October 12, 2011

What should I expect with my filler service?

Cosmetic fillers like Restylane®, Perlane®, Juvederm®, and other hyaluronic acid fillers are an excellent alternative to surgical procedures.  These products are composed of a cross-linked sugar gel that can correct wrinkles, volumize the nasolabial fold and lips, fill acne scars, and improve under-eye dark circles.  Dr. Steinsapir is the inventor of a unique and effective method that specifically addresses under-eye discoloration.  This technique is called the Deepfill™ method.  Facial fillers last about a year and treatments are easily adjusted using hyaluronidase, if necessary.  For many years, Bovine Collagen was the gold standard of fillers, but has now been displaced by Restylane® which is now the filler to which all others are compared.

Like Restylane, Perlane® is intended for volumizing, but it differs from Restylane in that Perlane is intended to provide facial volume in the deep dermis and superficial subcutaneous fat.  Perlane and Restylane are not equivalent products.  It is essential that your doctor places Perlane deeper than Restylane.  When used properly, Perlane is an excellent alternative to volumizing products like Scluptra® and Radiesse® and even fat transfer.  Treatment with Perlane also lasts well over a year.

Where are injections commonly performed?

Hyaluronic acid fillers are office-based services. You may see estheticians and unqualified individuals like medical assistants offering injections illegally in spas and salons under the justification that they have a “medical director.”   No States permit this arrangement.  Unless a doctor is present and performs the service, this type of situation is the illegal practice of medicine.  As with BOTOX®, don’t let an unqualified individual perform your Restylane or Perlane service.

Just like BOTOX, only a licensed medical doctor or a nurse under the direct supervision of a licensed medical doctor can inject hyaluronic acid fillers.  The exact details of the required qualifications vary by State so it’s important to research the individual you wish to perform the injection to ensure he or she is qualified.  However, just because your doctor or nurse is minimally qualified to perform the injection does not necessarily indicate he or she is the ideal choice for the procedure.  As with many other medical procedures, the best results require a certain level of qualification, skill and experience; these concerns are perhaps even more important when considering modifications to your physical appearance.

What’s the typical recovery course and what are the physical restrictions?

Many of Dr. Steinsapir’s patients resume their normal activities just after leaving the office with the exception of no workouts for 24 hours.  Wait a day before going to the gym.  If you don’t bruise, there will be about thirty to forty hours during which you experience minimal swelling.  Many patients, both men and women, can hide this swelling right away with a camouflage makeup that matches their skin color if necessary.  If your lower eyelid skin quality is poor and you often collect a small bag of puffiness under the eye, the doctor may counsel you regarding the need to consider a procedure like a chemical peel or surgery prior to getting regular filler treatments so you don’t experience prolonged recovery after each filler service.  This can be discussed when you have your initial consultation.

What are common complications and how are they addressed?

Most people, about 70 percent, do not experience bruising after a Restylane treatment; the other 30 percent experience some degree of bruising; most of it mild.  But a very few (one or two in a hundred) will develop a black eye.  The black eye can take about two to three weeks to completely resolve, and this is a cosmetic concern without health dangers.  The worst part of this is that many will assume that you were the victim of domestic violence.  Glasses and makeup help to hide the bruise while it is resolving.  Considering that Restylane will last over a year, the recovery process is very mild and comfortable even for these few.

For the few Restylane recipients who experience bruising, the short-lived bruise is worth the long-term results.  It’s a good idea to obtain treatment at least three weeks before big events like vacations.  For the biggest occasions such as your own wedding, Dr. Steinsapir advises have treatment 2 months ahead of the event to be completely certain that your pictures will turn out great.

To minimize your risk of bruising, your doctor will ask you to stop taking certain medications that thin the blood, such as aspirin.  If you are taking anything prescribed by a doctor, Dr. Steinsapir strongly advise that you consult with your prescribing physician before discontinuing the medication.  If your doctor suggests that you continue the medication, this does not mean that you aren’t a good Restylane candidate.  If you are willing to be at a slightly elevated risk for bruising, Restylane can still be effective.  Your regular doctor and your cosmetic specialist can help you decide the best route to take.

The incidence of allergic reaction varies with the products used and should be discussed with the treating physician but the incidence of allergies to these products is very low.

