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Key Things You Should Know About Dermal Fillers


Millions of people worldwide receive dermal filler injections yearly, and the numbers are rising. It is one of the top non-invasive procedures performed in the world. Dermal fillers are a quick, effective way to improve your appearance and keep you looking younger for longer.

What do fillers in your face do?

Dermal fillers are substances injected into your face to improve your appearance and help with anti-aging. As we age, several things happen to our faces.

  • Loss of bone and muscle that gives us a sunken look
  • Fat redistributes and descends, causing the appearance of jowls
  • Skin becomes wrinkled and sags

Dermal fillers can help diminish the appearance of aging in various ways; however, they are not a substitute for a facelift or other surgical procedures.

  • Fill-in lines and wrinkles
  • Restore volume
  • Plump lips
  • Contour jawline
  • Lessen dark circles under the eyes
  • Rejuvenate the hands
  • Lessen the appearance of scars
  • Contour the chin
  • Elevate the corners of the mouth
  • Lift brows
  • Fill-in the temples
  • Redefine the nose

What is the difference between Botox and fillers?

Botox and fillers are excellent tools in our anti-aging armamentarium, but they work differently. Dermal fillers, as the name suggests, fill in spaces or lines to volumize, plump, or contour the face. Botox relaxes muscles to prevent wrinkles from appearing. They work well together and complement each other. Combination treatment often helps you achieve better anti-aging results than one procedure alone.

Are fillers painful?

Filler injections are not painful but can cause minor discomfort for some. There are ways to lessen the discomfort, making the procedure almost pain-free. Today, many fillers are combined with the anesthetic lidocaine to help with the pain. Many injectors use nerve blocks or numbing cream to help as well. Some injectors use vibratory devices to distract the patient and lessen any discomfort. Also, ice packs can be used before, during, and after injections to numb the area.

Are fillers good/healthy for your face?

Fillers are a less invasive alternative to surgery to achieve some of your anti-aging goals. Here are some of the benefits of fillers.

  • There is no risk of general anesthesia or invasive surgery with fillers.
  • There is no downtime with most fillers.
  • Little to no risk of scarring with fillers if performed correctly.
  • Fillers, like hyaluronic acid, can be reversed if you do not like the results.
  • Some fillers are temporary, so if you are not pleased with your results, they will fade with time.

When dermal fillers are injected by qualified injectors who understand the anatomy of the face and the inherent differences in the various fillers, amazing results can be achieved with little risk or downtime.

Always have a consultation with your injector before receiving dermal fillers. Review your goals, expectations, medical history, and medications with your injector before receiving injections. It is vital your injector also discusses the risks of all procedures.

If you are pregnant or breastfeeding, you should not have fillers injected. Patients on certain medications or who have certain medical problems also may not be candidates for fillers.

Are there any risks?

There are risks with any procedure. The more skilled and knowledgeable your injector is, the less chance of complications.

Here are the most common temporary side effects:

  • Redness
  • Swelling
  • Bruising
  • Tenderness
  • Bleeding
  • Textural irregularities
  • Itching

There are rare complications that can be severe and permanent:

  • Nerve damage
  • Delayed nodules
  • Infection
  • Scarring
  • Reactivation of herpes
  • Asymmetry
  • Skin necrosis
  • Blindness
  • Stroke
  • Death

What are the dermal filler types?

Different dermal fillers are available and vary based on their composition and longevity. They are not interchangeable and should only be used in particular sites on the face depending on the filler type. For example, thicker products such as Calcium hydroxylapatite are injected deeply and used to fill deep wrinkles. They should not be used for plumping the lips. Softer products, like some hyaluronic acid fillers, are perfect for the lips. Many of these fillers are FDA approved to treat only certain areas of the face but are often used off-label in other parts of the face.

Hyaluronic acid (HA) - HA fillers are composed of hyaluronic acid, a naturally occurring substance in parts of our bodies, such as skin and joints. It is a soft gel-like product that gives natural results. It hydrates while it volumizes. Several different filler manufacturers in the US have FDA approval for their products. These HA fillers differ based on particle size, concentration, and crosslinking.

