Monocheek syndrome: What to do if you have been overfilled with fillers.
Advantages of Fillers
One major appeal of hyaluronic fillers like Perlane, Restylane, and Juvederm–arguably some of today’s best facial fillers for many individuals–is the relative ease with which treatment can be given, modified, and even reversed. Opting to have facial filler strategically placed in areas of volume deficiency can greatly enhance your facial contour and restore the full features that are associated with youth. The type of filler or fillers you need and their placement will depend upon your unique facial structure and concerns, as well as medical history. In many cases, treatment of dark circles under the eyes can be achieved with Restylane and greatly complimented by Perlane placed in the upper cheek.
Treatment by facial fillers is a nonsurgical, comfortable procedure that can be performed as a comfortable, simple office visit to a qualified and experienced cosmetic surgeon who specializes in fillers and facial balance. The benefits of these hyaluronic fillers are long-lasting. Patients often find that under eye treatments can last a year and in some cases up to two years. This means that these nonsurgical results rival the longevity of surgical results and often exceeds the results of surgery.
Flexibility and Corrections with Fillers in the Cheek
However, if for any reason you are dissatisfied with your treatment, need a simple adjustment, or desire further consultation, your doctor can alter or essentially erase your filler results by using the enzyme hyaluronidase. In the case of an individual who has been overfilled with fillers, such as too much Perlane in the cheek. Overfill can take a couple of common forms. One type of over treatment is described by Dr. Steinsapir as the “monocheek” syndrome. This describes the situation when the top of the cheek is overfilled causing the lower eyelid crease to be filled up. It appears as though the cheek extends right up to the eyelashes. Another overfill syndrome is when the doctor overfills the cheek to low. This look is called the “New New Face” by Jonathan Van Meter. It makes the face look like a caricature of one’s face.
These overfill syndromes do not look natural. These treatments can be shaped to make the effect look much more natural. Correction by hyaluronidase is accomplished via small injections, which are comfortably and performed in the office. Typically, Dr. Steinsapir can help you completely resolve your concerns in just one or two office visits. The ease and safety of the correction means that there is just no reason why an individual should have to put up with dissatisfactory results. Dr. Steinsapir finds that some individuals put off being corrected because they are hoping the results will resolve on their own. However, because these treatments last a very long time, he advises having the service adjusted as early as possible to get the longest benefit from the treatment.
Expertise
The key with any satisfactory cosmetic treatment is choosing the right doctor. In most cases, your original cosmetic surgeon will be eager to correct your filler treatment with the hyaluronidase enzyme. Unfortunately, there are also underqualified medi-spas and nonspecialists performing these services, and this lack of expertise can be the reason you received too much filler, or filler that was not optimally placed in the precise anatomic areas where you need it. In such a case, it’s advisable to seek a second opinion from a board-certified cosmetic surgeon who makes facial fillers a major focus of his or her practice, and who has proven success and leadership in the field. As one of the top 3% users of Restylane and Perlane within the U.S., and as a Physician Consultant for Medicis, Inc. who distributes these fillers, Dr. Steinsapir provides unparalleled filler services and experience. If you are dissatisfied with treatment or desire a second opinion, you do not need to wait any longer. Please call us today to learn how you can improve your experience and achieve immediate benefits.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician or surgeon and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
Perlane Power
With a number of facial fillers on the market today and a number of fillers that have been used historically, we have seen great progress as these medical technologies and their applications develop over time. Restylane and Perlane stand out among the most trusted, safe, and useful fillers today. Perlane is one of the hyaluronic acid fillers distributed by Medicis, Inc., along with Restylane. We have found Restylane to be optimal for placement in under-eye hollows due to the thinness of the skin in this region, and we have also found that Perlane is a stand out product for volume replacement in the cheeks, chin, and in areas that require deeper filler placement for the shaping of the features. Often these are highly complimentary fillers, with Perlane restoring the deep fullness to the cheeks and provide a foundation for the volume that is associated with youth.
