Dermal fillers FAQ

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 What are injectable dermal fillers?

Injectable dermal fillers are injectable gels made from naturally-occurring substances, including collagen and hyaluronic acid. Dermal fillers are injected just under the skin in order to add volume to aging skin, lips and to fill and lift wrinkles and folds. Dermal fillers add volume for a more natural youthful appearance.

The majority of dermal fillers contain hyaluronic acid as their main active ingredient. Hyaluronic acid based dermal fillers include Restylane and Juvederm. Hyaluronic acid is a natural component of the skin.

Injectable dermal fillers are used to fill wrinkles, lines, folds, and scars (eg. acne scars). Dermal fillers are also commonly used to give a fuller appearance to the lips.

The most common areas treated with injectable dermal fillers are the smile lines around the nose and mouth, fine lines above the mouth, frown lines between the eyes, and acne scars.

·                     What are other names for injectable dermal fillers?

Injectable dermal fillers are also known as cosmetic fillers, injectable cosmetic fillers, dermal fillers, facial fillers, injectable facial fillers, tissue fillers, injectable tissue fillers soft tissue fillers, injectable soft tissue fillers, injectable hyaluronic acid, injectable collagen and just plain and simple injectable fillers.

·                     What are some examples of dermal fillers?

Some examples of dermal fillers include:

Restylane

Juvederm

Radiesse

Sculptra

Hylaform

Artefill

CosmoDerm

CosmoPlast

Cymetra

ZyDerm

ZyPlast

Hydrafill

Bio-Alcamid

Laresse

DermaLive

DermaDeep

·                     How do injectable dermal fillers work?

The skin is made of two layers, an outer layer called the epidermis and an inner layer called the dermis. The area between these two layers contains a jelly-like substance called hyaluronic acid. When we are young, our skin contains plenty of hyaluronic acid. However, when we age the hyaluronic acid between the layers of our skin diminishes. This decrease in hyaluronic acid causes the skin to lose its natural volume and fullness and creates wrinkles or folds. Dermal fillers replace the natural hyaluronic acid and add volume and firmness to the skin.

·                     How are Dermal Filler Treatments Performed?

A skin test needs to be performed before the injectable filler procedure if a collagen based dermal filler is being used. The skin test is required because approximately 3% of people are allergic to the collagen in these dermal fillers.

A skin test is not necessary if a hyaluronic acid based dermal filler is being used.

Before the procedure begins, some clinics and most patients prefer to numb the face with a topical anesthetic cream. If the procedure if for lip augmentation, anesthetic injections can be used.

During the dermal filler procedure, the dermal filler gel is applied under the skin in tiny amounts using a very fine needle. The procedure can be mildly uncomfortable.

The dermal filler treatment procedure can take up to an hour to complete. However, most treatments only take 5 to 10 minutes.

If the procedure is on a smaller area many people can resume their regular daily activities right away. If larger areas are treated longer recovery times may be required, up to a couple of days. The gel produces volume under the wrinkle, which is lifted up and smoothed out. When enhancing lips or facial contours, Fillers add volume and shape to the treated area.

·                     How Long Does It Take To Have A Dermal Filler Treatment Done?

Cosmetic procedures involving dermal filler treatments are usually very quick and easy. Most dermal filler treatments take from 5 to 30 minutes. The time to complete the procedure differs somewhat, depending on the type and extent of the correction that you wish to have performed.

·                     Do Injectable Dermal Filler Treatments Hurt?

This answer to this question depends on the person. Some people have much more sensitive pain responses compared to other people. Most people do not find that the injections hurt.

The level of discomfort also depends on the areas being treated. Treatments around the lips and nose tend to cause the most discomfort.

The use of topical anesthetic creams or ice packs before the procedure can greatly reduce the level of discomfort.

·                     How Quickly Do You See Results After The Injectable Dermal Filler Procedure?

The results of a dermal filler procedure can be seen right away. The result do tend to improve for a few hours after treatment.

