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One of the most popular ways to enhance facial features such as your lips and cheeks, as well as to reduce the appearance of aging, are facial fillers. According to the American Society of Plastic Surgeons, 2.7 million facial filler treatments were performed on patients in the year 2017 alone, and this demand has continued to increase as more patients are made aware of the ease and superior rejuvenating results of cosmetic facial filler technology.

Facial fillers come in a variety of formulations and styles, all with the simple goal of allowing patients to look and feel like the best version of themselves. Whether someone is seeking to enhance a naturally thin lip, reduce the appearance of smile lines, or the nasolabial fold, or create a more youthful cheek or defined jawline, dermal fillers can help. Dermal fillers are injectable fillers that are considered to be non-invasive, meaning they require no downtime unlike traditional plastic surgery procedures. In the world of dermatology, facial filler injections serve a wide variety of patient needs, from correcting the appearance of acne scars to replacing lost volume, treating fine lines and wrinkles, to having beautiful cheek or lip enhancement.

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If you’re interested in non-invasive cosmetic treatments, that will rejuvenate your skin, without the need for plastic surgery, facial fillers are an amazing option. Dr. Michele Green is a cosmetic board certified dermatologist in NYC, who has been on the forefront of cosmetic facial fillers for over 25 years. Dr. Green was one of the first dermatologists in New York to incorporate Restylane and Juvederm into her private, boutique, New York City dermatology office. If you are considering Botox injections, skin care, dermal fillers, lip enhancement, or pan-facial rejuvenation, Dr. Green is here to help.

What are Facial Fillers?

Facial filler is used to describe a facial cosmetic procedure that relies on dermal fillers. Dermal fillers are commonly administered as an injectable, and each varies in terms of their formulation and offers its own benefits. One of the most common forms of dermal filler is hyaluronic acid filler, which uses a substance naturally found in the body (hyaluronic acid) to ignite collagen production at and near the injection site, creating a revitalized look to the treatment area. Other popular dermal fillers include formulations with active ingredients like Calcium Hydroxylapatite and Poly-L-Lactic acid, which have a slightly different method to boosting new collagen and rejuvenating the skin. The goal of a facial filler is to rejuvenate and/or enhance the features of the face, which includes reducing the appearance of fine lines and wrinkles, correcting age-related volume loss, and boosting volume in desirable areas like the lips, chin, or cheeks.

What do facial fillers do?

Facial fillers are a popular method to treat a variety of issues. They have been popularized by celebrities who rely on hyaluronic acid filler for lip augmentation, and are often a go-to for women who are interested in reducing the appearance of facial wrinkles. As dermal fillers are designed to boost volume in the treatment area, facial fillers can help to eliminate fine lines and wrinkles, including smile lines (nasolabial folds), marionette lines, and vertical lip lines. They can also be used to reduce the appearance of depressed scars, like acne scars, by restoring volume to the depressed area. Additionally, facial fillers are an excellent option for patients looking to restore volume, whether it is volume that has been lost in the midface during the natural aging process, or simple lip, cheek or chin augmentation to enhance the contouring of the face.

How do facial fillers work?

Facial fillers are designed to boost the development of collagen in the layers of the dermis, which in turn creates volume at and surrounding the injection site. The way in which these fillers are able to stimulate collagen production depends on the type of filler being used. Hyaluronic acid (HA) fillers rely on hyaluronic acid to stimulate collagen development and hydration, as hyaluronic acid engages with this process in the body naturally. Due to its encouragement of the body’s own natural revitalization processes,  HA filler has become a go-to option for soft tissue filler and wrinkle fillers, and recent advancements in HA filler formulation allow for cross-linking of the HA molecules to the skin cells, resulting in an incredibly natural look. Other dermal filler formulations create volume through other methods, such as poly-L-lactic acid which injects biodegradable volume that is slowly replaced by the body’s own collagen development.

Who is a good candidate for dermal fillers?

