DERMAL FILLERS

Fillers are a popular form of skin rejuvenation for the face, lips, and hands. 

Hyaluronic acid is a natural occurring polysaccharide essential for various body functions, present in connective tissues, skin, vitreous humour of eye, extracellular matrix, synovial fluid, etc.  

 

Most fillers now contain local anesthetic such as Lidocaine which helps with achieving patient comfort during and after the procedure.

All aesthetic injections should be done at least one month prior to any special event such as wedding, engagement, anniversary, birthday, major holiday, or photo shoot. Bruising and swelling after injections can last up to 14 days in some cases. Please refrain from drinking alcohol, and taking pain medications (NSAIDS) such as Ibuprofen, Motrin, Aspirin or Advil, as well as vitamins, fish oil and other herbal supplements for 3-5 days prior to your visit, to minimize the chances of bruising. Some herbal supplements may increase risk of bruising. Herbs including gingko biloba, ginseng, ginger, glucosamine, turmeric, angelica and clove all have the potential to thin the blood slightly. This can make bruising more likely, especially if more than one of these herbs are taken together. 

Many patients confuse the mechanism of action in Botox and dermal fillers. Botox is a paralytic agent which reduces muscle activity by relaxing the muscle around wrinkles, while dermal fillers actually fill the lines and creases with a "filler" substance.

Important pre-procedure information:

  • Every injection carries a risk of infection.

  • As with all medications, allergic and systemic anaphylactic reactions may occur.

  • Some discomfort and pain can be experienced during the procedure.

  • Swelling, redness, pain, bruising, itching and warmth at the site of injection can be seen for up to 7 days following the procedure.

  • Rash and itching may also occur following injections.

  • Flu-like symptoms such as nausea, fever, and migraine headache can be experienced following the procedure for up to 7 days.

  • The body is not symmetrical, and sometimes the injections can have more pronounced effect on one side than the other.

  • Sometimes the procedure will not achieve a fully desired effect and may need to be repeated.

  • Alcohol, vitamins, herbal supplements, fish oil, anti-inflammatory medications also known as NSAIDs (Aspirin, Ibuprofen, Motrin, Advil) and blood thinners such as Coumadin, Xarelto, and Plavix taken 24-48 hours prior to the procedure can increase the chance of bruising at the injection site.

  • Although infection following injection of fillers is unusual, bacterial, fungal, and viral infections can occur. Should any type of skin infection occur, additional treatment including antibiotics may be necessary.

  • Filler treatment may induce an outbreak of cold sores in patients with a previous history. It is a rare but troublesome complication, caused by herpes virus reactivation. Herpes simplex virus 1 (HSV-1) and herpes zoster (HSZ) virus reactivation can be observed 24 to 48 hours after the procedure. Some patients with known previous history of herpes infection take preventative antivirals such as Acyclovir to help reduce the risk of cold sores. 

Juvederm

Hyaluronic acid fillers:

Hylauronic acid fillers are made of sugar molecules which bind to water and give the skin a natural plumpness. These fillers are eventually dissolved by the body’s enzymes within 6-12 months. 

  • Juvederm Ultra is the most popular filler in aesthetic medicine and is used for lip augmentation, smile lines, marionette lines, vertical lip lines and other hollow areas.

  • Juvederm Voluma is used to correct age-related volume loss in the mid-face and cheeks. It uses a new cross-linking technology to bind the hyaluronic acid molecules that produces the lift and fill needed for mid-face applications and contributes to its long-lasting nature. Studies have shown that with optimal treatment, results can last up to 2 years. 

  • Restylane (Kysse, Lyft, Contour, Defyne and Refyne) are designed to restore volume, correct moderate to severe wrinkles and folds, and add fullness and definition and are used for smile lines, marionette lines, lip, chin and cheek augmentation and help achieve a more youthful-looking appearance.

  • Belotero Balance is a very thin formulation of hyaluronic acid and is the filler of choice for tear troughs under the eyes. 

 

Calcium hydroxylapetite fillers: 

  • Radiesse is the only product containing calcium hydroxylapetite, a similar component found in bone. The skin creates a long lasting scaffolding around microspheres of calcium hydroxyl appetite, which gives improved appearance to wrinkles for up to a year. 

Poly-L-lactic acid fillers: 

  • Sculptra is a semi-permanent, longer-lasting alternative for individuals with more significant volume loss. Clinical studies have demonstrated results lasting up to 2 years.

Sculptra procedures require 2 separate visits. Since Sculptra has to be reconstituted 24 hours prior, we do not perform Sculptra treatment on the day of the consultation. During your initial consultation visit:

(1) we will assess if you are a good candidate for Sculptra

(2) request pre-payment of $600 for Sculptra, which will be done at a separate visit