·                     How Long do Injectable Dermal Filler treatments last?

The Results obtained with dermal fillers typically last 6 to 9 months. The results may last up to a year in some people. How long results last varies from person to person. Dermal fillers are gradually broken down and absorbed by the body, so the lines, wrinkles or lips will ultimately return to their previous appearance without follow up treatments.

USUALLY A FOLLOW-UP APPOINTMENT IS RECOMMENDED 2 WEEKS AFTER THE ORIGINAL PROCEDURE IN THE EVENT A TOUCH-UP IS REQUIRED. FOLLOW-UP APPOINTMENTS SHOULD ALSO BE SCHEDULED FOR 4 TO 6 MONTHS AFTER THE PROCEDURE.

·                     What Are The Common Dermal Filler Side Effects?

There are actually very few dermal filler side effects.

Some side effects of dermal fillers include:

    Bruising

    Mild swelling and redness

    Itching

    Discoloration

    Tenderness

    Rarely, redness, tenderness, and swelling develops a few weeks after treatment

    Also rarely granulomas can form. (Granulomas are inflammatory lumps under the skin that can last for months.)

·                     What Types Of Dermal Fillers Are Available?

Collagen: Originally, dermal fillers were all made of collagen derived from cows. This is referred to as bovine collagen.

Collagen is nature’s most abundant protein polymer. Collagen acts as a scaffolding for our bodies. It controls cell shape and cell differentiation. Collagen is the fibrous protein constituent of skin, cartilage, bone, and other connective tissue. It is the substance that fills the spaces between the cells of the body.

Collagen dermal fillers are not used as often now because of its potential to cause allergic reactions. Skin tests are preformed before treatment with bovine collagen dermal fillers to check for allergic sensitivity.

Today, collagen dermal fillers use human collagen. Cosmoderm, Cosmoplast, Zyderm and Zyplast are examples of human collagen-based dermal fillers still in use today.

Hyaluronic acid: (Restylane, Perlane, Juvederm, Juvederm Plus, Revanesse) The synthetic hyaluronic acid dermal fillers are the most common fillers in use today. If you see the term NASHA, this stands for Non-Animal Stabilized Hyaluronic Acid. The first hyaluronic acid products were made from rooster comb extracts. In fact, one product Hylaform is still made from rooster combs. The hyaluronic acid products used today are made by genetically copying human hyaluronic acid.

Poly-L-lactic Acid: (Sculptra) Sculptra is derived from fruit acids. It is a biocompatible and biodegradable injectable material known as poly-L-lactic acid that naturally stimulates the body to produce its own collagen.

Calcium Hydroxylapatite: (Radiesse) this product contains calcium hyroxylapatite (CaHA) microspheres. Calcium hydroxylapatite is one of the primary mineral substances of bone. No allergy testing is required. Over a period of weeks following injection your body encapsulates the microspheres with collagen, giving a filling effect. Because the calcium hydroxylapatite microspheres persist for 2-3 years, collagen production is continuous. This product provides the longest duration of all the temporary fillers, averaging about 18 months.

·                     What Problems Can Be Treated With Injectable Dermal Fillers?

Fillers can be used for smoothing out folds and wrinkles, lip enhancements and shaping facial contours. Commonly treated areas are the nasolabial folds (from the root of the nose to the angle of the mouth), the glabellar lines (between the eyebrows), the droopy mouth corners, and thinning lips, although other sites can also be treated.

·                     What Will I Look Like Immediately After The Dermal Filler Procedure?

You should expect to see some redness and swelling. This is quite normal with dermal filler treatments. If you are having a lip augmentation treatment done with dermal fillers your lips may be swollen for a few days afterwards.

·                     What properties does the ideal injectable dermal filler have?

The ideal injectable dermal filler has the following properties:

    non-permanent but long-lasting

    have minimal side-effects

    not require allergy testing

    be easy to use/inject

    be cost-effective both to the physician and patient.