Dermal Fillers

Dermal Filler Treatment

Hyaluronic Acid naturally occurs in skin providing youthful fullness. During aging and from sun damage breakdown of collagen and elastic fibers causes wrinkles. Over time fat, muscle and bone are lost causing volume loss in the face leading to sagging. Juvederm XC Injectable Gel and Restylane L are hyaluronic acid dermal fillers and are injected reducing or eliminating wrinkles. Dermal fillers are also used to improve hollowing under the eyes, replace lost volume in the lips and cheeks restoring youthful rounded contour.

Dermal fillers are very helpful in an anti-aging skin rejuvenation program to treat lines and wrinkles, smile lines, smooth acne scars, treat volume loss, plump lips, and help regain a firm and youthful appearance by restoring skin volume. That is why they are so popular.

Juvederm Ultra XC, Juvederm Vollure XC, Restylane L, Restylane Refyne are for more superficial placements and Juvederm Voluma XC, Restylane Lyft, and Restylane Defyne are for deeper filling. Juvederm Volbella XC, and Restylane Silk are for lip augmentation, and fine lines especially around the lips. All have a local anesthetic in them which decreases discomfort. All are sold by the syringe. The hyaluronic acid fillers give immediate improvement that lasts on average 1 year, with Juvederm Vollure, XC lasting on average of 18 months, and Voluma XC lasting on average 2 years. After the results of the filler treatment begin to wane, we will do another treatment to maintain improvement.

The hyaluronic acid fillers in the Juvederm and Restylane families plump up wrinkles from below and provide lost fullness. But if the line is etched from being folded ten million times, you will need skin resurfacing to really smooth the sharp line. If you stretch the skin and the wrinkle totally disappears, usually filler is all you need. If there is still a surface crease, you will need resurfacing. But either way the line will look a lot better after filler.

Treatment with Cosmetic Skin Fillers

Number of Treatments— usually one treatment, although several syringes may be needed. When budget is an issue, our patients often start with one or two syringes and then add more later. And many patients only need one or two syringes to get the improvement they want. Also, at the time of retreatment, it is not unusual to not need as much treatment, as some of the results are lasting.

Discomfort— in our office we use an anesthetic cream. The hyaluronic acid fillers now have anesthetic in them. With the combination of anesthetic in the filler itself, and in a pre-treatment cream, most of our patients find the procedure very tolerable.

Time to See Results—results are seen immediately and settle in over a couple of weeks.

Duration of Results—in general, the hyaluronic acid fillers last 1 year in the smile lines and lips; longer under the eyes, in the cheeks and temples. Juvederm Voluma XC for deeper volume replacement lasts 2 years. Your filler may not last as long, or it may last longer.

Recovery Time/Side Effects

Bruising—is the most common problem after cosmetic dermal filler injections but can be reduced a great deal if you follow the instructions below.

Swelling— after treatment for several days occasionally occurs. Lips, if treated, may feel stiff for several days.

Mild Tenderness—lasting a few days may occur.

Infection— is rare but very occasionally occurs.

Lumps, Bumps or Too Much Fullness—occasionally, a patient either develops a lump, too much fullness in an area, or simply doesn't like the result of treatment , usually under the eyes or in the lips. One of the advantages of the hyaluronic acid fillers is that these can be reversed with an injection of a medication, hyaluronidase.

Extremely Rare Complication—compression of a blood vessel by the filler after any filler injection very rarely occurs. If the hyaluronic acid fillers Juvederm or Restylane are involved, they are dissolved with an injection of the medication, hyaluronidase.

How to Reduce Bruising after Juvederm and Restylane

  • For one week before, and two days after, avoid aspirin, NSAID's (Ibuprofen, Aleve, Motrin, etc.), St. John's Wort, Vitamin E, Multivitamins, Fish Oils, Flaxseed Oils, Omega-3, Gingko, Ginseng, Garlic and Glucosamine to minimize bruising.
  • Buy a fresh (not frozen or canned) pineapple. Eat half the day before treatment, one quarter before you come in and the final quarter after your treatment. Pineapple contains bromelain which helps decrease bruising.
  • You will receive Arnica gel to reduce bruising. Starting 30 minutes after your procedure, apply Arnica gel every hour the first day and every two hours, starting the second day, while awake until bruising is gone.
  • You will receive a free GentleWaves treatment and cold packs immediately after injection to reduce swelling and bruising.
  • Apply cold compresses as needed for the first 8 hours to reduce swelling.
  • Avoid exposure to extreme heat, such as a sauna, to reduce redness and swelling.
  • Avoid touching the treated area within 6 hours after treatment, except to apply Arnica. After that it may be gently washed with soap and water. Foundation may be patted on.
  • If the lips were treated do not put pressure on them with a straw, water bottle nozzle, etc., for one week.
  • Do not put significant pressure on treated areas for 3 weeks. (i.e. don't lay face down on massage table cradle).
  • Bruising may be covered with makeup. The most complete coverage is Dermablend Cover Cream.