Facial Fillers & Injectables

Facial Fillers and Injectables have been used for decades in an effort to rejuvenate the face, softening and minimizing the effects of aging. The fillers are, basically, a substance that is introduced under the skin to “fill in” areas where aging changes have occurred. These changes include wrinkles and folds as well as the volume loss associated with aging. Although most fillers are FDA approved for use in the correction of nasolabial folds, many physicians use them in an “off-label” fashion in a number of other areas.

The correction of deep facial wrinkles, particularly in areas that are resistant to other techniques (e.g., Botulinum toxin, facelifting, etc.) has been revolutionized by the development of reliable injectable fillers.

What Causes Facial Wrinkles?

Wrinkles are a sign of aging but are also a function of several other factors. Strong facial musculature may produce deep furrows, sun exposure, and cigarette smoke can produce fine wrinkles, and genetic factors make each individual more or less likely to develop wrinkles at any given age. Plus, the loss of facial volume also contributes to the development of facial wrinkles, analogous to the difference between a grape and a raisin.

What Areas are Commonly Treated with Dermal Fillers?

Dermal fillers are used to treat static wrinkles–those that are caused by a combination of gravity and loss of skin elasticity–they are typically located in the lower 2/3 of the face. These types of wrinkles include the nasolabial folds (those that go from the nose to the corner of the lips), marionette lines (those that go from the corner of the lips to the chin), “smoker’s lines” around the mouth, and fat loss in the cheeks.

Dr. Pero uses dermal fillers, such as Restylane and Juvederm (hyaluronic acid (HA)-based fillers) to

  • Correct the depressions found along the junction between the eyes and cheeks, known as the tear trough
  • Correct the crease between the nose and the lips, known as the nasolabial folds
  • Improve the marionette lines below the lips
  • Fill thin lips
  • Correct temple hollows
  • Aid in scar camouflage
  • Other areas depending on patient needs/anatomy

Hyaluronic Acid (HA)-Based Fillers

HA-based fillers are currently the most popular injectable filler products used in the United States today. HA is a naturally occurring material in all vertebrate animals and can be produced by some bacteria as well. This non-cellular material does not produce an allergic reaction, therefore requires no skin test. It fits the need for a longer-acting material that is potentially reversible, has a favorable risk profile and provides natural appearing results. Generally, HA products offer 9-24+ months of effect and the possibility of longer effects with repeat injections. Some products contain lidocaine, an anesthetic that may improve the experience of receiving the injections.

Examples: Restylane™, Juvederm™, Juvederm Voluma®, Prevelle Silk™, Elevess™

Other Products

Multiple other materials have been developed with variability regarding the duration of effect, risk of complication and overall natural-appearing results, including:

Radiesse™ is a Hydroxyapatite product that is also popular and produces results in excess of 12-18 months. It may be used for deep nasolabial and marionette folds and for cheek augmentation.

Kybella™ is a prescription medicine used in adults to improve the appearance and profile of moderate to severe fat below the chin (submental fat), also called “double chin.” The active ingredient in Kybella is synthetic deoxycholic acid, which is a naturally occurring molecule in the body that aids in the breakdown and absorption of dietary fat.

Risk of bumps or irregularities are possible with all injectable fillers but many physicians feel they are less likely with the HA fillers than others.

Fat Transfer

The transfer of fat from one part of the body to the face for augmentation and filling of wrinkles is used by many experienced physicians and offers the benefit of long-lasting, natural augmentation. In the past, there were difficulties with the predictability of fat resorption after it was transplanted–sometimes it would last and other times it would not. Fortunately, the techniques have been refined in the last few years, greatly improving the predictability of fat transfer. This, combined with the advantage of (in many cases) larger amounts of material for injection (compared to other fillers), makes this a powerful technique to correct the loss of volume commonly associated with the “aging face” appearance.

Can Facial Fillers Remove Dark Circles Under the Eyes?

Yes, facial fillers can help remove dark circles under the eyes. Take a look at these “before and after” pictures of a 29-year-old with complaints of tired appearance and dark circles beneath her eyes.

A facial filler was injected into the tear troughs (lower eyelids) to reduce the appearance of dark circles and shadows underneath her eyes. The “after” picture was taken 2 days following injectable filler treatment.

Facial Fillers and Injectables/FAQs

Results are immediate with dermal fillers.

We would advise that you not schedule these procedures within a week before an important event (such as a wedding) because there is always a chance of bruising. Plus, on rare occasions swelling may last a day or two. Lip filler may result in swelling lasting 5-7 days.

Most patients can return to normal activity or work an hour after application. Note, though, that swelling may take several hours to resolve, so you should refrain from exercising or from any strenuous activity that day.

Before dermal fillers are administered, a topical anesthetic cream is applied to your face. While Dr. Pero is injecting the fillers with a very fine cannula, his assistant will apply acupressure to various points on your face to help decrease the sensation of the filler as it is being applied. After application, a cold ice pack is placed on the injection site for 20 minutes to reduce local swelling.

For 5 days before the procedure, you should avoid aspirin or anti-inflammatory medications to limit bruising after the procedure.

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Dr. Pero is skilled and experienced in helping patients achieve a natural look with injectable treatments for facial rejuvenation. Call us today at (214) 382-5100 to schedule your consultation with Dr. Pero.