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Aside from fat grafting, there are a variety of less permanent injectable fillers available today. As we age, our faces begin to show the effects of gravity, exposure to the sun, and years of facial muscle movement, such as smiling and squinting. The underlying tissues that keep our skin looking youthful begin to break down, often leaving laugh lines, smile lines or facial creases over the areas where this muscle movement occurs.
Injectable fillers can help fill in these lines and creases, temporarily restoring a smoother, more youthful-looking appearance. When injected beneath the skin, these fillers plump up creased and sunken areas of the face. They can also add fullness to the lips and cheeks. Among the most popular are:
Botox®
Botox is the number one cosmetic procedure in the United States, with 3.8 million treatments in 2005. Botox was introduced in the late 1980s by ophthalmologists for treating optic muscle disorders. It was approved by the FDA for cosmetic use in 2002, helping millions of patients get rid of nagging facial lines and wrinkles. It is a simple, nonsurgical, physician-administered treatment that can temporarily smooth moderate to severe frown lines between the brows. For product information, view the following link: http://www.botox.com.
Botox typically reduces wrinkles by 80 percent. Patients are typically between the ages of 35 and 60. Results vary among individual cases, and the results are temporary. You will need to plan for additional injections, depending on your long-term treatment goals.
Botox injection is performed in office, usually without anesthesia. However, a numbing cream may be applied to the treatment area. Patients may experience some minimal discomfort from the needle injection.
The selection of injection points is critical to the success of the procedure. The points of injection are first scored with a marking pencil. The doctor may select numerous injection points for each location to be treated. These points may not be located on the wrinkle itself, but at the area where the muscle contracts. Antiseptic is also applied.
The Botox filler is then injected into the marked points beneath the skin. The toxins in Botox fasten to the muscles' nerve endings, which inhibits the release of the chemical acetylcholine. This will stop the muscle contractions that wrinkle the skin.
Recovery
Depending on the extent of treatment, the procedure can take a few minutes up to 20 minutes. Generally, patients return home shortly after the treatment is complete. Patients may experience muscle weakness or drooping of the upper eyelid muscles. This side effect usually resolves itself within days, or in rare cases, months after the procedure.
Dysport®
Dysport® is a simple, effective, nonsurgical, physician-administered treatment that works by relaxing facial muscles on the forehead, thereby reducing and smoothing away frown-lines and wrinkles. For product information, view the following link: http://www.dysport.com.
Studies showed that Dysport was:
- Most effective in women
- More effective for African-American patients
- Longer-lasting for African-American patients
- Less effective for people 65 and older
Restylane®
Restylane® is a hyaluronic acid dermal filler that is injected into the skin to restore volume to correct moderate to severe facial wrinkles and folds, such as the lines from your nose to the corners of your mouth (nasolabial folds). Restylane enhances your natural looks by restoring your skin's volume, creating softness and revitalizing your appearance. http://www.restylaneusa.com
Restylane is injected into the skin in small amounts using a very fine needle. The gel provides hydration and structure and gives natural volume to smooth away the appearance of lines, enhance facial shape, or create fuller lips.
The treatment is very quick and often takes less than 30 minutes. The treatment benefits can normally be seen instantly and Restylane does not affect facial expression. No skin test is required because Restylane does not contain any animal-derived ingredients.
Recovery
You can expect slight redness, swelling, pain, tenderness, itching and/or bruising following Restylane treatment. This is the same as you might expect with any type of injection. However, the discomfort is temporary and generally disappears after a few days.
Perlane®
Perlane® is a hyaluronic acid dermal filler that is injected into the skin to restore volume to correct moderate to severe facial wrinkles and folds, such as the lines from your nose to the corners of your mouth (nasolabial folds). Perlane® has larger gel particles than Restylane® and is intended to be injected deeper within the skin. Perlane® lasts around six months. However, results may vary and correction is temporary. Supplemental "touch up" treatments may be required to achieve and maintain optimal results. For product information, view the following link: http://www.restylaneusa.com.