Perlane is a thicker hyaluronic acid filler, which makes it ideal for the types of contouring described above. It is a product with proven utility and safety, and its application is also easy and convenient. Treatment with Perlane can be as simple as an office visit with a qualified expert physician. Indeed, many individuals seeking advice from Dr. Steinsapir opt for treatment in the office at the time of the initial consultation. This treatment offers the benefit of longevity yet the convenience and flexibility. While you can enjoy your Perlane results for a year or more, eventually they will wear off. This allows for treatment at convenient intervals and without the concerns often associated with surgery. We find that most individuals receiving Perlane filler from Dr. Steinsapir are happy with their results and choose to maintain the aesthetic benefits achieved with periodic office visits.
In the past facial fillers like grafted fat, sculptra, and silicone oil have had their supporters and detractors. Today Perlane is typically a better alternative to these permanent and semi-permanent options. With Sculptra, altering your treatment is far more challenging. A saline injection may have some utility in breaking up the filler, but often it’s insufficient, and you may even require excision to alter your results. Silicone filler can also be understood as a permanent filler, and over time you are more likely to have dissatisfactory outcomes that are more complicated to change. And while grafted fat is sometimes indicated, Perlane is usually a more comfortable, minimally invasive, nonsurgical option. Surprisingly Perlane has a longevity that is very competitive to grafted fat, which often seems to require repetitive treatments to maintain the effect.
Lumps and bumps created by the permanent fillers can require major surgery to address. Conversely, results from the filler Perlane are easy to shape and change when needed. A treatment might hold a little too much volume and this can easily be modified in the office with an injection of the enzyme hyaluronidase. With a simple, comfortable office visit you can have your results shaped when necessary to achieve the best possible result. Perlane results rival and in many cases, exceed what can be accomplished with surgery.
When choosing a treatment provider, be sure to choose someone with differentiated expertise. As one of the top 3% users of Restylane and Perlane, Dr. Steinsapir makes facial fillers a major focus of his private practice in Beverly Hills. For a treatment plan customized to help you achieve your most natural aesthetic results possible, we invite you to consult with Dr. Steinsapir today. Please contact us for more information on how you can achieve remarkable improvements in your facial appearance without surgery.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician or surgeon and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
Will photo facial treatments affect my Restylane service?
Minimally invasive procedures have become a very popular way of improving one’s appearance. Several different treatments can be performed at one time minimizing downtime. Photo facial and facial filling with Restylane and Perlane is a very common combination of services. The fillers address volume deficiencies like under eye dark circles, lip lines, loss of facial fullness and Photo facial can improve sun damage, facial redenss to even the complexion. The filler is placed sufficiently deep in or below the skin that it is unaffected by the Photo facial. So there is no reason to be concerned if you are having both services at the same time or if you previously were treated with fillers. Your suitability for either or both of these procedures is best determined at a private consultation with a qualified oculoplastic surgeon or cosmetic surgeon. The good news is that these procedures are compatible, safe, and comfortable.
Understanding the basis for how Restylane and Fotofacial both work will clarify why it is safe to receive both treatments. Photo facial is an intense pulse light treatment (IPL) that improves red spots, small blood vessels, and sun damage. These treatments are the basis for photo facials, and they are generally delivered over the course of four to six sessions at three weeks intervals. This is sufficient time to see improvements in your skin’s appearance, creating a more even tone and skin firming. Fotofacial works by directly treating your skin where the sun damage, pigmentary, and capillaries responsible for redness reside.
Restylane treatment, on the other hand, is carefully placed under the skin to correct deficiencies in facial volume, such as the under eye circle. For example, under eye Restylane is safely placed beneath the skin to address the volume needs, thus improving what we perceive as dark circles under the eyes. Because Restylane works from under the skin while Fotofacial directly targets the skin itself, Restylane treatments are unaffected by IPL treatment, and vice versa.
It is important to always disclose your complete past and current medical history with your physician as you develop your treatment plan. This will ensure that your care is as safe and personalized as possible. Dr. Steinsapir specializes in both Fotofacial and Restylane treatments and is the inventor of of Deepfill Restylane method, the breakthrough approach to correcting under eye hollows. Dr. Steinsapir is friendly and approachable, and will gladly answer your questions and help you feel confident in your treatment choices. Call us today to schedule an individualized consultation and see results.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us
I am having a complication from a Restylane treatment and my wedding is in six weeks. What should I do?
