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Dr. Lloyd Van Wyck

Dermal Fillers: A Non-surgical Option to Reduce Signs of Aging

Wrinkles are best classified into Dynamic and Static lines. The dynamic lines which are due to muscle activity are best treated with Botox while the static lines more commonly due to environmental damage and aging are more frequently addressed with the use of dermal fillers. The variety of dermal fillers are numerous and will be reviewed individually. Soft tissue loss is most commonly addressed with the use of Sculptra, Alloderm or fat injections. Skin Tightening, Skin Resurfacing and Skin Rejuvenation are additional skin concerns which are addressed utilizing Laser Technology and will be discussed in a subsequent section.

Injectable dermal fillers are designed to augment areas of facial creases and wrinkles. They are manufactured in such a way as to be considered either temporary, semi-permanent and most permanent. These fillers are quite often used in conjunction with Botox to help improve the areas of both dynamic and static lines. Alternatively, the use of the so called volume fillers are designed to augment areas of soft tissue loss.

The problem for the consumer is that the choice for any number of these products becomes difficult for a variety of reasons. Not only does the duration of effect vary between the different products but the volume of each syringe, the side effects as well as manufacturing costs make the final decision for the patient somewhat difficult. In general, the fillers are designed to be injected at different levels into the dermis and subcutaneous tissue layers.

Lip augmentation or enhancement is commonly achieved utilizing various dermal fillers discussed below. The details of lip augmentation itself is outlined in the facial procedure section under the heading of lip augmentation. Hyaluronic acid fillers are routinely recommended for initial treatment sessions so that patients are able to assess whether or not they truly like their new look on a temporary basis. More permanent solutions include the use of ALLODERM or Softform.

If you would like to learn more about the types of Dermal Filler, please keep reading below, or you can request a consultation by clicking here.

Temporary Dermal Fillers

Collagen fillers were initially the product of choice but has more recently been replaced with the use of RESTYLANE and PERLANE (Medicis) and JUVEDERM (Allergan).

It should be noted that these temporary fillers are classified as Hyaluronic acids which are naturally produced by the body and play an important role in giving firmness to the skin. Not only are there differences within each product line in terms of molecular size and shape but the extent and degree of cross linkage also varies. It is these structural differences which make the products amenable to treating either fine superficial lines or the deeper grooves of advanced aging and skin damage.

The main limitation in the use of these products relates to their longevity. Although the average duration of effect is 3 months, this time frame may be less or longer. Research has identified that the more an anatomical area moves the shorter the duration of product. This is one of the main reasons why injection into the lip mucosa and nasolabial folds which are considered dynamic areas often last less time than when this material is injected into static areas of the face. The use, benefits and limitations of the different products will be reviewed at the time of your consultation in an effort to allow you to make an informed consent on the product which you prefer.

Individuals who are facing the natural process of aging now have more options than ever when it comes to diminishing the appearance of unwanted wrinkles and creases. The most popular of the dermal fillers currently on the market are JUVERDERM and RESTYLANE. Although JUVEDERM and RESTYLANE share some of the same benefits, they do have some differences and those considering dermal filler injections should consult with a skilled practitioner to learn which treatment option is best for them.

Juvederm vs. Restylane

Both JUVEDERM and RESTYLANE are FDA approved and aid in restoring the skin’s natural youthfulness and overall vitality. Depending upon personal preference and your desired results, JUVEDERM and RESTYLANE are both effective treatments for patients 35-60 years of age.

Similarities

  • Both fillers are made from hyaluronic acid, a naturally occurring substance that helps to hydrate and add volume to the skin.
  • Each is effective for smoothing wrinkles, sculpting lips, and improving other facial features
  • Both are minimally invasive and require little to no recovery time

Differences

  • JUVEDERM typically takes a maximum of 24 hours for recovery and RESTYLANE can take anywhere from two to three days for swelling to go down
  • Results for JUVEDERM are reported to appear instantly and the results for RESTYLANE won’t be as evident until about a week after the procedure
  • The results of JUVEDERM typically lasts from three to nine months while results for RESTYLANE can last for six months or more

SEMI PERMANENT DERMAL FILLERS
Dr. Van Wyck refers to these fillers as semi permanent because they do indeed last longer than the temporary fillers mentioned above. They more common products include the use of EVOLENCE and RADIESSE, both distributed by Canderm.

RADIESSE

In December 2006, the Food and Drug Administration approved RADIESSE for the treatment of deep facial folds and wrinkles as well as for augmenting and restoring areas of the face affected by lipidatrophy, or fat loss. RADIESSE, like other dermal fillers, is injected just beneath the surface of the skin to add volume to sunken areas and to enhance overall facial appearance. Significant results are typically visible after only one treatment, but additional treatments are usually necessary for maintenance.

RADIESSE contains particles of a synthetic substance known as calcium hydroxylapatite that are suspended in an injectable gel. Calcium hydroxylapatite, although synthetic, is similar to a substance found naturally in bones and has long been used in medical devices.

Ideal candidates for RADIESSE include individuals with deep wrinkles and facial folds who want smoother, younger-looking skin. RADIESSE is also ideal for restoring facial fullness in patients with HIV who frequently suffer from lipidatrophy – a condition marked by sunken cheeks and hollows around the eyes.

Benefits of RADIESSE include:

  • Improved facial contouring
  • Procedure is minimally invasive
  • Immediate results
  • Results generally last for at least one year
  •  Little or no downtime

As with other dermal fillers, RADIESSE should only be injected under the supervision of a board certified plastic surgeon. Side effects are generally mild but may include redness, bruising, swelling, and possibly infection.

The Procedure

RADIESSE is a synthetic solution made up of a compound known as calcium hydroxylapatite (CaHA) – a compound similar to that found in teeth and bones. The RADIESSE injection procedure is a fast, and fairly painless one. Radiesse is injected into the skin in the desired areas, where it then works to augment and add volume to the depressed or creased areas. An injection of numbing medicine may be used before the additional injections are administered by your health care professional.

The Healing Process

After RADIESSE injections, a patient may experience mild swelling – which typically subsides within 24 hours of the procedure and with the help of ice. Mild bruising or small spots may also temporarily appear in the area of the injections, but these too will heal within a short period of time. Once injected, RADIESSE takes on the form of the tissue surrounding it and becomes fairly soft when it’s injected into fat.

Results, however, are immediate and last as long as nine months. Patients who receive RADIESSE injections walk away from the procedure with a more youthful, healthy facial appearance. RADIESSE costs vary according to the extent of the procedure and the doctor, but consumers should always remain wary of someone offering RADIESSE injections at extremely low prices.

RADIESSE side effects and the healing Process

Doctors have yet to conclude if there are any severe RADIESSE side effects; however, as with all cosmetic treatments, RADIESSE injections do carry some risks, although typically minimal. Some of the more common RADIESSE side effects include mild swelling and bruising surrounding the site of injection, but this typically subsides after 24 hours with the help of ice.

The benefits of RADIESSE often outweigh any minimal RADIESSE side effects. Benefits include improved facial appearance and lasting results. In most instances, the results of Radiesse injections can be expected to last for up to nine months.

If you would like to request a consultation to see which Dermal Filler is best for you, you can do so by clicking here.

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