  1. Juvederm family of fillers
    1. Ultra - It can last 6-12 months and is FDA approved to treat moderate to severe wrinkles and folds on the face, such as the nasolabial folds, lips, and perioral areas.
    2. Ultra Plus - It can last 6-12 months and is FDA approved to treat moderate to severe wrinkles and folds on the face, such as the nasolabial folds.
    3. Voluma - It can last up to 2 years and is FDA approved to treat the cheeks and chin.
    4. Volbella - It can last up to 12 months and is FDA approved to treat the lips, perioral lines, and undereye hollows.
    5. Vollure - It can last up to 18 months and is FDA approved to treat moderate to severe wrinkles and folds on the face, such as the nasolabial folds.
  2. Restylane family of fillers
    1. Restylane L - It can last 6 months or more and is FDA approved to treat moderate to severe wrinkles and folds on the face, such as the nasolabial folds.
    2. Silk - It can last up to 6 months and is FDA approved to treat lips and perioral lines.
    3. Lyft - It can last up to 12 months and is FDA approved to treat moderate to severe wrinkles and folds on the face, such as the nasolabial folds and the cheeks.
    4. Refyne - It can last up to 12 months and is FDA approved to treat moderate to severe wrinkles and folds on the face, such as the nasolabial folds and the lips.
    5. Defyne - It can last up to 12 months and is FDA approved to treat moderate to severe wrinkles and folds on the face, such as the nasolabial folds and the lips.
    6. Kysse - It can last up to 12 months and is FDA approved to treat moderate to severe wrinkles and folds on the face, such as the nasolabial folds and the lips.
    7. Contour - It can last at least 12 months and is FDA approved to treat the cheeks and midface contour deficiencies.
  3. Belotero Balance - It can last 6 months or more and is FDA approved to treat moderate to severe folds and wrinkles on the face, such as the nasolabial folds.
  4. Revanesse
    1. Versa - It can last 12 months and is FDA approved to treat moderate to severe folds and wrinkles on the face, such as the nasolabial folds.
    2. Lips - It lasts at least 6 months and is FDA approved to treat the lips.
  5. RHA family of fillers: They can last up to 15 months and are FDA approved to treat moderate to severe folds and wrinkles on the face, such as the nasolabial folds.
    1. RHA 2
    2. RHA 3
    3. RHA 4

Calcium hydroxylapatite (CaHA) - CaHA fillers contain calcium, a naturally occurring substance in our bones. Because it contains calcium, it can be visible on CT scans and X-rays. It is a thicker product and tends to last longer than HA fillers. CaHA is placed under the skin to help eliminate deep wrinkles. Studies have also shown that it can stimulate your body to produce collagen.

  • Radiesse - It can last up to 18 months and is FDA approved to treat moderate to severe folds and wrinkles on the face, such as the nasolabial folds and the back of the hands.

Poly-L lactic acid (PLLA) - PLLA filler is composed of material used to manufacture sutures. However, it is not a true filler. It is a bio stimulator that stimulates your body to produce collagen. Because it is a bio stimulator and not a traditional dermal filler, it lasts longer and gives semi-permanent results. It is also injected under the skin to fill in deep wrinkles.

  • Sculptra - It can last 2 or more years and is FDA approved to treat HIV lipoatrophy and to smooth facial wrinkles, such as smile lines.

Polymethylmethacrylate (PMMA) - PMMA is a permanent filler composed of tiny plastic balls suspended in a collagen gel. It is a thick product injected under the skin to fill deep wrinkles.

  • Bellafill - It lasts at least 5 years and maybe forever. It is FDA approved to treat nasolabial folds and moderate to severe, atrophic, distensible facial acne scars on the cheeks.

Autologous fat (AF) - AF requires a surgical procedure called liposuction to harvest your fat. Your fat is then purified and injected into the areas in your face requiring filling and rejuvenation. It is a permanent way to fill deep wrinkles, but it does have more side effects, risks, and downtime.

How long do fillers last?

The composition of the dermal filler determines the longevity of the results. HA fillers tend to last 6-12 months. CHA can last over a year, while PLLA may last two or more years. PMMA and AF are likely permanent products.

What happens when fillers wear off?

Temporary fillers gradually disappear over months as our bodies slowly break them down. There is no sudden disappearance of the product.

One size does not fit all when creating an anti-aging plan. Most people start to consider dermal fillers when they first notice the signs of aging, which varies from person to person. Many begin by plumping their lips in their 20s or 30s and then graduate to filling their nasolabial folds and cheeks in the 40s or 50s. It is a personal decision based on your genetics, desires, and goals. It is best to discuss your options with your injector so they can create a personalized plan.

Key takeaways

Dermal fillers are a quick, less invasive way to restore your youthful appearance.

Depending on what areas you want to be treated and your treatment goals, your injector will help you select the correct type of dermal filler for your needs.

In the right injector's hands, dermal fillers have little risk of complications.

Never buy fillers on the internet and inject them yourself. This is very dangerous.

References

https://www.aad.org/public/cosmetic/wrinkles/fillers-overview

https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/fda-approved-dermal-fillers

https://www.allerganaesthetics.com/en/botox

https://www.juvederm.com/

https://www.restylaneusa.com

https://radiesse.com

https://www.sculptrausa.com

https://bellafill.com

https://revanesseusa.com/

https://rhacollection.com

https://www.belotero.com

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