As we age, our bodies produce less collagen every year after our twentieth birthday. Collagen is responsible for providing our skin’s underlying structural support. This decline, along with sun damage and other factors, leaves our face with areas of volume loss. This volume loss declares itself in sunken cheeks, creases and lines, and an overall older appearance.
Dermal fillers return some of that lost volume. At The Med Spa at Northwestern Specialists in Plastic Surgery, we offer a variety of dermal filler options for our patients.
What are dermal fillers?
Dermal fillers do exactly as their name says — they fill in areas that have sunken or are showing signs of volume loss. When a filler is injected beneath a crease, such as a smile line, the filler simply returns volume to the area, pushing the skin back upwards and erasing the crease.
How are fillers used?
Dermal fillers are used to return volume. Natural fillers are made from hyaluronic acid, a naturally occurring substance in the body that is responsible for hydrating and plumping the skin. When a natural filler such as Juvéderm® is injected into an area, the hyaluronic acid binds with nearby water molecules and plumps and firms the skin.
Synthetic dermal fillers are made from other materials such as calcium microspheres (Radiesse®). They both fill in volume immediately and can increase the body’s collagen production in the injection area to extend their results for a longer period.
Issues That Dermal Fillers Can Address
Dermal fillers are used on the lower two-thirds of the face, typically from the under-eye area through the chin. They are also used to return volume to the backs of the hands. Fillers may return volume to these problem areas:
- Nasolabial lines (lines that run from the nose to the corners of the mouth)
- Marionette lines (lines that run downward from the corners of the mouth)
- Parentheses lines (lines that frame the sides of the mouth, like parentheses)
- Barcode lines (vertical lines above the lips)
- Sunken cheeks
- Under eye tear troughs
- Chin wrinkles
- Thin lips
- Asymmetrical lips
- Covering tendons and blood vessels on the backs of the hands
What Dermal Filler Is Right For Me?
Our team at The Med Spa has extensive experience and training with the different fillers we offer. Once you tell us what areas you want to target, we’ll discuss which fillers are right for the job.
What To Expect During Injectable Treatment
These sessions take 30 minutes to an hour, depending on the area we are treating. Many fillers have lidocaine in the formulation, but we can apply topical numbing cream or lightly ice the injection area prior to the injections if you would like. There is no recovery or downtime, although you can experience bruising and swelling which is different for each individual.
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Types of Dermal Fillers
Here are the fillers we offer and where they are used:
We offer all five dermal fillers in the Juvéderm® family. Each filler is hyaluronic acid-based and is intended to address a different area of the face and replace decreased volume. Juvéderm® results last up to one year, except for Vollure™, which lasts 18 months.
- Juvéderm® XC — This was the first Juvéderm® product and it targets the lines that form around the nose and mouth. These are called parentheses lines and nasolabial folds.
- Juvéderm® Voluma XC — Juvéderm® Voluma is designed to add volume beneath the skin’s surface and contour the cheek area.
- Juvéderm® Ultra XC — Juvéderm® Ultra XC plumps the lips and adds definition to the lip borders. It also fills vertical wrinkles on the lips.
- Juvéderm Volbella® XC — Juvéderm Volbella® XC is also for the lips, along with Juvéderm ® Ultra XC. However, these fillers address different issues. Ultra is for visibly plumping the lips. Juvéderm Volbella® XC adds subtle volume to the lips and smoothes those irritating vertical lip lines.
- Juvederm Vollure™ XC — Juvéderm Vollure™ XC is the newest addition to the Juvéderm family of dermal fillers. Vollure™ is designed for the correction of moderate to deep creases and wrinkles such as nasolabial folds running from the nose down to the corners of the mouth, and parentheses lines framing the mouth. Vollure™ XC provides the longest lasting results of any hyaluronic acid filler — 18 months. This is six months longer than other hyaluronic acid fillers.
We offer all five dermal fillers in the Restylane® family. Like Juvederm®, all of these fillers are hyaluronic acid fillers and intended for different areas of the face.
- Restylane® — This was the first hyaluronic acid dermal filler. Approved by the FDA in 2006, Restylane® immediately became popular for addressing marionette lines, nasolabial folds, and other wrinkles. Its results last 6-9 months.
- Restylane-L® — Restylane-L is Restylane® with Lidocaine added for comfort.
- Restylane® Silk — Restylane® Silk is an alternative to Juvederm Volbella. It is used for subtle lip enhancement and for the correction of vertical lip lines. It provides results for around six months.
- Restylane® Lyft — Restylane® Lyft adds volume to the cheeks and corrects smile lines. It is an alternative to Juvederm® Voluma.
- Restylane® Refyne —Restylane® Refyne was approved by the FDA in December 2016. This addition to the Restylane® line (along with Defyne, see below) is used to correct smile (marionette) lines and nasolabial folds. Refyne is specifically formulated to treat mild to moderate lines and wrinkles. Galderma has cross-linked the gel in Restylane® Refyne and Defyne to help support the patient’s natural expressions — for real-life results that help maintain natural movement when smiling, frowning, or otherwise moving your mouth.