Wanting to look your best for your wedding day is something everyone is entitled to. In the event that you experience unwanted effects from your Restylane® treatment, hyaluronidase makes it easy to adjust hyaluronic acid fillers like Restylane, Juvederm®, and Perlane®. In most cases its best to return to your original doctor who should be eager to make sure you are happy with your treatment and outcomes. However, there are circumstances where there is simply no substitute for seeing a leading expert to help you get the results you need.
Seeking a second opinion
Dr. Steinsapir often sees individuals frustrated with treatments they received elsewhere. Surprisingly, many people are not aware that the hyaluronic acid fillers can be adjusted using the enzyme hyaluronidase. This enzyme is delivered with a small injection during a very comfortable office visit. Dr. Steinsapir has helped people who put up with unsatisfactory treatments for much longer than they need to. These issues are easily dealt with using the enzyme in one or two visits. It is the ability to make these adjustments that makes it feasible to provide many of the advanced filler services.
Correcting the problem
Restylane is a long-lasting, but not permanent sugar-gel facial filler that is preferred for improving facial contours due to its natural results, even in sensitive areas like dark circles under the eyes and the lip edge. Restylane and Perlane offer the ability to modify results when necessary. This includes treatments that were performed in the past and need fine-tuning. The ability to adjust a treatment with an enzyme can take a good treatment and make it great. In some cases, as the body slowly breaks down the material over time, slight irregularities may develop despite the initial quality of the treatment. Sometimes, the answer is adding filler rather than subtracting volume. For this reason, it is best to start with a detailed assessment with an expert like Dr. Steinsapir.
Restylane has long-term benefits and it is also easily adjusted even long after a treatment. These characteristics are essential in the eyelid and surrounding areas. The skin here is very thin and the tissues are very sensitive, so even small issues show up. Don’t live with a treatment that isn’t everything you want it to be. See an experienced cosmetic surgeon who can help take a treatment from like to love.
About Dr. Steinsapir
Dr. Steinsapir is a much sought after oculofacial surgeon. He is an innovator in minimally invasive cosmetic and reconstructive procedures and has invented new methods for treating with BOTOX, Fillers and cutting edge reconstructive eyelid and midface surgery. He specializes in high precision eyelid surgery and is a leader in correcting prior facial and eyelid surgery, including multiple revised cosmetic eyelid reconstructions. He attended medical school at the UCLA and completed ophthalmology residency at The University of Chicago. He is multiple fellowship trained including three years of fellowship training in oculofacial plastic surgery at UCLA, and a two-year cosmetic surgery fellowship in Rancho Mirage. He is widely published and lectures to other surgeons nationally and internationally. He is an associate clinical professor of Ophthalmic Plastic and Reconstructive Surgery at the Jules Stein Eye Institute at UCLA. His private practice is located in West Los Angeles, immediately serving the Los Angeles and Bevery Hills communities. Additionally, individuals from all over the country and the world regularly come to Los Angeles for this expert care.
To learn more about Dr. Steinsapir’s specialized Restylane treatments, please contact us today.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
Could I be allergic to Juvederm?
Just as it’s possible but rare to have an allergic reaction to Restylane as we recently discussed, it is also possible but rare to have an allergic reaction to Juvederm. Why do we mention both Restylane and Juvederm here? These facial fillers are each hyaluronic acid fillers, so they share properties that make them both very safe; however, in the unlikely event that you are allergic to one, then you are probably allergic to the other. Whenever you consider undergoing any medical procedure, you should be mindful that there is always some degree of risk involved. This is why it’s especially important to have an open conversation with your doctor about your circumstances and medical history to best determine whether you are one of the many people who can benefit from facial fillers.
If you have a history of any of the following, carefully discuss them with your doctor, as they indicate that Juvederm is probably not right for you, and instead you should consider one of other safe treatment options. According to the Juvederm webpage, you should not use Juvederm injectable gel if you have:
• Severe allergies with anaphylaxis
• Allergies to gram-positive bacterial proteins
• Allergies to lidocaine
Allergic reactions to Juvederm are so rare that no testing is recommended prior to treatment, but remember rare events do happen. The best thing to do is consider the benefits against your personal risk factors. The good news is, hyaluronic acid fillers like Juvederm are safe for the overwhelming majority of people.
