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Dermal Fillers

What are Dermal Fillers?

As we age, loss of facial volume and elasticity results in facial drooping, hollowness, and permanent lines or grooves on the face. Dermal fillers are substances that are injected under the skin to restore volume and to diminish deep lines or furrows on the face. There are many different fillers available, and each one has a specific indication or use. One of the easiest ways to categorize the various fillers is by their molecular structure.

  • Hyaluronic Acid (Juvederm, Restylane) – Hyaluronic acid (HA) is a naturally occurring substance found in soft tissue and skin, and it plays a role in keeping the skin plump and hydrated. HA fillers are used to temporarily diminish lines and wrinkles and to restore volume to areas that have become deficient, including cheeks, under eyes, and lips.
  • Calcium Hydroxylapatite (Radiesse) – Calcium hydroxylapatite is a substance typically found in bone. It can be synthetically produced and used as an injectable filler to fill in and diminish moderate to severe wrinkles. It is also used to restore volume in areas that have become volume deficient, including the back of the hands.
  • Polylactic Acid (Sculptra) – Polylactic acid is a synthetic material that stimulates the body to produce its own collagen. Results are not immediate, but appear over several months, as the body begins to create its own collagen. Most patients require several treatments, but the effects last longer than with other types of fillers.

Who is a candidate for Dermal Fillers?

You may want to consider injection of dermal fillers if you are concerned about:

  • Deep forehead lines that persist despite use of botulinum toxin
  • Smile lines (lines that run from the nose to the outside of the mouth)
  • Marionette lines (lines from the corner of your mouth to your chin)
  • Loss of volume in your cheeks
  • Hollowing under the eyes
  • Lack of volume in your lips

How are Dermal Fillers injected?

Dermal fillers are injected in the office. Injections are performed with very fine or blunt needles. Topical anesthetics can be applied prior to injection. Regional anesthetic blocks are also employed to assist with pain control. Some of the fillers have lidocaine mixed with them, resulting in decreased pain with injection.

Dermal fillers can be combined with injection of botulinum toxin to enhance the outcome of both procedures. Together, they can diminish wrinkles and provide improvement in contour and volume.

Risks

All procedures are associated with risks. Risks associated with dermal filler injection include bruising, prolonged swelling, asymmetry, and need for revisional procedures. Extremely rare but serious complications include skin necrosis and blindness. For this reason, it is important to use a highly trained practitioner with a strong knowledge of anatomy and technique to decrease the risk of adverse complications.

Recovery

Dermal filler injections are performed in the office. Depending on the number of areas injected, the procedure can take between 15 minutes to an hour. Patients may resume regular activities immediately after the procedure. Depending on the location and type of filler used, swelling may persist for up to a week or more.