Who is a candidate?

Anyone who wants cosmetic improvement of smile and/or frown lines, cheek wrinkles, thin or wrinkled lips, cheek, under-eye, or chin hollows or scars is a candidate for this procedure.

Pregnant women should not receive injectable fillers and anyone with an allergy to any of the ingredients in the above mentioned products should not receive that type of injectable filler.

What is Restylane™, Perlane™, JUVÉDERM™ Injectable Gel, Radiesse®, Sculptra™, and CosmoDerm™ like?

Anesthesia is recommended for each filler treatment, as it is an uncomfortable procedure without it.  When you arrive for your appointment, a potent topical anesthetic will be applied to the areas that are to be treated.  We may follow that with dental blocks, injections into the gums, which completely numb the area, especially for upper lip and lower lip injections.  You do not have to have injection anesthesia if you do not wish.

The material is injected slowly into each line or area while you are laying down.  There is a fair bit of artistry involved in balancing the wrinkle and getting the 3-dimensional effect achieved to be aesthetically pleasing and harmonious.  Some may be injected into the body of the lip to enhance the volume.  We pride ourselves on natural looking results, one of our key guiding principles at Advanced Dermatology’s aesthetic division.

When the procedure is completed we supply you with an ice pack and do recommend icing the area on and off during the day.  Makeup may be applied immediately after the procedure, however, you need to expect anywhere from 2-5 days of swelling and redness.  If a nerve block was performed, you may not be able to eat or talk well for an hour or two post-treatment.

How does Restylane™, Perlane™, JUVÉDERM™ Injectable Gel, Radiesse®, Sculptra™, and CosmoDerm™ work ?

Injectable fillers work by putting volume into an area that has lost volume.  Certain fillers work by stimulating your own skin to make new collagen.  When this is done artfully, the appearance of lines and areas of concavity are erased, and a much more natural, youthful appearance is created.

What type of equipment is used?

Restylane™, Perlane™, JUVÉDERM™ 24HV Injectable Gel, JUVÉDERM™ Ultra Injectable Gel, JUVÉDERM™ Ultra Plus Injectable Gel, Sculptra™, Hylaform™, CosmoDerm™, CosmoPlast™, and Radiesse™ are utilized and purchased directly from the companies that distribute them.  We use sterile needles and syringes.  CosmoDerm™ and CosmoPlast™ require refrigeration.

What desired results can be expected?

The results are very gratifying for the majority of people.  Filling in lost volume and wrinkles can often transform one’s appearance in a very profound but natural way.  Most of the time one’s family and friends know something has changed but they are not sure what it is.  We pride ourselves on natural results as this is part of our core mission in aesthetic dermatology.

These fillers are temporary (see discussion below under negatives).  The length of duration for each filler is somewhat variable but expectation guidelines are as follows:  Hylaform™, CosmoDerm™, and CosmoPlast™:  2-4 months; Restylane™ 4-9 months; JUVÉDERM™ Injectable Gel 6-12 months; Perlane™ 9-15 months; Radiesse® 9-18 months; Sculptra™ 2 years (after a series of 2-4 treatments).

Are there any negatives?

The most common potential adverse events are swelling, redness, and bruising.  Most of the time redness and swelling are gone in 1-2 days, but it can occasionally take 3-5 days, and uncommonly 1-2 weeks.  Bruising can be prevented to a large degree by avoiding aspirin, vitamin E, and non-steroidal anti-inflammatory drugs (like ibuprofen) for the 7-10 days prior to the procedure.

Occasionally the material can clump in one place instead of diffusing evenly, resulting in a “lumpy” feel or an asymmetry.  This can usually be corrected either with deep massage, extrusion of the material, or injection of an enzyme that breaks down hyaluronic acid.

The fillers used at Advanced Dermatology are temporary, which may be viewed as a negative to some.  The fillers last anywhere from 2-24 months, but none stay forever.  Although a permanent filler is obviously an attractive option for you from a time and money aspect, the fillers that are permanent are usually some form of silicone or plastic, ie: not naturally occurring substances found in the human body.  These can lay inert for long periods of time and then become the focus of an allergic reaction as long as ten years later.  Since the filler is permanent, the reaction is too, and sometimes the only way to correct this is by surgically removing the filler.  In addition, permanent material may migrate (shift from place to place) over time, so what started in your smile line can wind up being a lump down by your jawline.  Thus we feel that “temporary” fillers that can be naturally absorbed and metabolized by your body are safer options.

What happens after Restylane™, Perlane™, JUVÉDERM™ Injectable Gel, Radiesse®, Sculptra™, and CosmoDerm™?

After the procedure you are provided an ice pack to take home which lessens the redness and swelling and advise you to periodically apply ice to the treated area for a couple of hours.  You may put makeup on immediately and resume whatever activities you have planned, as long as you recognize that you will be a little red and swollen for a half a day to a few days.  We usually ask you to come back at two weeks when everything is settled to evaluate your results and ensure that you are satisfied with the outcome and have had no problems.

The desired results of Sculptra™ are achieved over time.  Two to four treatment visits may be necessary to achieve the best results.

Is there another way to get the same effect?

There are many alternative fillers to those offered at Advanced Dermatology with many more awaiting FDA approval.  However, we use the majority of fillers approved by the FDA as well as those that are utilized most on a global basis.

Other treatment options used for reducing wrinkles, building volume and augmenting facial structure include, but are not limited to, BOTOX® Cosmetic, tissue tightening procedures such as Titan®, Thermage®, ReFirme™ ST, or Polaris™ WR, the PanG™ Lift.  More invasive procedures such as laser resurfacing (to soften deep wrinkles, although this will not enhance volume), fat injections (which require harvesting the fat from another part of your body and usually causes prolonged bruising), and rhytidectomy (face-lift) may also be considered as alternatives.

How is this different than other procedures?

This procedure usually provides immediate gratification, although there may be a period of a few days of swelling and/or redness.  Although it uses needles to inject a substance under the skin, it is usually less invasive and has less downtime than the other procedures that might be substituted.  In addition, other than fat injections (which costs more and has more bruising typically associated with it, although it may be more permanent) or implants, there really are few other ways to increase volume.

Can this be combined with other treatments?

BOTOX® Cosmetic is commonly performed at the same visit as injectable fillers.  BOTOX® Cosmetic helps with the upper one-third of the face whereas injectable fillers generally help with the lower two-thirds.  The combination is one of the most widely used and most effective methods of achieving a significant aesthetic improvement within 1-2 weeks time.

Fillers can be combined with just about any other aesthetic treatment that exists.  When it comes to high intensity lasers, we may recommend waiting a month after having the filler or doing the laser first, to avoid the unlikely chance of heating up the filler and altering its shape in the skin.

What is the cost of Restylane™, Perlane™, JUVÉDERM™ Injectable Gel, Radiesse®, Sculptra™, and CosmoDerm™?