A good candidate for dermal fillers is any patient aged 21 or older who is generally in good physical health. Patients who are concerned over their complexion or facial contouring, have mild to moderate facial wrinkles, or who are interested in enhancing their facial features (such as lip augmentation) are all excellent candidates for facial fillers. If you have allergies or a pre-existing skin condition, you should talk to Dr. Green prior to treatment with dermal fillers. Additionally, dermal fillers are contraindicated for women who are pregnant or currently breast-feeding.

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What are facial fillers made of?

Facial fillers rely on active ingredients that are FDA-approved to enhance collagen production within the body. Popular active ingredients include hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, and polymethylmethacrylate, among others. These substances are all either synthetic versions of naturally occurring substances in the body, or have been proven to be safely broken down within the body’s metabolic processes. Additionally, many dermal fillers contain a small amount of lidocaine (anesthetic) to prevent any pain at the injection site. This, when coupled with a topical anesthetic during the cosmetic procedure, helps to prevent any potential patient discomfort.

Types of Dermal Fillers

There are a variety of dermal fillers available on the market, and each dermal filler offers  unique benefits. Though hyaluronic acid fillers are perhaps the most well-known, poly-L-lactic acid, calcium hydroxylapatite, and polymethylmethacrylate fillers all can be used for to meet specific rejuvenation goals to wondrous effect.

Hyaluronic Acid Fillers

HA fillers are long-lasting, non-invasive injectables that have become popular due to their integration into the skin, as well as their reversible nature. The most popular varieties of HA filler are Juvederm, Restylane, and Belotero Balance. Juvederm and Restylane each offer a variety of formulations that are tailor-made to treat different areas of the face and hands.

Juvederm

Juvederm is a popular line of HA fillers from the pharmaceutical giant Allergan (makers of Botox, CoolSculpting, and many other aesthetic treatments). Juvederm offers a wide variety of different formulations, including:

  • Juvederm Vollure to treat nasolabial folds
  • Juvederm Voluma XC to increase volume in the cheeks, chin, and midface, creating a “liquid facelift” by reducing facial sagging and the appearance of jowls
  • Juvederm Volbella to create subtle lip enhancement, as well as reduce the appearance of fine lines. It can also be used to reduce the appearance of under-eye hollows due to its gentle formulation
  • Juvederm Ultra to restore facial volume and smooth fine lines and wrinkles around the mouth, as well as for lip augmentation
  • Juvederm Ultra Plus XC to treat nasolabial folds, smile lines, and marionette lines, as well as to enhance volume in the lips
  • Juvederm Volite to provide clinically proven dermal hydration, helping to improve skin quality and elasticity

Restylane

Restylane is another prominent product family of HA fillers, distributed by Galderma, that offers a similar array of tailored formulations to Juvederm, though the particle size of each brand differs somewhat. Restylane offers formulations custom designed for rejuvenation, volume, and facial enhancement, including:

  • Restylane and Restylane-L to correct moderate facial wrinkles in the mouth and eye area, as well as for subtle, natural-looking lip enhancement and acne scars
  • Restylane Lyft to treat severe lines and wrinkles, correct age-related volume loss in the midface, and restore a younger looking appearance to the hands
  • Restylane Contour to augment the cheeks and correct age-related volume loss in the midface
  • Restylane Defyne to treat severe-to-moderate smile lines and laugh lines, and to enhance the chin and jawline
  • Restylane Refyne to treat moderate-to-mild smile lines and laugh line
  • Restylane Volyme to boost volume and enhance the look of the cheeks, chin, and jawline
  • Restylane Kysse to augment the lips and correct upper lip lines (perioral lines)
  • Restylane Silk to create plump, enhanced lips, and to reduce the appearance of fine lines around the mouth
  • Restylane SkinBoosters to deliver dermal hydration and improve the overall health of the skin through a series of microinjections.

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Botox and Restylane – 1 syringe

Calcium Hydroxylapatite Filler (Radiesse)

Radiesse is a calcium hydroxylapatite filler that is FDA-approved to replenish lost collagen under the skin. It relies on a patented microsphere technology to create initial volume in the treatment area while simulaneously igniting collagenases. Through this method, patients are able to immediately see an improvement in the appearance of fine lines and wrinkles in the treatment area, with continued results as new collagen production begins to replace the calcium hydroxylapatite microspheres being naturally absorbed into the body. Radiesse is a popular facial filler for patients seeking to reduce the appearance of wrinkles and deep lines around the nose and mouth, and can also be used to rejuvenate the hands, contour the jawline, and enhance cheekbones.

