by April Harrison, PA-C, from the Fall 2009 issue
There are many wonderful options for facial dermal fillers today but, with so many options, it can be confusing. During cosmetic consultations, I am frequently asked – which filler is the right one for me? The answer depends on the area we are filling.
The new direction in facial fillers is enhancing mid-face volume, or the apples of the cheeks and temples. As we age, gravity causes the normal fat pockets under the skin to migrate downward. This gives a drawn, tired look to the face and a flattened appearance to the cheekbones. This also creates nasolabial folds (the lines from the nose to the mouth) and marionette lines (the lines from the corners of the mouth to the chin). Additionally, we lose volume in our temples, which creates a triangular shape to the face with the upper face being narrower than the lower.
A youthful face has more volume in the cheeks and tapers down to the chin, creating an inverted triangle shape. By restoring volume to the appropriate areas with dermal fillers, we can subtly give a more youthful, rested appearance. Radiesse® is a filler that we use to restore volume in the cheeks and temples. Radiesse is composed of calcium-based microscopic spheres suspended in a water-based gel. It is biocompatible so there is no need for prior skin testing. After about three months, the water-based gel is dissolved naturally and the calcium-based spheres stimulate the body to build new collagen. Over time, the calcium spheres are absorbed naturally. Radiesse is placed deeply in the skin to restore the natural contours. In doing so, nasolabial folds and marionette lines are lifted, so there may be little or no need to fill these areas. With mid-face enhancement, we are treating the problem, not the symptom. And the best news is that the results are immediate! Radiesse will last up to 18 months so there is no need for frequent touch-ups.
Sculptra® Aesthetic is a long-lasting, volumizing filler that can be used in the cheeks and temples, nasolabial folds and marionette lines. This novel filler is composed of microscopic particles of absorbable suture material. We mix the filler with sterile water and an anesthetic solution. After a topical anesthetic is applied to the area to be injected, Sculptra Aesthetic is injected in small amounts over the area to be treated. During the following 48 hours, the water and anesthetic are harmlessly absorbed by the body, leaving the tiny particles of filler behind. These particles stimulate the skin to build collagen around them – a process that takes about four to eight weeks. Most patients require two to three different treatment sessions to build up to the desired effect. Once that is achieved, results can last for two or more years!
Hollows under the eyes or tear troughs are other areas that I am commonly asked about. Fortunately, we have several options for those as well. If we are building up the cheeks with Radiesse, then we can also use this filler under the eye. Tiny injections are placed deeply on the bone under they eye to lift the skin and soften the tear trough groove. Sculptra Aesthetic can also be used in this area. Sometimes the tear trough area is the only place a patient desires to have corrected. In that case, we can use a hyaluronic acid filler, such as Juvéderm®, or a long-lasting collagen filler, such as Evolence®. Hyaluronic acid is a natural sugar molecule that we all have in our body. It acts like a sponge, absorbing the body’s water. This plumping effect provides a nice result when used as a dermal filler. Evolence is a porcine, collagen-based filler that can last up to a year. Collagen fillers by nature tend to produce less temporary bruising than other fillers, making them a good option to use in many areas. But any filler can cause bruising, so this is important to keep in mind when scheduling.
Juvéderm and Evolence are versatile fillers that we use often when filling the nasolabial folds and marionette lines. And the beauty of them, and most other fillers, is that the results are immediate! You will leave the office completely filled in. Juvéderm can also be used to fill fine lines on the skin, such as vertical lines above the lip and smile lines on the cheeks.
As we age, we also lose volume in our lips. It is natural to restore that volume with a dermal filler, such as Juvéderm. To learn more, read Kiss and Tell, Dr. Kristel Polder's article on lip fillers.
Common side effects of fillers are redness, bruising, and swelling in the treated area. These side effects are temporary and most resolve within a few days.
We would love to help you decide which filler or combination of fillers is right for you. At your visit, we’ll discuss the options in detail so we can tailor a personalized treatment plan specifically for you!
Call 713.850.0240 and press 2 to schedule a consultation.
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