Common uses for Perlane® filler include:
- Wrinkle correction
- Diminishing worry lines, smile lines, crow's feet, marionette lines at corners of the mouth, and smoker's lines
- Lip enhancement
- Reducing the severity of nasolabial folds
- Chin augmentation
- Filling cheek depressions
- Redefining lip border
- Softening acne scars
Other, less common, uses for Perlane® filler include:
- Filling hollows under the eyes
- Creating a temporary eyebrow lift
- Correcting facial depressions caused by fat loss
- Softening the appearance of jowls
Juvéderm Ultra ®
Juvéderm Ultra® injectable gel is a hyaluronic acid dermal filler that restores skin volume and smooths away facial wrinkles and folds, like "smile lines" or "parentheses" (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth). One Juvéderm® treatment could smooth lines and wrinkles for up to 1 year. However, results may vary and correction is temporary. Supplemental "touch up" treatments may be required to achieve and maintain optimal results. For product information, view the following link: http://www.juvederm.com.
The actual treatment takes from 15 to 30 minutes. Injections of tiny quantities of the Juvéderm® using a fine needle below the line or wrinkle they are treating or, during lip enhancement, into the edge of your lip. As the anesthetic takes effect you are likely to feel numbness and a bit of tingling in the area that has been treated.
Recovery
Immediately after treatment, it's likely you will be a little swollen—this is totally normal. While the changes you notice at your first glimpse in the mirror may be bigger than you were expecting, you shouldn't panic. Once the swelling has gone down, which could take a few days, you will see the final result.
- Applying make-up for 12 hours afterwards
- Drinking anything too hot or too cold (if you have had lip treatment)
- You may see some swelling, bruising or redness at the injection sites
- Use a perfume-free moisturizer if you have any dry skin
- If you have any concerns, contact your practitioner
- Expect to be invited back for a follow-up appointment after around 2 weeks to make sure you are happy
So nothing too complicated. You should expect your new look to last for up to 12 months in lines, and somewhat less in the lips. However, everyone is different and this depends on some of your natural biology.
Juvéderm Ultra Plus®
Juvéderm Ultra Plus is a more robust formulation for volumizing and correcting deeper folds and wrinkles. Juvéderm Ultra® injectable gel is a hyaluronic acid dermal filler that restores skin volume and smooths away facial wrinkles and folds, like "smile lines" or "parentheses" (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth). One Juvéderm ® treatment could smooth lines and wrinkles for up to 1 year. However, results may vary and correction is temporary. Supplemental "touch up" treatments may be required to achieve and maintain optimal results. For product information, view the following link: http://www.juvederm.com.
Radiesse®
Radiesse® dermal filler is made of calcium-based microspheres suspended in a water-based gel. It can restore a healthy, youthful appearance, and enhance existing features. Results last up to a year or more for many patients,. However, results may vary and correction is temporary. No pretesting for allergies is required with Radiesse®. For product information, view the following link: http://www.radiesse.com.
Once injected, Radiesse dermal filler starts a process called neocollagenesis, or the creation of new collagen. It stimulates collagen production in your own body and encourages collagen growth around the injection site. In many cases, results may last up to a year or more.
Radiesse dermal filler is injected into the skin through a simple, safe, quick, and minimally invasive outpatient procedure. Treatment typically takes place in a physician's office with the use of a local anesthetic.
Recovery
Most patients experience little to no downtime and return to normal activities almost immediately after treatment. Other patients may need more time for recovery. By 24 hours after treatment, most swelling and redness will have subsided.
Evolence®
Evolence® is collagen dermal filler that improves and refreshes your appearance by smoothing out and softening the appearance of unwanted facial wrinkles and folds, and restoring structure and facial contour in volume-depleted areas. Evolence® lasts through 12 months. Evolence® does not require a skin pre-test for allergies. For product information, view the following link: http://www.evolence.com/us/about-evolence-us.jsp.
Evolence may include injection-site reactions such as mild swelling, redness, and pain. Typically these go away from within hours to a few days. Other rare side effects with Evolence include the development of small areas of firmness under the skin at the treated sites. These lumps or bumps may be noticed when the areas are pressed upon.
Zyderm®
Zyderm® is collagen dermal filler that is injected just below the surface of the skin to smooth wrinkles or define the lip border. Part or all of the correction may last for 2 years or more. Zyderm 1 is used to treat fine lines, wrinkles, shallow scars and thin-skinned areas. Zyderm 2 is used to treat moderate lines, wrinkles and scars. Zyderm® requires collagen allergy pre-testing. For product information, view the following link: http://www.allergan.com/products/medical_aesthetics/zyderm_zyplast.htm.
The procedure takes only a few minutes to perform and you can resume normal activity immediately following the treatment. Some patients even get Zyderm® and Zyplast® injections on their lunch break and then return to work looking years younger. Small amount of gel are injected into the area to be enhanced using a very fine needle. I will massage the area to make sure there are no bumps and to ensure that the product is distributed evenly and smoothly. One of the most attractive features of Zyderm® and Zyplast® is that they contain a numbing agent called lidocaine to help patients feel more comfortable during the short procedure.