Poly-L-Lactic Acid Filler (Sculptra)

Sculptra is an FDA-approved, biocompatible synthetic injectable that stimulates the body’s collagen production. Sculptra relies on poly-L-lactic acid (PLLA), which has been commonly used in medical products like dissolvable sutures and implants for over two decades. Unlike other dermal fillers, Sculptra’s results develop over the course of 4-6 weeks, but it’s a popular option for offering a “liquid facelift”, as it uses a deep injection technique to create long-lasting results for up to two years. Sculptra is excellent for patients interested in volume restoration in the cheeks, temples, jaw, and chin, as well as facial rejuvenation along the forehead and mouth area. In addition, Sculptra is commonly used for butt augmentation, knee rejuvenation, hand revitalization, and the reduction of stretch marks, cellulite, and acne scars.

Polymethylmethacrylate (Bellafill)

Bellafill is a polymethylmethacrylate dermal filler that can help to restore the skin. It’s synthetic microspheres of polymethylmethacrylate (PMMA) are combined with purified bovine (cow) collagen gel in order to create a volumizing matrix that supports and enhances the body’s collagen production. It was originally approved for use to reduce the appearance of nasolabial folds and depressed acne scars, and can also be used to add volume to other areas of the face, such as the cheeks.

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Are facial fillers better than Botox injections?

Facial filler is an injectable cosmetic procedure that is designed to rejuvenate the skin by restoring volume and collagen production. Though Botox and other neuromodulators like Dysport, Jeuveau, and Xeomin are injectable treatments designed to reduce wrinkles, they differ from facial fillers in terms of their approach. Botulinum toxin type A formulations, including Botox, are designed to target and essentially “freeze” the nerve signals to overused muscles that create dynamic wrinkles on the face. By limiting the motion of these muscles, Botox in turn is able to reduce the appearance of fine lines and wrinkles, and also prevent these wrinkles from worsening. Since Botox mainly treats dynamic wrinkles, it is utilized primarily for the wrinkles on your forehead, glabella, and around your eyes. Both Botox and facial fillers are excellent options for reducing the appearance of fine lines and wrinkles, and in fact are complementary treatments, meaning they can be combined in a treatment plan for pan-facial rejuvenation.

What are the best facial fillers?

When it comes to choosing the ideal facial fillers, there’s no one “best” option for all patients. Each facial filler offers a unique formulation that requires time and expertise to match with a patient looking for facial revitalization. When you work with Dr. Green, she’ll be able to assess your medical history, current skin condition, and aesthetic goals in order to determine which dermal fillers may be right for you.

How long do facial fillers last?

Facial fillers vary in terms of their longevity, but recent technological developments in formulation have created competitive duration. In general, HA fillers like Juvederm Voluma and Restylane Lyft can last up to one year when injected into the midface. Restylane injections under the eyes, in the tear trough, last six to nine months. Juvederm Ultra Plus lasts approximately one year when used for lip enhancement. Radiesse typically lasts up to one year, though some patients find that their results last beyond the one-year mark. Sculptra typically requires multiple treatment sessions within the first six months of treatment, but results can last up to two years after full correction is achieved. Bellafill can last up to five full years, which is the longest lasting dermal filler of any facial filler currently on the market.

Which facial fillers last the longest?

Bellafill is the longest-lasting facial filler currently available in the world of dermatology, lasting up to five years in duration. Sculptra, when injected to full correction, lasts about two years. Hyaluronic acid dermal fillers, such as Restylane and Juvederm, last from 6 to 12 months, respectively. Restylane Lyft lasts approximately one year and the Juvederm family of dermal fillers also lasts about one year. However, almost all facial fillers offer long-term positive benefits when it comes to healthy skin and collagen production, and the results of any dermal filler can easily be continued through touch-up treatments spaced 1-2 years apart.