For unwanted highlights or bumps that occasionally occur after an otherwise excellent filler treatment, the enzyme hyaluronidase makes Restylane injections easily adjustable to a more desired aesthetic, and your doctor can even erase the treatment completely if you determine together that this is your best option.  In the event that you experience lumps or unwanted effects from your Restylane treatment, hyaluronidase makes it easy to adjust hyaluronic acid fillers like Restylane, Juvederm and Perlane.  This flexibility created by the ability to adjust a service is one of the most important factors making HA fillers such a popular service.

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.

June 23, 2011

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.

June 11, 2011

Can Surgery Remove Persistent Dark Circles?

Dark circles under your eyes can make you look old and can even degrade your self-image.  Diet, exercise, and plenty of rest are cited as solutions for dark circles.  Skin creams and dark circle concealers can provide some help.  Often people are under the mistaken impression that surgery will fix the dark circle.  While there are a small percentage of individuals who will benefit from surgery for their particular type of dark circle, in the majority of cases surgery will be of little benefit and can make the situation worse.

Why don’t cosmetic creams and bleaches work?

Although creams and bleaches don’t work to brighten the area under your eye, a dark circle concealer may do the trick.  Dark circle concealers work by mixing mineral particles in the cream.  These minerals reflect the light to create the illusion that the area under your eye is fuller.  Concealers are less expensive than under eye filler, but concealers stay on the skin just a few hours.  In contrast, and under eye filler service can provide help for up to a year and in some case longer without the need to constantly apply makeup.

The darkness of under eye circles is optical.  The skin is dark because there is no fat between the thin lower eyelid skin and the darkly colored muscle just under the skin.  Filling the hollow with hyaluronic acid fillers reduces the area in the lower eyelid that can shadow, improving the dark circle.  Under eye filing with Restylane using the DeepfillTM method developed by Dr. Steinsapir directly helps the hollowness in the lower eyelid, a major factor contributing to the dark circle.

Restylane can help

Dr. Steinsapir finds that under eye Restylane® is the best option for dark eye circles.  Restylane® is a hylauronic acid filler made of up cross-linked sugar gel used to fill wrinkles and provide volume in the face.  “Unfortunately, that lower eyelid circle develops early on the face,” notes Dr. Steinsapir who commonly treats young entertainers who needs to maintain their youthful edge in Hollywood.  The treatment requires a skillful hand but once placed and adjusted, the treatment is completely natural and can’t be detected by others. No wonder this has become the most popular eye dark circles treatment.

When you do decide to have under eye filler, take time to look for a doctor who knows what they are doing.   Dr. Steinsapir reports that when he teaches other doctors to perform the method, he often finds that they lack the detailed anatomic knowledge needed to successfully perform the treatment.  It is also critical that the injecting physician assess how you do after the treatment because a certain percentage of treatments require an adjustment.  Dr. Steinsapir explains that everyone holds a slightly different amount of water in the tissues and small areas of fullness can spoil an otherwise great result.  For this reason, he encourages his patients to follow up about a week after treatment to assess how the service has settled.  “Adjustments can easily be made with the Restylane® treatment at any time after the service, which is why the treatment is so powerful,” he notes.  He advises avoiding medicines and herbal products that can thin the blood for about a week before treatment.  If you are taking something prescribed by a doctor, check with your doctor first before stopping a medication.  Also it is advisable not to work-out until 24 hours after a treatment.  These precautions minimize the risk of bruising.

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 Beverly 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 specialization in 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.

February 13, 2011

I had a chin implant in the past. What are my options for improving my appearance now?

There are many different styles of chin implants that vary from the old-style button-chin implants to oversized, so-called anatomic implants. The differences range from attachment method, material, size and shape. Whether your implant is porous silicon, held in place by your own tissue or secured via bone screws, the results are a balanced appearance and striking silhouette. Mentoplasty provides a look of youth and vigor, but as you age, the appearance of your implant can change. As we age, our faces naturally lose the sub dermal fat that contributes to the shape and volume of our facial features. With the inevitable loss of facial volume and the natural changes we all face as we age, the contours of your chin implant can become increasingly evident. Cosmetic surgery can have long-lasting benefits, but it can’t stop the clock—you may find that as you gradually see the benefits of a past chin implant fade, with the gradual loss of soft tissue volume.  This progressive change over time compromises the silhouette that was originally achieved by the implant.

