Fillers

Fillers are the most popular, injectable materials available to physicians today for the correction of signs of aging of the face. They provide an effective, non invasive, non surgical alternative for facial rejuvenation. Fillers have experienced an astounding demand in the worldwide market since the introduction of bovine collagen-based dermal fillers during the 1980s. The introduction of Restylane®, a hyaluronic acid (HA)-based filler at the end of 2003, has increased use of fillers by 700% . Today, dermal fillers are the fastest growing non-invasive esthetic procedure in the US, according to the American Society of Aesthetic Plastic Surgeon. Recent advances in injection techniques and a better understanding of facial aging results in superior results when using dermal fillers for facial rejuvenation.

• Hyaluronic-Acid based fillers
• Teosyal family of products
• Restylane
• Puragen
• Puragen Plus
• Prevelle
• Prevelle Plus
• Belotero
• Hylaform
• Hylaform Plus
• Captique
• Restylane
• Juvederm Ultra
• Juvederm Ultra Plus
• Perlane
• Elevess

What are Fillers?

Fillers are a group of natural and synthetic substances which are injected into or under the skin to add volume and to smooth out wrinkles. Some are permanent, others last only a few months after which time the treatment needs to be repeated.

Treatment Areas

• Glabellar lines
  • The symmetrical lines between the eyebrows respond extremely well to BOTOX. However, in cases when these creases are deep and permanent, fillers can be added to produce the best results for the treatment of this area.
• Forehead lines
  • Forehead horizontal lines are the resultant defect produced by the dynamic action of the forehead muscle. Wrinkles in this area could be dynamic (appear when facial muscles move) or non-dynamic (are always present). Non-dynamic forehead wrinkles result mostly from the volume loss of the underlying tissue. Injected superficially, HA fillers can provide good esthetic results.
• Periocular areas
  • The hyperactivity of the underlying muscles around the eye region by smiling and squinting results in much of the development of the crow's feet. Most of these wrinkles respond best to botulinum toxin therapy. Deeper periocular wrinkles qualify and respond well to treatment with HA dermal fillers.
• Temple area
  • Facial aging affecting fat atrophy of the temple area responds well to HA treatment. Due to the availability of several types of HA materials, we can now inject them in layers to produce a more substantial effect in this area.
• Eyebrows
  • The facial aging process results in dropping and receding brows. The injection of HA fillers has become very popular to elevate the brow and produce a younger facial expression. Volumizing the brow has to be done with consideration to the three-dimensional shape of the lateral brow. The end result is a desirable arching contour. The filler material is injected just below the cilia. Due to the malleable properties of these fillers, the material can be contoured by pressing it along the brow between the thumb and the index fingers. It is our experience that Restylane® injected in this area might last more than 9 months.
• Inferior orbital rim
  • Intrinsic and extrinsic factors play a major role in the aging effects of the area around the eyes. Sleep deprivation, stress, extremes diets, and the genetic makeup can result in loss of the fat pads that give youthful appearance. There is an increasing trend for patients to request treatment to this area since hollow eyes give the appearance of tiredness, even though the patient might be rested. HA fillers do provide a refreshed facial expression when properly injected. The filler is injected into the deep cutaneous tissues followed by a massage

• Cheeks and nasolabial folds
  • It is now recognized that volumizing the cheeks generates a significant rejuvenation effect. With the passage of time, the facial triangle of a young face where the apex is at the chin gets reversed, and the volume that was once on the mid-face moves down reversing the orientation of this triangle of youth. Presently, the cheek and malar areas are rejuvenated by injecting HA dermal fillers, especially the most robust formulations such as Perlane® or JuvédermTM Ultra Plus. Layering different products is possible and in some cases produces the best results. By volumizing the cheek and the lost malar fat pads, not only is the nasolabial fold corrected but, moreover, an overall facial rejuvenation is achieved. The face looks younger and plumped.
• Mouth area
  • Fine lines develop on the mouth region due to repetitive motion of the underlying musculature when pursing the lips such as when smoking or sucking through a straw. These fine lines can be treated by injecting HA fillers.
  • Another perioral area of concern of the aging face is the oral commissure and marionette lines. This downturn of the lateral lip corners is the result in the appearance of sadness and old age. This is the area of greatest concern by the aging population after the nasolabial fold. The oral commissures and marionette lines can be treated safely and effectively with a combination of HA fillers. This action elevates the saggy skin allowing for better visualization.
• Lips
  • One of the most requested areas for tissue augmentation in young and old patients alike are the lips. Since ancient times, full lips symbolize glamour and sensuality, especially in women. Lips are a key esthetic feature of the lower face. Lips are also affected by the aging process. Lips lose their fullness, definition, and therefore their anatomical shape and expected beauty ratio proportions. They become narrow, pale, and flat. Fillers replenish the lost volume and re-establish the pleasing esthetic look of well proportioned and voluminous lips.
• Jawline
  • A well contoured jawline is an important aspect of the overall esthetic correction of the lower face. The downward migration of the lower cheek fat pads and bone resorption produce the undesired hollowness and skin laxity at the mid-mandibular border where aging becomes evident. HA fillers are excellent materials to reshape and contour the atrophied jowls by lifting and tightening the senescent sagging cutaneous tissues to create a younger-looking appearance.
• Crease of chin
  • Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin. Because the loss of dermal collagen and subcutaneous fat pads add to this insult, patients find this defect very unattractive. HA dermal fillers provide a successful and lasting treatment effect to this area.

After Filler Injection

After injections you will have a some swelling that will resolve over the next few days. Occasionally bruising may develop. This may take a few days to go away. Once all the swelling has settled down you will be able to see the final result. Depending on the type of injection, you may need to return for further treatments. Permanent fillers stay forever while non-permanent fillers last between 3-9 months after which they need to be redone. Resorbable fillers are a good choice for the first-time patients and when trying out new areas.

Who can benefit from Filler Injections?

Filler injection procedure will improve facial wrinkles, and tighten the skin. It can improve the appearance of your face and give it a more youthful look. If any of these concerns affect you, you may benefit from a facelift.

What are the risks of Filler Injections?

Filler injection is a non-surgical procedure. Like all procedure, there are general risks that apply. Please read our information page on potential risks. With regards to fillers, there are special considerations that need to be taken into account. These include infection, skin discoloration, and surface irregularity. With permanent fillers additional surgery may be required, while non-permanent fillers can be allowed to dissolve on their own. In rare instances allergic reactions may develop to fillers. These complications are rare, and usually resolve without leaving you with any long-lasting abnormalities. In some cases you may need additional surgery to ensure ideal results