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Soft Tissue Injectable Fillers

Soft Tissue Injectable Fillers

Facial aging is a complicated process involving changes to the skin, volume loss of the soft tissues of the face, relaxation of the fibrous/muscular tissues, descent of the soft tissues of the face, and volume loss of bone in the facial bones.  Sun exposure, genetics, stress, environmental factors, and weight loss can make these changes more apparent.  The end result is the formation of rhtyids (wrinkles) and laxity (looseness) in the skin, loss of cheek volume, jowl formation, collection of adipose tissue (fat tissues) under the chin and neck, bands in the neck and loose neck skin.

Dr. Cynthia M. Gregg and her nurse injectors are skilled in the use of Belotero Balance®, Juvederm® Ultra XC, Juvederm® Ultra Plus XC, Juvederm® Voluma XC, KYBELLA™, Perlane®, Perlane-L®, Radiesse®, Restylane®,  Restylane-L®.  Restylane® Silk, and Sculptra® Aesthetic.

What are fillers made of and are they safe?

Belotero Balance®, Juvederm® Ultra XC, Juvederm® Ultra Plus XC, Juvederm® VolumaTM XC, Perlane®, Perlane-L®, Restylane®,  Restylane-L®.  Restylane® Silk are all hyaluronic acid fillers.  Hyaluronic acid is a substance that is present throughout the human body, acting to provide hydration and lubrication to various tissues.  Hyaluronic acid soft tissue fillers can be used to treat fine wrinkles, deep wrinkles, creases, and to add volume where it has been lost over time.  Hyaluronic acid fillers are safe and non-toxic.

Radiesse® is made from calcium hydroxyapatite powder in a gel form.  This is the natural component of bone.  It is safe and non-toxic. It must be injected into deeper tissues.

Sculptra® is injectable poly-L-lactic acid. Details about Sculptra® can be found here.

Which filler is right for me and can they be combined?

We think of these various fillers as different paintbrushes for different parts of the canvas.  We use specific fillers for specific areas of the face.  They may be safely combined to give full facial rejuvenation, the so-called “liquid facelift”, with minimal/no downtime.  Schedule a consultation today to determine which options are best suited to your individual needs.

What areas can be treated by hyaluronic acid fillers?

The areas of treatment include:

  • Temples
  • Brows
  • Crow’s feet (the fine wrinkles around the corners of the eyes)
  • Tear troughs (the under eye hollows near the nose, where the lower eyelid meets the cheek)
  • Volume loss of the cheeks and midface
  • Nasolabial creases (the so called “smile lines” that extend from the corner of the nose to the corner of the mouth),
  • Upper and lower lip “lipstick lines” (the fine radial lines of the upper and lower lips)
  • Restoration of lip volume and definition
  • The corners of the mouth
  • The so-called marionette lines extending from the corner of the mouth to the jaw
  • Fine skin wrinkles of the cheeks
  • Depressed scars from acne or trauma

Soft tissue fillers are commonly used in combination with neuromodulators such as BOTOX® Cosmetic or Dysport®  to weaken overactive muscles and can also be combined with other treatment options, such as laser resurfacing and Ultherapy® in order to give you full facial and neck rejuvenation with minimal to no downtime.

In general, fillers cannot be used to rejuvenate the neck.

How long do fillers last?

Each hyaluronic acid filler has slightly different properties, which results in some differences in their duration of effect.  In general, most fillers will last from between six months to one year. Juvederm® VolumaTM XC has been shown to last up to two years in clinical trials. Radiesse® has been shown to last up to one year.  The location of placement also will effect how long particular fillers will last, with slightly shorter duration when injected into areas that are frequently in motion (such as the lips, nasolabial grooves, and corners of the mouth).

Does treatment hurt?

This is a very common question for first-time patients.  We offer our patients topical numbing cream prior to treatment in order to make treatment as comfortable as possible.  Additionally, many injectable fillers have lidocaine pre-mixed into the product.  This also helps to make for a more comfortable experience.  Our goal is to make your visit as comfortable as possible!

What to Expect After Treatment

Mild bruising and swelling may occur.  You will see improvement immediately after treatment and this will continue to improve and soften over the first two weeks.  It is recommended that immediately after the treatment, the head stay elevated for three hours.

Can fillers be removed?

Hyaluronic acid filler can be removed using hyaluronidase enzyme.  This is a separate injection and results in breakdown of the filler over a few days.  Occasionally, repeat injections may be necessary.