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Aging Face
Did you know that many visible signs of aging can be traced back to volume loss? As facial tissues thin out, lines become etched around the nose and mouth and cheeks look a little hollow. Dermal filler can replace lost volume to help smooth wrinkles, plump the lips, and restore a more youthful appearance.

Injectable Filler
Dermal filler are gel-like substances that are injected beneath the skin to restore lost volume, smooth lines and soften creases, or enhance facial contours. More than 1 million men and women annually have choose this popular facial rejuvenation treatment, which can be a cost-effective way to look younger without surgery or downtime.

How Can Dermal Filler Enhance My Appearance?
While dermal filler are casually known as “wrinkle filler,” they can do much more than just smooth out wrinkles, although they are excellent at this too! Here are a few of the common issues dermal filler can help address:
– Smooth out lines around nose and mouth (a.k.a. marionette lines, smile lines, and
parentheses)
– Enhance & restore volume to sunken cheeks or temples
– Diminish vertical lip lines
– Plump & enhance the lips
– Smooth out a chin crease
– Improve symmetry among facial features

What are Filler Made With?
There are a variety of FDA approved filler products that cosmetic surgeons use. In general, filler are categorized by the substance they are made from. A note for your safety: always make sure that you are receiving FDA approved, brand name filler, which are only available through a licensed physician, such as a board certified cosmetic surgeon.

Hyaluronic Acid (HA)
Hyaluronic acid is a naturally occurring substance that is already found in your skin. It helps keep skin plump and hydrated. HA filler are typically soft and gel-like. The results are temporary, lasting 6 to 12 months or longer before the body gradually and naturally absorbs the particles. Most HA filler are infused with lidocaine to help minimize discomfort during and after treatment. FDA approved HA filler include:
– Restylane products: Restylane, Restylane Silk, Restylane Lyft, Restylane Refyne, and Restylane Defyne
– Juvéderm products: Juvéderm XC, VOLUMA, VOLBELLA, VOLLURE Belotero Balance

Calcium Hydroxylapatite (CaHA)
Calcium hydroxylapatite is also a naturally occurring substance, found primarily in our bones. When used in a filler, the calcium particles are nearly microscopic and suspended in a smooth gel. The consistency of a CaHA filler is typically thicker than that of a hyaluronic acid filler and typically last longer as well, about 12 months for most patients. Calcium hydroxylapatite is also reported to help stimulate natural collagen production, and it is typically used for deeper lines and wrinkles. FDA approved CaHA filler include Radiesse®.

Poly-L-lactic Acid
Poly-L-lactic acid is a biocompatible (meaning it is safe to use in the body), biodegradable synthetic substance. It has been used for many years in medical devices, such as dissolvable stitches. Poly-L-lactic acid products are technically classified as “collagen stimulators,” as their main mechanism to smooth fine lines is by helping your skin rebuild natural collagen—the filler gel itself dissipates a few days after treatment. Poly-L-lactic acid is typically used to treat deeper facial wrinkles, and results can last more than 2 years. FDA approved Poly-L-lactic acid filler include Sculptra® Aesthetic.

Polymethylmethacrylate (PMMA)
Polymethylmethacrylate (PMMA) is a synthetic, biocompatible substance that has been used in medicine for much of the last century. In dermal filler, PMMA takes the form of a “microsphere” or tiny ball, that remains beneath the skin indefinitely to provide continued support. PMMA filler will also contain collagen, a naturally occurring substance in the skin that provides structure and firmness. FDA approved PMMA filler include Bellafill® (formerly known as Artefill).

Choosing a Provider for Filler Treatments
When selecting a provider for injectable treatments, give your decision the same level of care and scrutiny that you would for a surgical procedure. Non-surgical filler treatment is still a medical procedure that requires specific training, knowledge and skill to ensure safe treatment and natural-looking results. Choose a provider with an extensive knowledge of facial anatomy, a well-developed aesthetic eye, and a surgeon’s skill and precision. Whomever you choose, make sure your provider has a proven background in cosmetic medicine as well as training and substantial experience performing filler injections. Ask to
see before & after photos of a potential provider’s patients.

Which filler do I need?
With so many dermal filler products on the market, it can be difficult to know which option is best for you without an experienced cosmetic surgeon’s guidance. Each product is uniquely formulated to have a certain texture, density, and injection depth, which means that certain filler work better for certain areas of concern. While your provider will determine what product is best for you, the following diagram illustrates in general where cosmetic surgeons tend to apply certain products:

What to Expect During Treatment?
Dermal filler injections are non-surgical and typically completed during an office visit. Your initial treatment will begin with a consultation, during which you will meet with your cosmetic surgeon to discuss your concerns and goals.

Pre-treatment consultation
During your consultation, your cosmetic surgeon will evaluate your area of concern and review your medical history. While the risks associated with dermal filler are minimal, you need to fully disclose your medical history prior to treatment, as certain allergies, skin and neurological conditions, or medications can jeopardize your safety or results. For instance, you need to tell your cosmetic surgeon if you have been taking NSAIDs (e.g., aspirin, ibuprofen, naproxen) or blood thinners, as these increase the likelihood of bruising.

Your injectable filler treatment
Just before the actual treatment, the area will be cleaned, and you may be given a topical anesthetic to numb the area prior to injection. Many filler products also contain lidocaine, a mild anesthetic, which is intended to help minimize discomfort during and after your treatment. Your provider will then inject a precise amount of filler strategically beneath the skin.
Depending on the product and the areas treated, you should be able to notice results immediately after receiving filler injections. Some patients experience mild bruising and swelling, but these are temporary and should subside over the days following treatment. You will be able to go back to your normal activities right after treatment, but your cosmetic surgeon may ask you to take the day off from exercise or other strenuous activity.


How Long Do the Results Last?

How long the effects of dermal filler will last depends on the product, the area of treatment, and the patient. Generally speaking, the denser the product is and the more deeply it is injected, the longer it will last, although this is not a hard and fast rule. To maintain your results, your cosmetic surgeon will simply repeat treatment, adjusting the amount and techniques as necessary to ensure optimal results.
Hyaluronic acid filler tend to be the most temporary option, and therefore are often recommended for first-time filler patients. These will typically last from 6 to 18 months.
Injections to the lips will wear out a little faster than those to the nasolabial folds. Certain HA filler, such as VOLUMA, are formulated to last longer, but are usually limited to certain areas, such as the cheeks. Synthetic filler tend to last longer, as they are not absorbed by the body. They can be a great option for the right patient, but you’ll want to be ready to commit to results that will be there for several years—and choose an experienced, qualified provider whose aesthetic style you like.

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