Figure 1. Juvederm
More and more people are coming to see me for injectable fillers such as Juvederm and Restylane. These types of fillers are known as hyaluronic acid (HA) fillers and they improve the facial appearance by lifting and adding volume to the wrinkles and folds in the treatment area. Common treatment areas include:
1) nasolabial folds—folds between the nose and the corner of the lips
2) eyelids—help improved the dark circles or “bags” under eyelids
3) cheek bones
4) lip augmentation
There are various different types of fillers that can safely be injected to improve the appearance of the face. Injectable fillers include a variety of materials, which last for different lengths of time and have different effects and uses. I like using HA fillers such as Juvederm and Restylane since they are safe and well tolerated in the skin. HA fillers are injectable fillers that include hyaluronic acid, a natural complex sugar that bolsters skin elasticity, providing a smooth and supple appearance. It is biocompatible, supplementing the body's natural hyaluronic acid, which age has depleted.
HA fillers are transparent gels that are injected with a syringe into the mid- to deep dermis of your face. The dermis is the subsurface skin layer that contains connective tissue, nerve endings, sweat and oil glands, and blood vessels.
The advantage of using HA fillers such as Juvederm or Restylane is that they can offer long-lasting outcome without risks associated with permanent fillers and they can be safely repeated.
Side effects with Juvederm and Restylane are rare, but may include redness, tenderness, or pain at the injection site. If these occur, they usually subside within three days. Rarely, discoloration may occur, but this is reversible. Firmness, swelling, bumps and bruises are also rare side effects, and should subside within seven days. As much as I try to avoid bruises, they are sometimes inevitable and patients may use concealers to cover the bruise up. A yellow-based concealer paste can often help “disguise” the underlying bruise.
How is the procedure done?
The procedure is done in the office and I usually use topical anesthetic and some ice to the area to help prevent bruising while I inject the product. I also like to have some local anesthetic placed directly in the filler product to ensure as completely comfortable experience for my patients as possible. The procedure usually takes anywhere form 10-30 minutes depending on the surface area of the treated areas.
You will notice some immediate improvement in the office; but you will see the final result of the treatment a few days once the mild swelling has resolved. You are able to resume most regular daily activities after leaving the office—your doctor should go over these with you.
How many syringes do I need and what is the cost of fillers?
This is a fairly common question and it all depends on how heavy your folds are and to what level of improvement you wish to achieve. Some end up using one syringe while others require more than 3 syringes. The price range per syringe is anywhere from 650-800 dollars and depends on the type of product and size of syringe.
How long does it last for?
After 9-12 months, the biocompatible compound is naturally absorbed into the body. However, some patients find improvements that last up to 1-2 years.
Figure 2. Lip augmentation to enhance the upper and lower lips (top is pre treatment, bottom is post treatment). Restylane was used in this patient.
Figure 3a.
Figure 3b.
Figure 3. Pre and post treatment for the heavy nasolabial folds and marionette lines using Juvederm Ultra Plus.
Figure 4a.
Figure 4b.
Figure 4. Pre and post treatment for the heavy nasolabial folds and marionette lines using Juvederm Ultra Plus.
