| Dr. Chad L. Prather is board certified by the American Board of Dermatology. Here the Doctor has answered some of the common questions bizymoms visitors have about Dermal Fillers.
Q: What are Dermal Fillers used for?
A: Dermal fillers, second only to botulinum toxins (Botox) in popularity, can be used for tissue augmentation and cosmetic improvement in many areas of the body. Importantly, dermal fillers have become a cornerstone for youthful rejuvenation of the face. They are most often used for improving the appearance of facial lines and wrinkles, enhancing the lips, cheekbones, and eyebrows, and re-volumizing the aged and sagging face. They can also be used for improving the aged appearance of the hands by filling out the "hollows" on the backs of the hands that come with time.
There are many types of dermal fillers, and each has its unique properties and best areas for use. It is very important when considering having a filler to see a physician that has considerable experience with different types of fillers. Not all can be used interchangeably, and a good outcome does depend on physician's technique, but also on choosing the correct filler for the area to be improved. When used incorrectly, patients may have bad outcomes, so to trust in your physician is the key.
Q: How do Dermal Fillers work?
A: Dermal fillers help restore the face’s youthful appearance by re-contouring and sculpting the aged face.
Q.What are the types of Dermal Fillers? How long does the effects of Dermal Fillers last?
As mentioned before, there are different types of fillers, and each one works by different mechanisms and lasts for different lengths of time. Some only last for a few months, while other may last for years. Those approved by the FDA for use in the U.S. are found below:
Collagens - (Cosmoderm, Cosmoplast), one of the original dermal fillers, are used for filling shallow lines and wrinkles, or for lip enhancement. Collagens are natural substances found in the skin, and collagen fillers are derived from animal sources. The collagen replaces the lost collagen of the skin, which shrinks as we age, providing a "plumping effect". They have been used since the early 1980s with great benefit, but have a short duration of action. They are broken down by enzymes in the body after about 3 months, so the cosmetic improvement only lasts for 2-3 months, and injections must then be repeated.
Hyaluronic acids - (Restylane, Juvederm, Perlane, Prevelle, Captique, etc.) are the most popular dermal fillers, and are ideal for patients who are have never had dermal fillers before. Hyaluronic acids are great introductory fillers because of their safety, soft feel, and moderate duration of action. Hyaluronic acids are also a naturally occurring substance in the skin, and these products are synthesized from animal or bacterial sources. They also work by replacing lost volume in the skin, and are naturally broken down over time by the body's enzymes. Furthermore, they last longer than collagen fillers, ranging from 3 months to 1 year depending on the specific brand of product and where it is placed in the face. Prevelle Silk, which is mixed with a lidocaine anesthetic to decrease pain, lasts for about 3 months, and is a great filler for lips or finer lines around the mouth. Juvederm, which can be used in many areas of the face, can last up to 1 year, which makes it an attractive choice for longer term cosmetic improvement. My favorite places to use hyaluronic acids are for lip enhancement, for correcting nasolabial folds and marionette lines, and for correcting hollowing under the eyes. They can also be used to help reshape the profile of the nose.
Calcium - Radiesse, a calcium-based product suspended in a water-based gel, is a synthetic dermal filler. It works best for the nasolabial folds, marionette lines, and for re-volumizing the jawline and cheeks. It is a thicker filler, and shouldn't be used in the lips. Radiesse helps fill deeper lines, and also causes the skin to lay down new collagen around it, which further enhances the volumizing effect. It can last for 1 to 1 1/2 years, which makes it an attractive filler for patients who have previously had hyaluronic acid filler, but want longer results.
Poly-L-lactic acid - Sculptra, is a synthetic sugar (also used in absorbable stitches) that can help re-volumize deeper areas of the face, including the temples, cheeks, and hollow areas of the jawline. It works over several months and repeated sessions by slowly having the body build up natural collagen around it. Sculptra is different that the above fillers, as the effect is not immediate, but occurs over the course of several months. It is more cost effective for deeper lines, but shouldn't be used in the lips or for shallow lines and wrinkles. It is actually placed below, not inside, the dermis. While it takes longer to achieve correction or enhancement, the improvement does also last longer. Currently, patients are seeing a sustained improvement that may last for 2 years, and possibly longer.
Q: How effective are Dermal Fillers?
A: Dermal fillers have proven to be one of the most effective minimally invasive treatments of modern times. Over the past decade, they have assumed a prominent place on the shelf of most aesthetic physicians because patients really find them to be one of the best ways to restore a youthful facial appearance. They are relatively safe when administered by trained physicians, but should never be used outside of an appropriate medical setting. When administered properly, downtime is minimal. Most patients experience only a slight amount of redness and swelling, and mild bruising that may last a few days, but do not experience the larger downtime associated with many procedures such as chemical peeling, dermabrasion, laser treatment, or traditional cosmetic surgery. They can also be combined with botulinum toxin (Botox) or other cosmetic procedures to achieve maximum aesthetic improvement. For busy moms who want cosmetic improvement, and want to "reverse the clock" by several years, but don't want their friends or coworkers to know they've undergone cosmetic work, fillers should be one of the main products considered. As always, it is important to choose a physician you trust, and have an in depth conversation with them about the benefits and risks of various dermal fillers - there is no substitute for a face to face evaluation and conversation when deciding if dermal fillers are right for you.
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