Filler Composition

The majority of fillers today are comprised of a naturally occurring substance in the body known as hyaluronic acid, or HA.  Found in connective tissues and cartilage, HA is not derived from animal sources, and it is compatible with the human body.

Differences in HA fillers are based on varying degrees of softness.  Some fillers are soft and thin, ideal for areas such as the lips, while others are more gel-like and sturdier, better for enhancement of cheekbones.

Method of Action

When injected into the skin, HA fillers act as a cushion to support facial tissues that may have lost volume and elasticity.  They also draw water to the surface of the skin, improving skin quality and helping skin look fresh and supple.

Indications for Use

Fillers can be used throughout the face to diminish facial lines and restore volume and fullness.  Fillers can plump thin lips, fill-in “laugh lines” around the mouth and chin, augment the cheek, and improve jowling.  Fillers can improve the appearance of set-in wrinkles, such as in the forehead and crows feet, or used to correct subtle asymmetries and smooth irregularities that were the result of injury, or present from birth, such as in the nose.

After listening to a patient’s desired areas of improvement, a facial analysis and skin evaluation is performed.  The treatment sites are determined, and the skin is cleansed of makeup and oil.  Depending on a patient’s comfort level with injections, topical medicine or a cold pack can be applied to temporarily numb the skin, or a nerve block performed for particularly sensitive areas.

Fillers come in pre-filled syringes and are administered in a series of injections.  The skin is massaged to evenly distribute the filler, and a cold pack applied to minimize swelling and the chance of bruising.

Fillers require little recovery time.  We recommend patients use a cold pack for the first twenty minutes after injections to minimize the chance of swelling or bruising.  Patients are asked not to massage their injection sites, or engage in vigorous exercise for 24 hours.

We believe in being preemptive to avoid any side effects, but occasionally the following may occur:

Localized Reactions: Patient’s may have temporary swelling, redness, or soreness at the site of injections.  These reactions typically resolve within 24 hours.

Bruising:  Bruising develops within a day, and typically resolves within a week.  The bruising from fillers is normally light enough that it can be covered by makeup.

Over/Under Correction: Depending on the filler, it may take several days, to a week, to see your final results.  The skin and overlying tissues need to settle, and any swelling to resolve.  As a result, more severely affected areas may need several treatment sessions to see appropriate correction.  If an area is overdone, there is a medicine that can dissolve the filler, if needed.

Palpability of Filler:  Depending on the level of the skin that the filler is placed, patients occasionally describe feeling the filler underneath the skin.  This can be in the form of a lump, nodule, or ridge. These will resolve spontaneously with time.

Asymmetry:  Despite best practices, asymmetry may occur after filler administration, requiring additional treatments to correct

Number of Treatments: Some patients may require multiple treatments in order to reach a desired result.

Duration of Results: Fillers create impressive improvement, but their results are only temporary.  Fillers can delay the need for surgery, but if not re-treated, the gains obtained with fillers will disappear, and the facial appearance present before treatment, will return.

How long will my filler last?

There are many fillers, each with a different expected length of action based on its composition. Filler duration also depends on the location of placement, as areas with more movement, such as around the mouth, cause faster resorption of the filler than areas where little motion occurs, such as the cheek and temple regions.  In our practice we use fillers that can last from 3 months to over 2 years.

Will fillers take away my wrinkles?

Though often talked about in the same conversation, wrinkle relaxers and dermal fillers work in different ways to improve a patient’s appearance.  Wrinkles form as skin contracts and relaxes due to the actions of muscles underneath the skin surface. Wrinkle relaxers, such as Botox and Dysport, temporarily paralyze these muscles, preventing wrinkles from becoming permanent and deep-set.  Dermal fillers lend support to surrounding tissues while adding volume to smooth areas that have sagged and atrophied with age, such as the cheek or laugh lines around the mouth.

Can I have a wrinkle relaxer and filler placed in the same setting?

Yes, wrinkle relaxers and dermal fillers can be safely used together, and can complement each other’s effects.  For example, a wrinkle relaxer placed in the same area as a filler can prolong the filler’s duration by limiting motion of the underlying muscle, thereby slowing the body’s resorption of the dermal filler. Conversely, dermal fillers can help smooth the appearance of a wrinkle that persists, despite the use of a wrinkle relaxer.