If
you'd like to restore youthful fullness to your face, enjoy plump lips,
enhance shallow contours or soften those facial creases and wrinkles,
dermal fillers may be the answer. Dermal fillers have been called
"liquid facelifts" because they offer many of the benefits of a surgical
facelift without the downtime.
Although they can't help with excess sagging skin, these soft tissue
fillers can add more volume and provide immediate results at a lower
cost than surgery. These treatment aren't permanent, however, and they
must be repeated and maintained.
Some dermal fillers are used in conjunction with other skin
rejuvenation treatments such as injections of botulinum toxin. Your
plastic surgeon will assess your needs and recommend one or a
combination of treatments to achieve your desired results.
Wrinkle fillers can be divided into two categories: Temporary and Semi-Permanent.
Temporary
Human fat, also known as autologous fat, is harvested from your own
body. Using your own fat requires a more extensive procedure than other
injectable fillers because you first must undergo liposuction to extract
the fat prior to injection. You eliminate the risk of allergic reaction
or rejection by the body by using your own fat. You should know that
not all of the live fat cells survive when transplanted into a new site.
You can expect a fairly high rate of re-absorption. Because of this,
your doctor will likely overfill the area being treated. At first you
might look abnormal, but it will soon settle and you'll enjoy a new
look. When your doctor extracts this fat via liposuction, it's possible
that there will be more than is needed for one application. Most natural
fat can be stored for touch-ups.
Collagen
is a natural substance known as a protein, and the main component in
cartilage, teeth and bones. It is derived either from human skin or cows
(known as bovine collagen). Brand names include: CosmoDerm, Cosmoplast,
Zyderm, Zyplast.
Human cadaveric dermis is skin that's cultivated from a cadaver, then
injected into your face. This substance results in particularly
impressive filling of facial hollows. Brand names include: Cymetra,
Dermalogen, Fascian.
Hyaluronic acid
is also a natural substance found in your body. High concentrations are
found in soft connective tissue and in the fluid surrounding your eyes.
It's also in some cartilage and joint fluids, as well as skin tissue.
If the name sounds familiar, it's because the same substance is often
injected into the aching joints of people with arthritis to ease pain by
providing extra cushioning. Hyaluronic acid is not derived from animal
sources. Brand names include: Captique, Esthélis, Elevess, Hylaform,
Juvéderm, Perlane, Prevelle, Puragen and Restylane.
Calcium hydroxylapatite,
the heaviest of facial fillers, is found naturally in human bones. This
mineral-like compound is reserved to fill the deepest creases such as
nasolabial folds, marionette lines and frown lines. It's also used to
enhance fullness of the cheeks and other facial contours. Calcium-based
microspheres are suspended in a water-based gel. Brand names include:
Radiesse, Radiance.
Polylactic acid
is a synthetic material. When it is injected, it stimulates the body's
own production of collagen. This substance is known to work particularly
well in the lower half of your face to fill the lines caused by
laughing, to augment thin lips and fill out deep nasolabial folds. This
substance is unlike other dermal fillers because it doesn't produce
immediate results. Instead, it stimulates collagen production, so
results appear gradually over a period of a few months. Brand names
include: Sculptra, New-Fill.
Semi-Permanent
PMMA
(polymethylmethacrylate) fillers contain about 20 percent of tiny PMMA
microspheres that are suspended in 80 percent purified collagen gel.
This substance, considered semi-permanent, can be removed. PMMA is most
often used to treat medium-to-deep wrinkles, folds and furrows,
particularly nasolabial folds. It can also be used to fill out pitted
scars and to augment thin lips. PMMA has been used for many years in
permanent surgical implants. Because of this, your surgeon will likely
under-fill on the first treatment, adding more later if needed. Brand
names include: Articol, Artefill, Metacrill.
What happens during dermal filler injections?
Assess.
First, your surgeon will listen to your desired
results and then evaluate your facial appearance and skin tone,
examining the areas of your face to be augmented with a cosmetic dermal
filler.
Map a strategy.
Next, the surgeon will mark strategic points on your face as guides to the appropriate injection sites for the filler.
Clean the area.
Your injection sites will be cleansed with an antibacterial agent.
Then a topical anesthetic will be used to numb the area, particularly if
you are sensitive to injections. In some cases, the dermal filler
includes an anesthetic in the mixture.
Inject.
The actual injections will take just a few minutes total, and just seconds per site.
Clean up and ice.
The marks will be washed away and you will be offered an ice pack to
reduce any minor and temporary discomfort. At this point you may apply
makeup, but be careful not to apply pressure to the treated areas. Doing
so may result in movement of the dermal filler.
A special note about scars and deep lines: these areas will often
require multiple injections to achieve your desired results. If a deeper
injection is required, you'll be offered a local anesthetic to remain
comfortable. Common sites for deeper tissue fillers are the nasolabial
folds and marionette lines, or to enhance fullness in the cheeks.
Injectable
dermal fillers can plump thin lips, enhance shallow contours, soften
facial creases, remove wrinkles and improve the appearance of recessed
scars.