As we all age, the skin of our faces lose fat, water, collagen and elasticity. Dermal fillers are a non-surgical, non-invasive way to replace these lost elements and restore youthful beauty to the face. Dermal fillers are safe, naturally occurring gels that are injected into the skin with a fine needle to smooth out wrinkles, plump lips, accentuate facial contours, fill in lost volume and lift sagging skin. The treatment usually takes about 45 minutes, and Dr. Lawton offers all clients the option of a nerve block with lidocaine anesthetic to minimize the discomfort. The results are immediate and long-lasting, often up to one year, and the downtime is minimal. Make-up can be applied immediately after treatment and most people can go back to their normal activities immediately.
JUVEDERM ULTRA XC AND JUVEDERM ULTRA PLUS XC
Since its FDA approval in 2006, Juvederm gel has rapidly become the dermal filler of choice because of its smooth consistency and long lasting results, often up to 1 year with only one injection session. Juvederm is an injectable gel made of cross-linked hyaluronic acid. Hyaluronic acid is a large, water-absorbing molecule that is naturally present throughout our bodies. Back in 1934, researchers at Columbia University studied the properties of hyaluronic acid and found that one of its major functions in the body was maintaining the volume and hydration of skin and connective tissues. However, hyaluronic acid in its native form is like a liquid. If you inject native hyaluronic acid into the body, it is broken down by enzymes in about 1 day. However, if you chemically bind the large hyaluronic acid molecules together with sulfur bonds, the liquid becomes like a viscous gel and is much more resistant to degradation by the body’s natural enzymes. This process is called “cross-linking”, and it’s what gives Juvederm its long-lasting quality.
Allergan, the makers of Botox Cosmetic and Juvederm, developed a patented process for cross-linking hyaluronic acid called Hylacross™ technology. This new technology creates an incredibly smooth consistency gel that actually lasts longer than older fillers like Restylane. This smooth consistency gel is both easier to use for the physician injector and yields a smoother, more natural looking result for the patient. In the photo below, you can see the smoothness of the Juvederm Ultra and Ultra Plus gels on the left versus the Restylane gel on the right, which appears gritty and granular.
Juvederm also provides the flexibility to tailor the dermal filler experience to each patient’s unique needs. Juvederm comes in the Ultra form, a thinner but highly cross-linked gel for more delicate areas of the face or finer wrinkles, and the Ultra Plus form, a thicker, more highly cross-linked form that provides more robust volumization for deeper folds.
Juvederm XC is the same Juvederm gel we already know but with the added benefit of having the local anesthetic lidocaine mixed in with it. The lidocaine used is a solution of 0.3%, preservative-free lidocaine. As soon as the Juvederm XC is injected, the lidocaine quickly diffuses into the surrounding tissues and numbs them. This makes for a more comfortable experience for the patient, especially when treating sensitive areas like the lip. In a clinical study prior to the 2010 FDA approval of Juvederm XC, patients felt the local anesthetic effect of the lidocaine within just 3 seconds of the initial injection. And in that same study, 93% of patients reported that the injection experience was more comfortable than when a non-lidocaine gel was used.
RADIESSE and RADIESSE VOLUME ADVANTAGE
Radiesse is composed of calcium-based microspheres surrounded by a collagen-like scaffold. It is safe, biocompatible and has been in use for years in other areas of medicine such as hip replacements and dental implants. This soft, creamy gel stays soft and looks natural after injection. What’s unique about Radiesse is that it acts like a scaffold after injection, providing structure and stimulating your body’s own collagen to grow into the area. This natural collagen growth continues for months after the injection, which extends the initial volumizing effects of Radiesse. Most patients can achieve results that last up to one year with just one injection session. Radiesse is available in two sizes, unlike Juvederm products. There is a 0.8 cc syringe size as well as a 1.5 cc syringe size, called “Volume Advantage”. The larger size is equivalent to 1.5 syringes of Juvederm, which can provide a cost savings for the patient who desires more correction than one syringe of Juvederm but whose budget does not allow for the purchase of 2 syringes. It’s important to remember, however, that Radiesse is not the ideal filler for lip augmentation. Up to 10% of people can develop nodules when Radiesse is injected into the lips. For lip augmentation, it is safer to use the Juvederm family of products.
WHAT CAN I EXPECT THE DAY OF MY DERMAL FILLER TREATMENT?
Dermal filler gels are injected under the skin with a very fine needle. The gel produces volume under the wrinkle thereby lifting it up and smoothing it out. The entire procedure takes only about 30-45 minutes. Dr. Lawton offers nerve blocks with lidocaine, like one would get at the dentist, so that the entire procedure is nearly pain free. The most commonly treated area is the “smile lines” or “parentheses”, which are called the nasolabial folds. These are the folds that go from the sides of your nose down to the corners of your mouth. Other treatment options include down-turned mouth corners, filling lines around the mouth and lips, cheekbone or jawline enhancement, lip enhancement and filling under-eye hollows. With all dermal fillers, it may require more than one syringe of product or more than one treatment session to achieve your desired cosmetic result.
WHAT CAN I EXPECT AFTER MY TREATMENT?
The effect of dermal fillers is immediate. You will see results right after the treatment. You may have some redness, swelling, tenderness or bruising after the injection, but this is normal and usually lasts only a day or two. Most people are able to apply make-up over the treated area and immediately go back to their normal activities. You can minimize your downtime by avoiding aspiring, ibuprofen, green tea, Vitamin E, St. John’s wort or any other blood thinner for one week prior to your treatment. Dr. Lawton will consult with you during and after the treatment to optimize your results.
MORE INFORMATION ABOUT DERMAL FILLERS
Visit our Blog section, where Dr. Lawton has posted numerous blog articles about the specifics of fillers and filler injection techniques. If you have more question, do not hesitate to call us directly at 714-846-5950 and we will be happy to answer your questions or set up a free consultation with Dr. Lawton to discuss your plans for filler injection.