool pack to decrease the possibility of bruising. The product is then injected through a very fine needle into the areas where increased fullness is desired. Afterwards, we will have you continue to apply a cool pack to decrease swelling. The entire procedure takes 30-45 minutes.
Following the procedure the injected area will typically show some swelling for the first day or two. Bruising may be present as well, particularly if we inject in areas where the skin is thin, such as under the eyes. However, this can typically be covered with makeup. You may resume everyday activities right away, but we suggest you to refrain from strenuous activities such as vigorous exercise for the rest of the day. If you are having injections for the first time we will generally have you return in a week or two to see if we have achieved the desired effects. This will help us adjust and fine tune your future treatments. Our goal is to give you a natural appearance, not an overdone look. If we feel that additional volume is needed to achieve your desired result, we can schedule you for additional injections.
Areas we typically treat
- Nasolabial folds (“parentheses” around the mouth)
- Labiomental folds (“marionette” or “puppet” lines around the mouth)
- Forehead creases
- Periorbital region (hollows under the eyes)
- Depressed scars
Use with other treatments
Fillers may be used alone or in combination with other treatments to enhance your overall appearance. For example, we have found that deep furrows in the forehead and glabella region may respond best to treatment with a combination of Botox or Dysport injections followed about 1 week later with a dermal filler. This temporary muscle paralysis enhances the result of the filler and gives us a longer lasting result. Fillers may also be used during other surgical procedures, such as in conjunction with a facelift, to enhance the result.
How we charge
Like most practices, we charge by the syringe, and find we can generally achieve the desired result with one or two syringes. Some patients will require more product to achieve the same effect than others. We try to use the minimal amount necessary to achieve the correction you need. If more is needed, it can be added at any time.
Duration of effect
The body gradually breaks down Hyaluronic acid based fillers over time. In most patients, we are seeing a duration time of about 9-12 months before additional injections are required. Newer products (Voluma, and others) have effects lasting as long as 18-24 months. For patients desiring an even longer lasting correction we can talk to you about fat grafting, as this is one our favorite long lasting fillers.
Hyaluronic acid based fillers are injected more than twice as often as all other injectable types combined.
Why we like this procedure
Dermal and soft tissue filler injections are an easy and effective way to quickly improve your appearance. They are also an excellent addition to other treatments, both surgical and non-surgical, that we offer. These products have an extensive track record supporting their safety and effectiveness that explains why this is a frequently performed procedure in our office and worldwide.