L.H 3 weeks Before and After JuvedermVoluma Cheeks 1 syringe UltraPlus NL 1 syringe MGWatermark

Juvederm Voluma and Ultra Plus to Cheek area – 3 weeks

Are facial fillers permanent?

Dermal fillers are typically made of substances that are naturally metabolized in the body over time, which means that the effects are indeed temporary. One of the benefits of dermal fillers, like Juvederm and Restylane, is that the results are not permanent, and can be easily dissolved if you are unhappy with the cosmetic results. Facial fillers have become exceedingly popular over the years particularly due to their temporary nature, and can be an excellent option for patients who are seeking a more flexible alternative to permanent cosmetic surgery.

Can facial fillers be removed?

Hyaluronic acid facial fillers are unique in that they are reversible through the use of synthetic hyaluronidase, the substance that breaks down hyaluronic acid naturally in the body. Other facial fillers are considered semi-permanent, in that their results will fade over the course of 1-5 years, such as Sculptra, Radiesse, and Bellafill, but they cannot be removed.

Do dermal fillers have any side effects?

In general, the side effects to dermal fillers are generally mild, and include redness, swelling, or bruising at or near the injection site. For patients who engage in Bellafill treatment, a small intradermal skin test will be necessary to ensure that an allergic reaction will not occur during the treatment session.

When dermal fillers with a thicker formulation are applied to the tear trough area, this can lead to lumps and/or a bluish tint under the eye (known as the “Tyndall effect”). For this reason, Dr. Green prefers smaller particle size facial fillers for the under-eye area, such as Restylane and Belotero, and discourages the use of thicker formulations such as Juvederm or Sculptra for this delicate area of the skin.

How long does it take for facial fillers to settle?

The length of time it takes a facial filler to settle varies widely depending on the filler being used. In general, HA fillers settle within the first few days post-treatment, once any initial swelling subsides. Radiesse may appear firm on the surface of the skin at first, but this should subside over the course of the first few weeks. Sculptra takes a bit longer to show results, and typically requires three to four injections each spaced about a month apart. Bellafill typically shows initial results within a few days of treatment, though many patients engage in a touch-up treatment 4-6 weeks after their first Bellafill procedure to ensure optimal results.

Are facial fillers dangerous?

When facial fillers are administered by a veteran, board-certified medical professional, there is very low risk for any serious side effects. However, it’s important to note that inexperienced injectors can put patients at risk for more severe side effects. Medical spas and other aesthetic services often advertise dermal fillers but, when these fillers are incorrectly administered, such as directly injected into a blood vessel, side effects such as vision impairment or blindness can occur. For this reason, it is vital that you work with an experienced, artful injector. Dr. Green has over two decades of experience with injectable treatments, and the safety and satisfaction of her patients is her top priority.

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How much are facial fillers?

The cost of facial fillers varies widely depending on the number of syringes of dermal fillers needed, the type of dermal filler utilized, the treatment areas, and the aesthetic goals of each individual patient. Costs can vary from $800-2500 depending on the treatment plan, though most patients find that their facial filler treatment is well worth the cost. When you develop your treatment plan with Dr. Green, she’ll be able to give you tailored options that incorporate your individual needs and goals, as well as your budget.

How do I get started with facial fillers today?

Facial fillers have completely revolutionized cosmetic dermatology and have replaced the need for many invasive plastic surgery procedures. Dr. Michele Green is an internationally renown expert in cosmetic dermatology and is known for her cosmetic artistry and her “less is more” philosophy. With over 25 years of experience in dermal filler injections, the best Botox injections, laser rejuvenation, and microneedling, Dr. Green will help design the best skin care and treatments for your skin. Whether the goal is to restore age-related volume loss, reducing the appearance of fine lines and wrinkles, lip augmentation or pan-facial rejuvenation, Dr. Green will help customize the best cosmetic treatment plan for you.

Dr. Green is consistently voted as one of the best cosmetic dermatologists in Manhattan by Castle Connolly, Super Doctors, New York Magazine, and The New York Times. Please contact us online today or call our NYC office at 212-535-3088 to schedule your consultation and treatment plan today with Dr. Green.

 

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