Maintaining the shape of your chin

A variety of methods can address the loss of facial volume and prominent chin implant contours based on the individual and their concerns. For some, Dr. Steinsapir may recommend removal and replacement of the original implant as the most appropriate treatment. By replacing the original implant with a different type or style of implant, the effects of aging can be reversed without sacrificing your appearance and facial shape. By replacing an older implant with a newer model and style that reflect medical advances in facial cosmetic surgery, the proportions of your face are restored to a more youthful appearance.

Minimally invasive methods

For some individuals, chin irregularity associated with the loss of natural facial volume can occur. If you’re beginning to experience this particular result of aging, you don’t need to have a chin implant to improve your appearance, you may benefit from injections of BOTOX® and hyaluronic acid fillers. Injections with facial fillers do not require surgery and last well over a year.  This is an excellent option for many individuals who do not wish to have surgery or a revisional procedure to replace a prior chin implant.  Revolumizing the chin, without changing the implant is a highly effective solution.  Fat grafting can provide a natural appearance and is an excellent option for some individuals. However, given the option most people are now choosing hyaluronic acid fillers like Perlane as a means of rapidly improving the appearance of the chin.

About Dr. Steinsapir

Dr. Steinsapir is a much sought after oculofacial cosmetic surgeon.  He is an innovator in minimally invasive cosmetic procedures and has invented new methods for treating with BOTOX, Fillers and cutting edge facial surgery.  He specializes in high precision eyelid surgery and is a leader in correcting prior facial and eyelid surgery.  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  Please contact us today to learn more about how Dr. Steinsapir can help you attain your aesthetic goals.

April 18, 2010

Are fillers good for acne scarring?

Acne scars and other depressed scars and deficiences can often greatly benefit from hyaluronic fillers like Restylane and Perlane.  Filling depressed scars is an effective treatment that is nonsurgical, minimally invasive, and gives benefits that can easily last six months to a year, and in some cases, longer.

filler for scar before and after photo

filler for scar before and after photo

How can fillers improve scars?

You may have an indentation from acne scars, a surgery, a cut from a sports injury, or for a number of other reasons.  This deficiency can stand out in your appearance and detract from your facial aesthetics.  For some, scars can even be painful reminders of past problems.  Fillers like Perlane and Restylane are often the best option for diminishing the visibility of scars on the face by eliminating skin irregularities and restoring the skin to its natural texture and shape.  By filling in the deficiencies that are responsible for these indented scars, you may find that your scars are no longer noticeable.  Facial fillers are safe and minimally invasive treatments that require little to no recovery time.  This, combined with their effectiveness, make them the leading choice for acne scar treatment without the prolonged recover associated with surgery.

Why are fillers better than laser resurfacing to treat scars?

Laser treatment at first seemed like a promising technology, but it has never reliably delivered great results, and it is associated with many complications, including permanent disfigurement.  Laser resurfacing for acne often yields no results, or – worse – it can make things worse.  An erbium laser generally provides only minimal improvement, while something like CO2 laser resurfacing is so aggressive that it can damage your natural pigmentation.  Fractional CO2 skin treatment are often big disappointment and very expensive.  It is almost always much safer and more effective to choose acne scar fillers than laser treatment.

How to Find a Facial Fillers Expert

Treating facial scars is both a medical procedure and an art that should be performed by a doctor who specializes in treatment with facial fillers.  Your doctor, whether a dermatologist or cosmetic surgeon, should also possess the great artistic skill needed to precisely place the filler for the best aesthetic results possible.

It can be tough to know where to begin when trying to assess your potential treatment provider’s ability, experience, expertise, artistic ability, specialization, and so on, but with some careful research you can find someone well-qualified to give you great results.  When seeking someone to help you remove acne scars, always find out whether the doctor will personally perform the procedure or instead use an assistant to administer your treatment.  Only choose a doctor who will personally treat you; after all, you don’t know anything about the assistant’s ability, and your results will be much better when the most qualified doctor performs them, rather than a non-physician in training.  An assistant may cost less, but your results will likely not be as good.

Carefully study your potential doctor’s scar removal before and after photos, noting any changes in camera angles or lighting conditions.  If you don’t like what you see in the example photos, you probably won’t like what you see in the mirror later either.

