Dermal Fillers and Injectables

Dermal fillers and Injectables are used to soften and minimize the effects of aging to rejuvenate the face. Dermal fillers are a substance introduced under the skin to “fill in” areas where aging changes have occurred. These changes include wrinkles and folds as well as the volume loss associated with aging. Although most fillers are FDA-approved for use in the correction of nasolabial folds, many physicians use them in an “off-label” fashion in a number of other areas.

The correction of deep facial wrinkles, particularly in areas resistant to other techniques (e.g., Botox, etc.), has been revolutionized by the development of reliable injectable dermal fillers.

Facial Wrinkles

Facial wrinkles are a sign of aging but are also a function of several other factors, including:

• Strong facial musculature may produce deep furrows.
• Sun exposure and cigarette smoke can produce fine wrinkles.
• Genetic factors make each individual more or less likely to develop wrinkles at any given age.
• Loss of facial volume contributes to facial wrinkles.

Facial Areas Commonly Treated With Dermal Fillers

Dermal fillers treat static wrinkles–those caused by a combination of gravity and loss of skin elasticity–they are typically located in the lower 2/3s of the face. These types of wrinkles include the nasolabial folds (those that go from the nose to the corner of the lips), marionette lines (those that go from the corner of the lips to the chin), “smoker’s lines” around the mouth, and fat loss in the cheeks.

Our clinicians use reversible dermal fillers, such as Restylane and Juvederm (hyaluronic acid-based fillers) to:

• Correct the depressions found along the junction between the eyes and cheeks, known as the tear trough
• Correct the crease between the nose and the lips, known as the nasolabial folds
• Improve the marionette lines below the lips
• Fill thin lips
• Correct temple hollows
• Aid in scar camouflage
• Improve other areas depending on the patient’s needs/anatomy

Types of Fillers Used on the Face

There are numerous dermal filler products available today that are used on the face. Whether you want to fill in those smile lines or add volume to your cheek area, our dermatology providers will pinpoint which product best suits your needs during your consultation. From Juvederm to Perlane to Radiesse and Sculptra, the various options allow us to tailor the filler to your individual circumstances.

Hyaluronic Acid-Based Fillers

Hyaluronic acid-based fillers are currently the most popular injectable filler products used in the United States today. Hyaluronic acid (HA) is a naturally occurring material in all vertebrate animals and can be produced by some bacteria. This non-cellular material does not produce an allergic reaction. Therefore, it requires no skin test. It fits the need for a longer-acting material that is potentially reversible, has a favorable risk profile, and provides natural-appearing results. Generally, hyaluronic acid products offer 9-24+ months of effect and the possibility of more prolonged effects with repeat injections. Some products contain lidocaine, an anesthetic that may improve the experience of receiving the injections.

Examples of hyaluronic acid-based fillers include Restylane™, Juvederm™, Volbella®, Vollure®, Voluma®, Ultra®, Ultra plus®, and RHA®.

RHA® Collection

The new RHA® collection of fillers represents the latest advancement in hyaluronic acid (HA) technology in more than a decade. It is the only FDA-approved hyaluronic acid filler for dynamic wrinkles and folds. It uses a gentle manufacturing process that helps to preserve the natural structure of the HA, allowing it to mimic the natural HA found in your skin. Results from the RHA® Collection are immediate, delivering natural-looking results for dynamic areas of the face for long-lasting results for up to 15 months.

Other Products

Multiple other materials have been developed with variability regarding the duration of effect, risk of complication, and overall natural-appearing results, such as:

• Radiesse™ is a hydroxyapatite product that is also popular and produces results in 12-18 months. It may be used for deep nasolabial and marionette folds and cheek augmentation.

The risk of bumps or irregularities is possible with all injectable fillers, but many physicians feel they are less likely to happen with hyaluronic acid fillers than others.