Dermal Fillers

Restylane®, Perlane®, Juvederm™ and Radiesse®

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If you feel youthful and beautiful, your skin should reflect that feeling! Aging is a fact of life, but wrinkles, lines and creases don’t have to be. Injectable fillers are highly effective in treating areas such as the lips, smile lines, “marionette lines” and acne scarring. They are also used for augmenting cheek bones and filling in cheek hollows, jowls and tear troughs.

What is happening to the look and feel of my skin? It wasn’t always like this!

Looking at aging skin shows that the dermis gradually begins to loose collagen, elastin and hyaluronic acid. Each of these components has its own place in giving the youthful look as seen in a child’s face. Collagen is the protein which gives major support for the skin, elastin gives the firmness to the skin (thereby resisting wrinkles), and hyaluronic acid helps to trap water and give volume and shape to our skin. In addition to these losses, we begin to have bone loss. Imagine the analogy of a table that starts to shrink while the table cloth remains and starts to hang in place. All of these changes occur gradually, so before resorting to a dramatic surgical facelift, consider dermal fillers which can help volumize the skin and soften the wrinkles.

Why do you have so many types of fillers?

There are differences in the way that each filler behaves, how they fill, and how long they last. This is based on what the filler is composed of. There are hyaluronic acid based fillers (Restylane, Perlane, Juvederm Ultra and Plus), Ca Hydroxyapatite based fillers (Radiesse) and fillers which stimulate your own collagen (Sculptra, which is administered like a filler but is not technically classified as one). We do not offer collagen based fillers in our office (Evolence, Cosmoplast) because they generally do not last very long.

Restylane® Lips: Before	Restylane® Lips: After

All types of filler materials can help improve the youthful appearance and fullness of facial skin, but there is no one filler that is ideal for everyone or for every area of the face. This is why it is important that the doctor is familiar with several types of fillers, not just one. For example, lips tolerate fillers differently than cheeks do, and not all fillers can be injected in the lips. In some cases, multiple fillers can be used in various places in the face to improve the entire facial aesthetic, in a procedure known as a “liquid facelift”. This effect is rapidly becoming popular and is starting to replace the standard surgical facelift, as a less expensive, easier, and less painful procedure to achieve similar results of decreasing saggy-looking skin and regaining that youthful appearance.

What should I expect during and after the procedure?

Most injectable fillers are administered in just a few minutes, and any discomfort can be managed with topical or injectable anesthetics. Dr. Prasad uses a thin needle to inject the dermal filler into the wrinkles, folds, or scars where treatment is desired. The injections are done at intervals along the line until the right amount of correction is achieved. The treated area is then gently massaged to smooth the surface. Some minor initial discomfort is normal, but should be brief, as most patients are comfortable returning to work or other daily activities immediately.

Restylane® Under Eyes: Before	Restylane® Under Eyes: After

Results are immediate and long lasting. Lines that are particularly deep may require a second treatment within 2 to 4 weeks of the first treatment. Long-term touch up treatments may be recommended after several months to maintain the correction.

How long do the results last?

The results can last from three months to three years, depending on the filler being used. Hyaluronic acid based fillers and Radiesse tend to endure longer, with effects usually lasting from six months to one year. Sculptra, which is not technically a filler, lasts for much longer because it works by activating your natural collagen instead of plumping the area with the product itself.

Location can also affect the duration of results. For example, fillers tend to last for significantly less time in the lips (3 to 6 months), compared to the nasolabial folds.

What are the possible side effects?

Dermal fillers are minimally invasive and very safe. The few complications that occur usually happen because the provider places the material in an area that it was not meant for or uses poor injection techniques, both of which can be avoided by choosing an experienced, qualified specialist. Side effects are uncommon but can include limited allergic reactions (hypersensitivity), reactivation of an existing herpes infection, localized bruising, redness or swelling at the injection site, and in very rare instances, vascular occlusion and ulceration. If hypersensitivity is a concern, choosing a hyaluronic acid based filler may be wise, since these can be broken down enzymatically in the event of a bad result or hypersensitivity reaction using an injection of Hyluronidase.

Restylane® Lips: Before	Restylane® Lips: After

Why should I choose Dr. Prasad for dermal filler injection?

Dr. Prasad is well versed and very experienced in the uses and injection of many dermal fillers. With over 10 years of experience in injecting, she can provide you with the experience and technique that you need to get the safest and best results. In addition, we have several types of fillers in our office, so unlike many other medical offices that only keep a couple and do this on the side, you can be sure that we will have the best possible option for you. At your consultation, Dr. Prasad will help you determine which filler is right for your skin’s condition and your individual needs. Our goal is to make you as comfortable as possible during the procedure and to help you achieve the look you want.