- Restylane® Defyne —Approved along with Refyne, Defyne also specifically targets nasolabial folds and marionette lines. The difference is that Defyne is designed for use on moderate to severe creases and lines. Both Refyne and Defyne provide results that last up to one year.
Radiesse® is a synthetic dermal filler that targets the lower face. Instead of hyaluronic acid, Radiesse® consists of calcium hydroxylapatite (CaHA) microspheres that are suspended in a water-based gel. Radiesse® works to add volume in two ways. First, when it is injected it provides immediate volume and wrinkle correction as the microspheres add structural support under the skin. Then, as the body begins to absorb the gel and breaks down the CaHA microspheres, this reaction triggers the body to produce new collagen in the injection areas. Radiesse® is particularly suited to address smile lines, marionette lines, pre-jowl folds, drooping corners of the mouth, and chin wrinkles. Radiesse® results last around one year, but it can boost collagen production longer than that.
Sculptra® is a synthetic filler that is made from poly-L-lactic acid (PLLA), which works within the skin to replace lost collagen. Sculptra® is effective for the typical lines and creases that develop around the mouth: parentheses lines, marionette lines, nasolabial folds, and chin wrinkles. Sculptra® is injected deeper than most fillers, into the deep dermal layer. Sculptra® is injected in three sessions over the course of three to four months. Like typical fillers, Sculptra’s gel initially provides volume where injected and pushes the depressed area back upward, but this is only temporary. After a week or so, the wrinkle can reform to a lesser degree, but this is when Sculptra® really works. Microparticles of PLLA work within the deep dermis to rebuild lost collagen and provide structural skin support. As the PLLA is absorbed, a collagen framework is created. This reinforced collagen structure provides a foundation that gradually restores the look of fullness to deep wrinkles and folds. This new collagen framework provides results that last up to two years.
Bellafill® is a synthetic filler. It consists of a mix of 80 percent collagen and 20 percent polymethyl methacrylate (PMMA) microspheres. PMMA is a biocompatible material that has been safely used in medical implants and other devices for over 65 years. Bellafill® works in two ways- first using the collagen in the filler and then the PMMA microspheres. The collagen shows first, immediately adding volume to the skin to lift and fill smile lines and acne scars.
As the body begins to absorb the collagen, the PMMA microspheres kick in. Once injected along with the collagen, the PMMA microspheres remain in place and create a matrix that supports new collagen production in your skin. So, in addition to the filling aspect from the injected collagen, Bellafill® also stimulates your body to create new collagen, which rejuvenates and fills the skin for years.
Neuromodulators Vs. Dermal Fillers
Neuromodulators like BOTOX work by relaxing the muscle they are injected into. Certain types of wrinkles are formed by muscle contractions under the skin — crow’s feet at the outside of the eyes, the 11’s between the eyebrows, and forehead lines. These are called dynamic wrinkles. BOTOX blocks the nerve messages that are sent from the muscle to the brain, so the brain never receives the message to contract the muscle. The muscle stays relaxed and the wrinkle doesn’t form above it.
Fillers have no effect on dynamic wrinkles formed by muscle contractions. Fillers work on what are called static wrinkles. These are wrinkles caused by sun damage, declining collage production, environmental factors, and personal habits such as smoking. Static wrinkles are on display at all times. Fillers are injected beneath the wrinkle, crease, or area of volume loss, and they simply return volume and push the skin back upwards, erasing the wrinkle or returning volume.
How long do results last with dermal fillers?
You can see the duration of the results with each filler described above. Fillers have various lifespans before the body absorbs the filler material. These results run from around six months with Restylane® Silk to a year for most of the Juvederm® fillers and the other Restylane® fillers. Juvederm® Vollure and Radiesse® can extend those results for 18 months and possibly longer (depending on the collagen production triggered by Radiesse®).
Generally, the lifespan of your results with hyaluronic acid fillers runs from around 6 months up to 18 months. Sculptra® and Bellafill® can provide a boost in collagen production for two years and longer.
Before & After Injectable Treatment
Side Effects With Dermal Fillers
The most commonly observed side effects with fillers are swelling, redness, pain, bruising, headaches, tenderness, lump formation, and itching at the injection sites. These are typically mild in severity and usually resolve themselves in seven days with smile and marionette lines, and within 14 days on the lips.
Because hyaluronic acid is a naturally occurring substance in the body, there are very few reactions to Juvéderm® and Restylane® products. Occasionally, lumps or granulomas can form near the injection sites. This side effect can be reversed with an injection of hyaluronidase, an enzyme that speeds up the natural degradation of the hyaluronic acid in the filler.
As with all fillers, the expertise of your injector is important to achieve the best results and avoid side effects. The entire team at The Med Spa has training and extensive experience with each of these fillers.
What if I don’t like the look of my results with a filler?
If the filler used was one of the Restylane® or Juvéderm® products, these fillers can be instantly neutralized with the injection of an enzyme called hyaluronidase, as described above. There are other modalities we can use to help reduce the response of unwanted fillers as well.
If you are interested in dermal filler or another cosmetic treatment, contact The Medspa at Northwestern Specialists in Plastic Surgery. Call us at 312.266.6240 to schedule your consultation today! Our practice serves Chicago, Illinois and surrounding areas.