Dermal filler treatment is one of the most common non-surgical cosmetic procedures and its popularity continues to grow.
Dermal filler treatment is one of the most common non-surgical cosmetic procedures and its popularity continues to grow. Dermal fillers are injectable medications which are primarily used to improve facial contours and treat wrinkles. The modern era of dermal fillers began with the hyaluronic acid fillers Restylane® and Juvederm®. These products last much longer than the first dermal filler, bovine collagen, and have very few side effects. Both Restylane® and Juvederm® continue to enjoy huge popularity and remain clinically useful. However, a number of new products and uses for existing products have been introduced over the last few years.
The upper cheek, also known as the malar eminence, has been a focus recently. This is an excellent area for treatment as this facial zone tends to deflate over time. Restoration of volume in the cheek creates a youthful change. Juvederm Voluma® was the first product specifically indicated for this area. Restylane® Lyft has recently gained an FDA indication for this zone as well. Fillers tend to have a long longevity in this zone, with duration in excess of one year frequently.
Aging around the mouth and the lips may also be lessened with fillers. Both Juvederm® and Restylane® are indicated for wrinkles around the mouth. Restylane® Silk is a new product with specific FDA clearance for use in the lips. Silk is useful for fine lines around the mouth, “smoker’s lines, “ as well as lip enhancement.
Although fat grafting remains my choice for “volumizing” the face, Sculptra® is a deep tissue filler we frequently use as a substitute for fat grafting. Sculptra® works in a manner slightly different from other fillers. It is injected as a mixture with saline. The body absorbs the saline so the day after the treatment it looks like nothing has been done. Then, over the next few weeks, the fullness returns yielding the volumizing effect. As with fat grafting, multiple treatment sessions may be required.
Can fillers provide the mythical non-surgical facelift? There is no filler, nor any amount of filler, which can take up extra skin or reposition tissues like the surgical procedure. However, use of fillers may help delay the need for surgery. Similarly, fillers may also be used after surgery to enhance and maintain the result.
Dermal filler treatment is usually accompanied by some degree of swelling and occasionally bruising. Our practice uses a chilling device during the injection process to improve patient comfort and decrease the risk of bruising. Where possible, special cannulas designed for filler injection are used. These are very small blunt needles which are less traumatic to the tissues than a sharp needle. They allow injection of a broad area through a single access point. Smoother deposition of the filler with less risk of disturbing a blood vessel which could create bruising are the benefits of a cannula.
There is no special certification needed to inject fillers, therefore anyone legally authorized to perform injections in Kentucky, may inject fillers. This includes physicians, nurses, and dentists to name a few. However, as with most cosmetic procedures, the quality of the result and safety of the process are strongly dependent on the skill of the injector. We have three injectors in our practice; myself, and two highly skilled nurse injectors. All three of us have a significant experience and have taken the opportunity for advanced training in the use of dermal fillers. Our patients always have the choice of who injects them. Over-treatment is a common error by inexperienced injectors and should be avoided. Just like surgery, the best results look completely natural.
Dr. David Kirn is a Board Certified Plastic Surgeon who is devoted to advanced techniques in Cosmetic Surgery of the Face, Breast, and Body. In private practice since 1998, he is located in a state of the art facility which includes a full service skin care center. The practice is focused on personalized patient care and attention to detail. Where possible, Dr. Kirn utilizes minimally invasive procedures. The goal is to deliver quality clinical results while minimizing patient recovery time. Examples of this include a no-drain tummy tuck, armpit incision breast augmentation with gel or saline implants, fat grafting, and a short scar facelift. In addition, Dr. Kirn and nurse-injectors Carey Sanders, RN and Shirley Ramsey DNP,APRN, offer a full spectrum of non-surgical treatments such as Botox®, Dysport®, Restylane®, Juvederm®, Voluma®, Radiesse®, and laser.