Thinking about the Best Filler for You
Juvederm was the first hyaluronic acid dermal filler to be approved by the FDA for addressing facial folds, lines, and volume deficiencies. It remains an excellent product to this day. However, we’ve found that Restylane’s flow characteristics usually make it more suitable for certain facial treatments such as treating dark circles under the eyes. This is because Restylane’s higher viscosity (basically its “thickness”) helps to keep the filler correctly placed around the undereye area. Both Juvederm and Restylane are readily adjustable by your cosmetic surgeon, both last about the same amount of time, and both are considered safe products. The key is in determining which cosmetic approach is best for your individual needs and then receiving a customized treatment.
Expert Consulting in Facial Fillers
If you are seeking to improve your looks and build confidence by treating facial concerns like wrinkles, hollowness, folds, and dark circles, consider how treatment with a hyaluronic acid filler or another procedure like the midface lift may help. The only way to find out what is the best and safest treatment for you is to consult with a highly experienced and qualified doctor who can go over your medical history and current needs with you in detail, then custom-plan a treatment approach that meets your goals. Dr. Steinsapir is a world leader in facial filler treatments, with an emphasis on minimally invasive technique that look completely natural. To start thinking about the best way to achieve you desired aesthetic, contact us today for your no-risk consultation.
What happens to my facial fat grafts when I gain weight?
Overview
Facial filler treatments and fat grafting can be excellent ways to soften the facial features by correcting imbalances and deficiencies in facial fat distribution. Your decision to pursue fat grafting treatment is one you should carefully consider with your doctor, as there are multiple options for achieving your desired look, and the solution that’s best for you will depend on variables like your medical history, present condition, and treatment goals. Like other treatment options available today, fat grafting is particularly suited for some individual’s needs, while for others there may be other more suitable options.
Fat Grafts and Changes in Weight
If your weight changes just a little, you probably won’t notice much difference in your treatment results. If you have significant changes in weight, though, you could see some differences in the form of increased facial volume. This is important to consider before opting for fat grafts. While you probably aren’t planning on gaining weight, you and your doctor should take into account the likelihood of weight fluctuations given your medical history and current lifestyle.
So what can you expect with changes in weight? This depends on the individual, but with small changes in weight there is generally little change in the fat graft volume. However, with an increased weight and body fat, the grafts also increase in volume like the fat compartment from which they were removed. For example, when the body fat increases 10% or more, the grafted fat also significantly increases in volume.
While the effects of most facial cosmetic surgery eventually diminish over time, it’s important to recognize that fat grafting does yield long-term results. This is a great benefit for those who seek long-term change, but there are also times when the nature of this treatment can result in an unsatisfactory result even years after the original fat grafting procedure.
Achieving the Best Long-Term Results
In an ideal world we will all of course adopt a healthy, active lifestyle that includes good nutrition and keeps your weight at a stable place where your body works best. But the reality is that most Americans gain about one pound of weight per year. While most qualified cosmetic surgeons can comfortably adjust and even reverse treatments with Restylane and other hyaluronic acid fillers, correcting the facial contour after fat grafting is not so simple or straightforward.
These tendencies lead many cosmetic surgeons to favor the new facial fillers—like undereye Restylane, Perlane, and Juvederm—for most patients. These fillers do not last as long as fat grafts, but they are very popular and effective because they are safe, provide benefit without the necessity of surgery, can be adjusted with the enzyme hyaluronidase, and have science-based, proven results.
Does this mean that fat grafting is wrong for you? Not necessarily—fat grafting is an excellent option for certain situations on a person-to-person basis, just as facial fillers and other procedures like the facelift work well for many individuals. You will need to consult with an experienced cosmetic surgeon before making a final decision that is right for you.
Experience Counts; Consult with the Best
Dr. Steinsapir is a leader in cosmetic facial fillers and other cosmetic facial treatments and surgeries. In fact, he has served as a physician consultant to Medicis, Inc. (Perlane’s and Restylane’s distributor). He has developed Deepfill Restylane, the world-renowned method of treating dark circles under the eyes. His practice emphasizes minimally invasive treatment methods that are customized for the individual’s unique situational needs, with the aim of fast healing time and natural results. For more information on how Dr. Steinsapir can help you determine your best treatment options, contact us today.
I’ve heard that the enzyme that erases Restylane wrecks the skin. Is that true?
