In last week’s post, Face Lift or Fillers? Best Options For The Aging Face, Dr. Herzog answered a Family Savvy reader’s question about options for an aging face. Today, Dr. Herzog continues this discussion by educating us on different fillers and how they are used. Whether 40, 50, or beyond, we can all benefit from being informed and aware of this exciting option in the realm of cosmetic enhancement.
Dr. Jo Herzog
As I promised last week, we will start discussing in-office procedures today, specifically the use of fillers. We will continue this discussion over the next couple of weeks, as there is a lot to cover.
The fillers are a group of products that do what they say – fill. Fillers can be used for filling fine lines, small spaces, or adding volume to large areas. Some fillers are better for lines, while others are best used to add a reasonable amount of volume back to the facial structure. Appropriate use of the fillers that we have available today allows us to sculpt a face and make some amazing changes.
Fine lines and small areas:
Restylane, Belotero and Juvederm are fillers that are appropriately used for filling actual lines and for shaping smaller areas such as the lips and the tear troughs under the eyes. These fillers are soft, easily shaped, and can be placed fairly superficially. Although they can be used more deeply to fill larger amounts of volume and will look fine, this is not very cost effective, as they do not have the lifting power of some of the thicker, firmer fillers. Results from these fillers last an average of 6-12 months, although this time does vary from patient to patient. When these fillers are injected, results are seen immediately. Some bruising is possible (more commonly under eyes).
Deep creases and larger areas of lost volume:
Deeper creases and larger areas of lost volume are better approached with a filler that is a bit thicker, firmer, and which has more lifting power. Perlane, the new Voluma, and Radiesse are best reserved for these jobs. In well-trained hands, Sculptra can be used with beautiful results. These fillers are injected more deeply in or more commonly beneath the skin. Most are available in larger syringes to do bigger jobs. On average, these fillers last from one to two years. Results are immediate with some possibility of bruising.
Areas in need of great amounts of volume:
Areas that are in need of large amounts of volume can be treated with Perlane, Radiesse, Voluma, or Sculptra. All of these can give good aesthetic results. However, when treating large amounts of volume loss, it might not be practical or cost-effective to use a filler that comes in a 1cc-1.5cc syringe. Sculptra provides more volume and lasts longer than the other fillers that we have been using. In my experience, sculptra provides more volume for the cost, over time; however, the results are not immediate. Sculptra is a process more that it is a procedure. I usually inject one vial at a time, but other physicians might inject multiple vials at a time. A few days after injection, the volume disappears, and the Sculptra takes up to six weeks to “grow” to what it will look like. I then do another treatment and wait another six weeks. Therefore, if you have a wedding in two weeks, Sculptra is not for you. If you want to look better in four months, then it might be your first choice. Many people prefer a combination of fillers so they can get a jump start from one while waiting for Sculptra to kick in. Any of these fillers can cause bruising when injected, and if not properly massaged, can also form lumps and bumps. These fillers last longer and require more precision to do a good job; therefore, be very careful, and select an experienced doctor.
1) There are other available fillers, but I discussed the ones which are most commonly used. Artefill is permanent and is becoming more popular. I have not used it yet. I am not sure about what I think about using a permanent filler but will let all of you know when I work with it some.
2) Bruising- This is the most common complication. If you take blood thinners or supplements that thin blood (fish oil, gingko, ginseng, garlic, aspirin, etc…), you are more likely to bruise. Unless you are taking these supplements by a doctor’s prescription, you can discontinue these a week before injections. Using arnica cream or gel before and/or after these procedures might also help prevent or decrease bruising.
Hope this was helpful.If you have any specific questions or want to submit a photo for general questions about your own face, feel free to do that through Family Savvy.
Until next week,