Make sure that your doctor has a lot of experience in filling scars on the face.  Choose a doctor who specializes in facial fillers.  Every doctor has special areas of talent and experience.  Just as you wouldn’t go to the same doctor for brain surgery and heart surgery, even if both are leading surgeons, you need to choose a doctor who makes fillers and facial cosmetic treatments a focus of their practice.

Finally, evaluate how well you get along with your potential doctor at your initial consultation.  You should feel comfortable around your doctor and confident in his or her ability to help you.  Sometimes for reasons beyond explanation a doctor and patient don’t “click” together, in which case it’s okay to move on.

Consult with an Expert in Facial Fillers

Kenneth D. Steinsapir, M.D.
provides treatment with facial fillers in Beverly Hills and Los Angeles as a major focus of his practice.  Medicis, Inc. – the distributer of leading fillers Restylane and Perlane – has recognized Dr. Steinsapir for his expertise in fillers.  Dr. Steinsapir understands how to correct the focal loss of fat often seen underneath acne scars and other types of scars because of his extensive education, fellowships, and practical treatment experience.  He will personally administer your treatment with the precise skill required to create natural results.  Please call us today for a filler consultation to find out how Dr. Steinsapir can give you immediate scar treatment results.

December 15, 2009

Should I Get Perlane® or Restylane®?

Restylane® and Perlane® from Medicis, Inc. are both hyaluronic acid fillers made of sugar gels. It is common to ask which product is better.   The reality is that these are similar products with important differences.  Restylane® is a softer product that provides excellent volume, tends to stay where it is injected, but can be shaped well once placed in the tissue.  Perlane® is also a soft product that provided slight better volumizing, tends to stay where it is injected, and resists shaping more than Restylane®.

Each product has a somewhat different role in facial volumizing.  The right choice for you very much depends on your issues.  This is best determined by an individual consultation with a highly qualified cosmetic surgeon.  Here are some general guidelines and common usages that can give you an idea of when each filler tends to be appropriate, but individualized treatment never takes a one-size-fits-all approach and diagnosis and treatment planning must be done in person.

Before and After: Restylane, Botox and Perlane by Dr. Steinsapir

Before and After: Restylane, Botox and Perlane by Dr. Steinsapir

What’s the Difference between Perlane® and Restylane®?

Both Perlane® and Restylane® are fillers that work especially well when volumizing the face to give it a softer, more youthful look and restore hollow and deflated areas.  Perlane® is a thicker material than Restylane® and it usually lasts a few months longer.  This is an amazing length of time as Restylane can be effective for a year or more.  Restylane® usually works better for the sensitive area under the eye where the skin is thin and there is little fat.  The ability of the Restylane to be readily shaped once it is placed in the tissue means that many potential irregularities can be resolved as the material is placed.  For the same reason, Restylane is also excellent at the lip edge.  Elsewhere in the face, there is much better tissue coverage for the placement of the slightly thicker Perlane®.

Perlane® has a larger molecular structure that Restylane and as a results it is a somewhat better volumizer than Restylane®.  It is preferred in areas like the cheeks, eyebrow, chin, and the tissues around the mouth called the perioral area. Why does it work best in these areas?  Because these areas have more fat to work with than the lower eyelid dark circle.  Perlane®’s thickness necessitates that it be placed deeper than Restylane®, while Restylane® works very well near the surface of the skin and in areas where little fat is present.  Perlane® is wonderful for adding volume to places with more fat under which a doctor can place this filler.  It is less ideal for the lip edge and under eye area where the Restylane serves as a better choice.

Because of both their similarities and differences, Restylane® and Perlane® can be used together to improve the facial aesthetics by eliminating unsightly angles, sunken features, and haggard looks.  For example, Perlane® can be placed in the top of the cheek at the time that Restylane® is used to treat the dark circles in the lower eyelid hollows.  Both of these actions are beneficial in themselves, and when used together they amplify the improvements even more.

What If I’m Unhappy with My Results?

These services are the fastest growing cosmetic services because of how happy people are with the results.  Yet service is not a magic wand and it is sometimes necessary for a treatment to be adjusted.  First make certain that your doctor is aware of your concerns.  If you are having an issue, don’t simply wait until your next visit.  It is a good idea to contact your doctor and let them know what is going on.  There is often a great deal of value in being seen early if there is some issue.  By consulting with your doctor after a procedure, these issues can be readily addressed.