One reason why fillers like Restylane and Juvederm have been so successful is because these treatments can be adjusted using an injectable enzyme called hyaluronidase, an ovine (sheep)-based enzyme that works as a sort of “erasure” to modify lumps and bumps that may occur as a result of facial filler treatment. Allergies to this product are reported to be less than 0.1%, which is considered rare.
Some people are nervous about seeking treatment because they’re not sure if they will like their new look and they want to have the option of reversing any undesirable results, or they simply wish to be able to change their mind later. Still others may be concerned that if they are dissatisfied with a filler treatment that they’ve already had, will they make things even worse by seeking a correction? These are understandable fears, but fortunately they are largely unfounded. There is no reason to believe that hyaluronidase will ruin your skin or make matters worse. Routinely, hyaluronidase is used to adjust hyaluronic acid filler treatments. While every medical procedure comes with a risk, and while it is possible that you are one of the rare individuals who could experience an allergic reaction, this is not likely. A reputable cosmetic surgeon can safely make adjustments, and in the unlikely event of a complication, your physician will know what to do.
How did the rumors about hyaluronidase get started?
At first when Juvederm and Restylane were being introduced as valuable cosmetic products, some dermatologists were concerned that some people could potentially have an allergic reaction to the enzyme. However, as time went on hyaluronidase benefited numerous treatment recipients who sought adjustment, it became clear that this enzyme is a safe way to make sure that treatments with hyaluronic acid fillers like Restylane, Perlane, and Juvederm achieve the best results.
Eye plastic surgeons are some of the professionals who use hyaluronidase the most, and they have found the enzyme to be reliable. Dr. Steinsapir has used this product for over 20 years, and hasn’t seen an allergic reaction yet. While there is always a chance of a negative response in the body, oculofacial surgeons have integrated the enzyme with hyaluronic acid filler product treatment as if it’s an eraser to modify a treatment after the fact. Since adjusting filler treatment with hyaluronidase is truly an art form, some less experienced providers are not comfortable with this practice. It is important to seek treatment from someone whose forte is facial fillers and cosmetic eye treatments. These days the core specialists in hyaluronic acid are quite comfortable using the enzyme to adjust overfill.
How will I look after my hyaluronidase adjustment?
This depends on your goals and the extent of the adjustment. In most cases, you’ll want your physician to adjust a highlight, or an area of fullness that detracts from the overall treatment effect to obtain an overall treatment effect. He or she can do this comfortably and with a high degree of accuracy. The enzyme can be used essentially until the original filler disappears from the face, so it’s also possible to have the filler broken down completely. If for any reason you choose to go this route, you can expect to look the same as you always have after giving your body some time to completely heal and for any accompanying swelling to subside. Generally Dr. Steinsapir does not advocate flooding an area to “erase all the product.” Instead it is best to sculpt the product and make the most of what has already been placed. Adjusting the work of other injectors is a reason than many new clients seek out Dr. Steinsapir.
You should never accept filler treatment that is touted as permanent or semipermanent. This will make it difficult to make adjustments, and it doesn’t account for the changes in the face over time. Later in life, exactly where and how you need help will change.
If you’ve already been treated with Restylane, Perlane, or Juvederm and feel that your treatment can benefit from some adjustment, don’t simply wait for the product to wear off. You may have to live with you unsatisfactory results for a full year or more, and after that you will likely be nervous about seeking further help. Have your treatment adjusted right away so you can see the real and safe benefits of cosmetic facial fillers and realize the benefits of your treatment.
Seeking the Best Filler Treatment Available
If you have already received hyaluronic acid filler injections and seek modification, in most cases you can talk with your treatment provider about revisions. If you aren’t confident in your doctor’s abilities or do not have a positive relationship with him or her, seek a second opinion from an acclaimed expert in facial fillers with natural results.
Dr. Steinsapir is a world-renowned fillers expert and has served as a physician consultant to Medicis, Inc., the distributor of Restylane and Perlane. He also invented Deepfill method for placing Restylane, a proven method for correcting dark circles under the eyes. Those who seek treatment with Dr. Steinsapir are almost always very happy with their initial treatment, but in the event that your filler needs adjustment, Dr. Steinsapir can also provide the service of safely and comfortably adjusting your treatment with confidence. Contact us today to learn more about how Dr. Steinsapir can assure that your treatment results are natural and customizable to your goals.
