Soft-tissue fillers are injected to enhance volume, recontour the face, diminish wrinkles and fill in depressed areas. These fillers are either temporary hyaluronic acid or collagen-based; longer-lasting fillers that contain microscopic particles that stimulate collagen deeper in the skin; permanent fillers, which aren’t broken down; or fat, which requires a liposuction-like procedure to be performed to extract fat from an area on your body.
HYALURONIC ACID FILLERS
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What are they?
Hyaluronic acid, usually suspended in a gel, can be injected to fill in lines, plump wrinkles, and add fullness. Working from the inside, hyaluronic acid fillers attract water to substitute the volume that has been lost with a nearly identical replacement.
The nuances associated with all hyaluronic acid fillers are the same, but each has a different molecular size, or density. This range allows skilled injectors to choose the right product for your skin type and implement the changes you wish to make. The more dense or thick the hyaluronic gel, the deeper it needs to be injected and the larger the needle size needed to inject it. These thicker gels are most appropriate for building volume, like in the cheeks, and because of their size are more likely to cause visible needle marks and some bruising after treatment. The less dense hyaluronic acids can be injected with a finer needle and do not need to be injected as deeply as the thicker formulations. These work well for fine wrinkles around the eyes or bleed lines on the upper lip.
Used to correct:
- Nasolabial folds (smile lines)
- Wrinkles
- Volume loss in the cheeks, chin and jawline *
- Nose bumps ("injectable nose job") *
- Thin lips *
- Droopy brows *
- Under-eye hollows *
- Tear troughs *
- Bony chest *
- Sunken temples *
- Acne scars *
- Drooping earlobes *
- Foot pain *
(*indicates an off-label use)
Brands
- Restylane
- Perlane (contains larger particles, intended for deeper injection)
- Juvéderm, Juvéderm Ultra, Juvéderm Ultra Plus
- Prevelle Silk (contains lidocaine for simultaneous pain relief)
- Elevess (contains lidocaine for simultaneous pain relief)
- Belotero
Treatment and Results
Your ExpertInjector™ will first apply topical anesthesia (in cream form) to the treatment area(s), and let it sit for 15 minutes to an hour, depending on where and how many areas are being treated, before administering the injectable (except with Elevess and Prevelle).
Side Effects and Risks
Temporary bruising, swelling, lumpiness, possible infection, allergic reaction.
SEMI-PERMANENT FILLERS
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What are they?
Longer-lasting collagen-stimulating fillers contain microscopic particles that prompt your body to make new collagen, leading to smoother skin and the correction of moderate to severe volume loss. Even though they are formulated differently—poly-L-lactic acid versus calcium hydroxyapatite—these kinds of fillers work similarly to create longer-lasting results.
The boost in collagen is essentially an immune reaction to the injected material that helps plump the area from within. Rather than instantly filling lines like traditional fillers, it adds volume that lifts the soft tissues, ultimately diminishing lines that way. These fillers are administered more deeply and are best suited for those with thicker skin.
Used to correct:
- Shallow to deep nasolabial folds
- Moderate to severe wrinkles
- Volume and fat loss in the cheeks and midface *
- Jawline *
- Bony hands *
- Nasal asymmetry *
(*indicates an off-label use)
Brands
- Radiesse: This thicker, calcium-based filler stimulates new collagen production in the injected area, while adding volume and providing some lift. Results last about a year.
- Sculptra Aesthetic: This poly-L-lactic acid filler can achieve notable volume with long-lasting results (1-2 years) appearing after three or four treatments spaced several months apart.
Treatment and Results
The 10-minute treatment is preceded by local anesthesia, and then involves 10 to 20 injections. Likely to exhibit cumulative results after multiple treatments, collagen-stimulating injectables are administered more deeply and are best suited for those with thicker skin. The gradual results last one to two years, sometimes more.
Side Effects and Risks
Soreness, puffiness, bruising, lumpiness, possible infection, allergic reaction.
Not Appropriate For…
Fine lines, lips, tear troughs.
PERMANENT FILLERS
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What are they?
Artefill is the only permanent dermal filler, and it is comprised of synthetic microspheres suspended in collagen. These microspheres do not disintegrate over time; instead they remain in the tissue after the collagen gel is absorbed, and new collagen grows around the microspheres much like scar tissue.
Artefill is most appropriate for deeper filling and contouring, and it is not recommended for use in areas of high movement, like the lips.
Used to correct:
Brands:
Treatment and Results
An allergy test is required prior to Artefill injections, which are not typically recommended to first-time filler patients. Although its FDA label still puts the longevity of its results at only 12 months, it has been shown to last five years. The only way to undo Artefill’s results is through surgical removal.
Side Effects and Risks
Possible allergic reaction, infection, persistent redness, or granulomas (lumps) that can occur years after injection and require surgical excision.
Not Appropriate For…
Lip augmentation, or any area with frequent movement.
FAT INJECTIONS
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What are they?
More permanent than the most popular dermal fillers, fat injections involve harvesting the patient’s own fat and strategically reinjecting it to replace lost volume or reshape the face. Often performed in conjunction with a facelift, today's injection techniques allow doctors to place the fat in a manner where a significant number of the fat cells will survive, providing long-term results.
Because the fat is your own tissue, there is no risk of allergic reaction or rejection.
Used to correct:
- Hollows under the eyes
- Volume loss in the midface and jawline
- Nasolabial folds
- Thin lips
- Lines around the mouth
- Bony hands
- Lumpectomy tissue loss
- Lack of volume or dimples in the buttocks
Treatment and Results
First, a liposuction technique is used to harvest fat from an area such as the hips or thighs. After being prepared, it is put in small syringes and then strategically reinjected to replace lost volume or reshape contours. You’ll see results instantly, but overfilling is necessary to ensure that enough fat “takes.” In fact, up to 50 percent of fat injections remain permanently, but your doctor may recommend a secondary procedure to ensure lasting results.
Side Effects and Risks
Bruising and swelling at donor and recipient sites, lumpiness, possible infection.