Unlike other fillers, hyaluronic acid fillers like Restylane® and Perlane® can be adjusted after treatment to resolve any surface irregularities that might be present after treatment.   In fact, it is possible to modify these treatments even if it has been quite some time since you were treated.  Over time, these products are absorbed by the body and eventually disappear over a year or two.

Seeking the Right Doctor

Dr. Steinsapir specializes in improving the face in both aesthetic and medically necessary situations.  As a specialist he has some of the highest levels of experience in addressing concerns about the face, including how to best apply fillers like Perlane®.  In fact, Dr. Steinsapir has served as a physician consultant to Medicis, Inc., who distributes both Perlane® and Restylane®, and he is considered among the top 3% users of these products.  He is thought to have the largest under eye filler practice in the World.  Call for a consultation to find out if you are a good candidate for Perlane®, including whether it will improve upon another procedure or could be combined with Restylane® treatment.  Dr. Steinsapir approaches everyone as an individual, customizing treatment to each person’s needs.  Contact us today to find out how he can customize treatment for you.

October 20, 2009

Facial Fillers: A Solution to Non-Surgical Cosmetic Treatment

Twenty years ago, the only solution for removing the classic signs of aging like wrinkles, sagging skin, under eye hollows, and thin lips was going under the knife or hardcore chemical peels and laser. But today, a range of facial fillers can be injected to smooth out those facial lines, enhance lips, treat nasolabial folds, and remove furrows between the brows, taking years off the face to bring back that youthful look. What makes injecting facial fillers so attractive? Facial Fillers also known as “dermal fillers” or “injectables” offer a cosmetic treatment that is minimally invasive with little or no recovery time. Injecting fillers has become the most popular way to solve anti-aging problems in a non-surgical manner. With so many types of dermal fillers available today, choosing the right one can be overwhelming. The following sections provide useful information about some of the most widely used fillers.

What are the Main Ingredients That Constitute These Facial Fillers?
Most of the commonly used fillers are derived from Collagen or Hyaluronic acid. Collagen is a naturally occurring protein in mammals that is used to create injectable fillers that are either bovine-derived, porcine or human-derived. Bovine-derived collagen is extracted from the tissue of cows that have been raised in consistently monitored, disease-free environment. The Allergan, Inc. Zyderm® and Zyplast® product is produced from highly purified collagen collected from a closed herd of cattle. As there is a 3-8 percent chance of an allergic reaction to bovine collagen, an allergy test is required prior to undergoing treatment with this filler. The source of human-derived collagen products varies. However, the most popular of these products, Cosmoplast® and Cosmoderm® from Allergan, Inc., is sources from cultured human fibroblast cells that have been maintain in tissue culture for 10 years. These cells are the source of other human derived products used to treated burn victims and have an excellent safety record. A pre-treatment allergy test is not necessary with the human derived collagen products. Evolence® is the latest collagen product produced from porcine collagen with a useful life in the face of about a year. The longevity of collagen injections depend on patient’s lifestyle, physical characteristics, and the part of the body treated. Collagen is observed to disappear faster in areas that are directly affected by muscle movement. Only a professional doctor can help you to determine the right period required for retreatment to maintain the results.

Hyaluronic acid is a type of polysaccharide called a glycosaminoglycan. Also known as hyaluronan or hyaluronate, hyaluronic acid occurs naturally in the human body and is central to regulating cell growth and renewal. Hyaluronic acid is non-immunogenic, which means the body doesn’t consider it as a foreign substance, thus minimizing the chance of an allergic reaction. While allergies to these products do occur, allergy testing is not recommended do the low incidence of allergies to these products. Dermal fillers that contain hyaluronic acid offer a soft natural look and also have great longevity. Hyaluronic acid fillers have an added advantage in that they can be manipulated even long after a treatment using the enzyme hyaluronidase. The results are like have surgery but the magic wand was an office procedure and a treatment comfortably placed with tiny injections.

The Most Popular Facial Fillers
Restylane ®
Known as one of the most effective and popular fillers, Restylane dermal gel composed of hyaluronic acid. The non-animal biodegradable filler adds volume to the skin treating under eye hollow and dark circles. It smooths facial folds and wrinkles in areas surrounding the eyes and mouth. The effects of this filler easily last for a year or more depending on factors like age and skin type, and the initial treatment volume.

