Fillers, Wrinkle Fillers, Non-invasive Not Surgical options in Columbus, Ohio

What areas of the face can be improved with fillers?
Fillers are most often used for the nasolabial folds (crease between the cheek and upper lip, otherwise referred to as the smile lines), the marionette folds (crease extending from the corner of the mouth to the chin), and for augmentation of the lips. In the case of shallow folds and lines the gel fillers ? Restylane, Juvéderm, and Hylaform work best. Typically 1.0 -1.4 cc of product is adequate to deliver the desired improvement.

Radiesse, which is a higher density paste, is usually better suited for individuals with deep naso- labial and marionette folds. The thicker paste provides more volume for filling in these areas.  One syringe of Radiesse which delivers 1.3 cc is usually adequate to treat these areas.

The ideal filler for lip augmentation and lip lines preserves their soft supple feel. Collagen performs well in this location but unfortunately lasts for only 2-3 months. Gel fillers like Restylane, Juvéderm, and Hylaform are also good options and usually last for 4-6 months.

The under eye area is a common area of concern as we age. In some cases the hollowness and dark circles can be addressed with either Restylane or Radiesse. However because of the thin nature of the under eye skin, any filler must be injected into the deeper subcutaneous tissue where the product will reabsorb more quickly. Fat, on the other hand, which is permanent is an excellent filler options for this location.

Currently there is no good filler product for crow's feet and forehead wrinkles.  These are considered dynamic lines; they arise as a result of muscle movement. Botox Cosmetic is the treatment of choice for these lines. However, when Botox Cosmetic alone is not enough for the deep vertical lines between the eyebrows, the gel fillers (Restylane, Juvéderm, Hylaform) can aid in the improvement. Studies show better and longer lasting improvement of these lines with a combination of Botox Cosmetic and gel fillers.  

Are any of the filler materials permanent?
Artefill is the only FDA approved non-absorbable injectable filler for the correction of wrinkles known as "smile lines".  The unique microspheres in Artefil are not absorbed by the body. These microspheres provide the permanent support the skin needs for long lasting wrinkle correction.   In the US Clinical Study, full wrinkle correction was maintained throughout the one year study. However European studies have demonstrated up to ten years of effectiveness with similar products.

What should I expect after a filler product injection?
With all injectable wrinkle fillers you can expect mild swelling and redness at the injection site. These effects will last from 24-48 hours. Occasionally there is mild bruising which typically disappears in three to seven days. Less common side effects include a rash or itching more than 48 hours after treatment, persistent swelling or redness, and increased sensitivity at some or all injection sites. One other rare potential side effect of all dermal fillers is lumps or unevenness with gel fillers (Restylane, Juvéderm, Hylaform).Unevenness of gel fillers usually responds to massage within five to seven days.  In the case of Radiesse and Artefil, lumps may signal a tissue reaction. Massage is encouraged however further treatment may be necessary.

What improvements can be made in the cheek area with fillers?
As we age, several events occur around the eyes, cheeks, and midface which contribute to a "tired"and aged appearance. Most notably, we lose fat in our face. This leads to loss of the normal cheek highlight, dark circles under the eyes, and hollowness of the cheeks. Volume restoration is often the treatment of choice. Typically fat transfer to the site or cheek implants  provide the best improvement however in selected cases, fillers can be used.

Gel fillers like Restylane, Juvéderm, Hylaform are used in the under eye area. This is an area of very thin skin. Therefore, a filler should be injected deep under the eyelid muscle layer. In this location the results may not last as long. Radiesse has also been injected for this purpose, c, however, is recommended because the white color of this product may show through very thin transparent skin.

Sculptra is used extensively for AIDS patients with moderate to severe lipoatrophy of the face. It can also be used for the fat volume loss changes which occur with chronological aging. In these cases, several Sculptra injection sessions are necessary to achieve the desired result. 

How should I choose my doctor?
All of the currently available filler substances are safe and effective when used appropriately and injected correctly. The skill of injection is easy to learn. What is not easy is recognizing who is a candidate, which of the myriad of fillers and procedures will give the best results, and lastly recognizing and treating side effects should they arise. A properly trained physician goes through a complex paradigm of treatment options for every patient.  The goal to any treatment will fillers should be to achieve the best possible improvement with the least amount of risk. This knowledge and expertise comes through years of proper residency training and experience not from a weekend course.  Always check your doctor's qualification and look for board certification in Facial Plastic Surgery, Plastic Surgery, or Dermatology.