So how do those Beautiful People in Hollywood do it? Is it surgery and Botox? Well sure, some of it is, but fillers are a necessary part of the fight against “looking old”. Why this is true has to do with the process of aging going hand in hand with LOSS OF VOLUME.
As we mature, our skin thins, the tissues below the decrease in volume, and the bones even shrink, (!). In addition to this, the volume in the face shifts…down towards the jawline. When fillers are placed high in the cheek/midface area, a more youthful look is achieved no matter what the condition of the skin or how many wrinkles are present. In regards to wrinkles, fillers are used to support the “base” of a wrinkle to lift it up.
Many fillers have been tried over the years, and the laboratory-made, (“non-animal derived”), absorbable fillers have greatly increased the popularity of fillers because they are easy to use, and very low in complications such as allergic reactions. All the “absorbable” fillers also increase collagen formation to help replace this component of skin and soft tissues that is lost over time, and this effect helps reverse some of the thinning of the skin and subcutaneous tissues.
The two most popular categories of volume fillers are Hyaluronic Acid fillers, (such as Restalyne, Juvederm, Belotero & Perlane), and Calcium Hydroxyapatite, (Radiesse). Hyaluronic Acid is a “plumping” sugar molecule in the skin that decreases in amount as we mature, so the Hyaluronic Acid fillers help “give back what nature has taken away”. The different types of Hyaluronic Acid fillers vary in their firmness and how long they “last”. An added advantage of the Hyaluronic Acid fillers is that they may be “dissolved” and thereby removed, with an injection of the, (animal derived), enzyme Hyaluronidase. The second category of absorbable filler, Calcium Hydroxyapatite, is composed of the same minerals our bones are made of, but is made in a laboratory. This filler is firmer than the Hyaluronic acid fillers, and because it is a “firmer” filler, it is not appropriate for all areas, (like lips), but is better at lending support, like in the cheeks.
How long does the filler “last”?
In different clients, this may vary, some people are faster or slower at metabolizing, or “breaking down” the filler than others. In general, The Prevelle lasts 2-3 months, Restalyne/Perlane products absorb in about 6-9 months, the Juvederm/Belotero products take about 9-12 months, and Calcium Hydroxyapatite lasts 12-15 months. This is a gradual process, and by having periodic “fill-ups, results are maintained.
Does it hurt?
These products are administered with a needle, so there is some discomfort. At our practice a strong “numbing” cream and a “chiller” machine are used on the surface of skin, and most of the fillers themselves are mixed with numbing, (lidocaine), medicine. Certain areas are more sensitive than others, like lips are more sensitive than cheeks.
Will there be bruising?
The answer to this is yes, and no. Some clients bruise more easily than others, and some areas of the facial tissues are prone to bruise than others. Medications such as aspirin and ibuprofen increase the tendency to bruise, as does ingesting the “g” herbs such as ginseng, garlic, gingko, even green tea and fish oils. Taking Arnica Montana homeopathic preparation is helpful before and after a treatment, as is avoiding the substances above before a treatment. If there is a bruise, it usually last about one week.
Are there allergic reactions?
The Hyaluronic Acid and Calcium Hydroxyapatite have very low risk of allergic reaction, unlike the “collagen products” of the past.
What about the “other” fillers?
Less popular fillers are:
- Collagen, now made in a form that has a very low risk of allergy, however, it is very short lasting, typically about 2- 3 months.
- Poly-l-lactic Acid,. “Sculptra”, not a true “volume filler, but stimulates collagen growth over about two years, and is often used to help thicken skin that is very thin. Nodules have been reported with use of this filler.
Which filler is “best”?
There is not one “perfect filler”, as the purpose for which the filler is being used, (volume or support), and the location, will dictate which filler is “best”. An experienced injector with an inventory that includes all the possible fillers will provide the best possible result for bringing back the “young look” without an unnatural appearance.