Juvederm ™
This injectable gel is the first FDA-approved hyaluronic acid dermal filler which restores your skin’s volume and addresses moderate to severe the facial folds, like “smile lines” or nasolabial folds. This filler is made up of cross-linked hyaluronic acid and effects last for an average of 6 months. Other hyaluronic acid fillers are granular in nature, but the smooth consistency of Juvederm ™ allows the injection to be administered with relative ease. Due to the enhanced ability of this product to flow in the face, it is best to discuss with your treating physician where this product will work best.

Perlane®
Another hyaluronic acid based filler – Perlane, with larger molecules and large concentration of hyaluronic acid, making it more effective to treat deeper wrinkles and larger folds. Though it is only FDA approved to last up to 12 months, it has found to be longer-lasting than Restylane ®. This product is the best of the hyaluronic volumizers for deeper lines or more active points of facial movement.

Botox ®
This facial injectable is made from Botulinum Toxin Type A and designed to eliminate facial wrinkles. It commonly treats areas like frown lines between the eyebrows, “crow’s feet,” and creases on the forehead. It primarily addresses the periocular region and its effects last up to 6 months. While Botox is not a filler, it is often used in combination with fillers to achieve results that previously could only be accomplished with surgery.

Zyplast® and Zyderm®
The first collagen based fillers approved by the FDA are made of purified bovine-derived collagen and are used to enhance facial contour and reduce fine lines and deep wrinkles. Zyderm® subtly smooths crow’s feet or fine lines around the lips. Zyplast® is used to treat deeper folds such as brow wrinkles or frown lines, and provides volume and contouring to your face. The longevity of this product is limited compared to the new hyaluronic acid fillers. The product contains local anesthetic making quite comfortable for lip edge treatment. Prior testing is needed to screen for potential allergies before actual treatment.


Radiesse ®
Formerly known as Radiance, Radiesse is made of calcium-based microspheres, the same component of bones and teeth. The filler stimulates the body to produce new collagen around the microspheres, which makes it last longer. It is utilized to correct moderate to severe wrinkles and contour the facial features. Radiesse® filler is the first FDA-approved one-year dermal filler that restores and corrects the signs of facial lipoatrophy in patients with HIV. Initially the manufacture claimed longevity of 5 to 8 years, however, clinical experience suggests that this product lasts 12-18 months when used as a facial filler.

ArteFill®
ArteFill® which is known as Artecoll® outside of United States is a dermal filler that offers longer lasting results than other cosmetic filler injections. It is made of polymethylmethacrylate (PMMA) microspheres that are suspended in bovine collagen and is mainly used to treat static facial lines, enlarge lips, fill in facial imperfections, and diminish nasolabial folds. It not only acts as a dermal filler, but its microspheres also stimulate the body to produce its own collagen. As the injected collagen slowly degrades naturally, the newly produced collagen replaces it. This leads to long-lasting, almost permanent results. Due to a tendency to form lumps, the product is not recommended for lip or lower eyelid treatment.

Silicone oil
Silicone oil has only one FDA approved indication for use in the repair of complex retinal detachments. This material finds its way into off label use as a medical grade facial filler. However, silicone oil has a number of side effects. Consequently it is not advisable to use liquid silicone for facial filler. Silicone oil is occasionally used by non-medical injectors for illegally black market treatment. Often the silicone oil used is not medical grade but rather industrial silicone oil, which was never intended for the human body. There have been deaths from these types of illegal treatments.

Benefits and Risks Involved in Injecting Facial Fillers
The biggest advantage of these fillers is that they do not require any invasive surgery and require little recovery time. While the results of fillers do not last forever, their longevity is sufficient to offer a practical alternative to surgery. In many case, the result of filler service can be better than what can be accomplished with actual surgery. Periodic top off allows the effects of service to be maintained. Side effects like bruising, swelling, lumpy firmness, and tenderness are seen in 5% of treatments. The incidence of allergic reaction varies with the products used and should be discussed with the treating physician.
Before undergoing an anti-aging treatment, it is important to consult a well-qualified and a board certified cosmetic surgeon, to help you to understand which FDA-approved filler is the best for you.