Recovery
After the Zyderm® and Zyplast® injections, you may experience tenderness, redness, slight swelling, or bruising at the injection site. These effects should subside within a day or two of the procedure, but healing time will ultimately depend on the person.
Zyplast®
Zyplast® is a collagen dermal filler that is injected just below the surface of the skin to smooth wrinkles or define the lip border. Part or all of the correction may last for 2 years or more.
Zyplast implant is used to treat pronounced lines and wrinkles, scars, and thicker-skinned areas. Zyplast® requires collagen allergy pre-testing. For product information, view the following link: http://www.allergan.com/products/medical_aesthetics/zyderm_zyplast.htm.
CosmoDerm®
CosmoDerm® is a collagen dermal filler approved for the correction of facial wrinkles, acne scars, and other soft tissue contour deficiencies, as well as for the restoration of the lip border. The collagen in CosmoDerm® dermal filler was designed especially for people with fine wrinkles or scars that are not very deep. It can be particularly effective in smoothing delicate frown and smile lines, as well as the fine creases that develop at the corners of the eyes, and above and below the lips. It can also help correct certain kinds of scars. Most people who choose to receive touch-ups for lines or deep wrinkles choose to do so within 3 to 12 months of the original treatment series. Based on the results of a clinical study conducted by Allergan, No pretesting for allergies is required with CosmoDerm®. For product information, view the following link: http://www.allergan.com/products/medical_aesthetics/cosmoderm_cosmoplast.htm.
The first visible damage to skin on the face usually comes in the form of fine wrinkles and lines caused by sun damage and pollution. CosmoDerm™ can help to reduce the appearance of these fine lines by adding collagen to the area just below the skin. If you are beginning to notice crow's feet around your eyes, or small vertical lines above your upper lip, you may be an excellent candidate for CosmoDerm™ human collagen injections.
Your appointment will likely take less than an hour—many people have treatment completed on their lunch breaks. Redness and swelling are generally unlikely after a CosmoDerm™ or CosmoPlast™ treatment, so you can immediately return to your busy lifestyle.
CosmoPlast®
CosmoPlast® is collagen dermal filler designed to treat depressions requiring a stronger treatment material. It is used for more pronounced wrinkles and scars (such as deeper scars, lines, and furrows) and for areas upon which more stress is exerted (such as the corners of the mouth). Most people who choose to receive touch-ups for lines or deep wrinkles choose to do so within 3 to 12 months of the original treatment series. For scars and depressions treated with CosmoPlast® dermal filler, the time between touch-ups may be longer. Based on the results of a clinical study conducted by Allergan, No pretesting for allergies is required with CosmoPlast®. For product information, view the following link: http://www.allergan.com/products/medical_aesthetics/cosmoderm_cosmoplast.htm.
CosmoPlast™ provides a treatment option for patients who have deep wrinkles between their brows or smile lines from their nose to their mouth. Severe acne scars can also be successfully treated with CosmoPlast™ human collagen injections. CosmoPlast™ works by filling in deep folds with collagen that acts just like the natural collagen that has been worn away with time.
Your appointment will likely take less than an hour—many people have treatment completed on their lunch breaks. Redness and swelling are generally unlikely after a CosmoDerm™ or CosmoPlast™ treatment, so you can immediately return to your busy lifestyle.
ArteFill®
ArteFill® consists of a combination of microsphere enhanced collagen and lidocaine for comfort. It is indicated for the correction of facial wrinkles known as nasolabial folds or smile lines. Studies have shown that patients who received an ArteFill® injection showed an improvement in the nasolabial folds five years after treatment. Artefill requires collagen allergy pre-testing. For product information, view the following link: http://www.artefill.com.
ArteFill is injected directly beneath the wrinkle to add a permanent support structure and smooth the area. As the injected bovine collagen is slowly absorbed during a few weeks, the newly generated collagen replaces it. This slow breakdown and natural replenishment process provides ArteFill with its unique and enduring results.
Recovery
Artefill also contains an anesthetic to lessen the pain from the procedure. With proper placement, Artefill cannot be felt after treatment. You will see immediate results and be able to return to your normal daily activities after the procedure.
As with any injectable wrinkle filler, you can expect mild swelling and reddening at the treatment site. These side effects are usually gone within 24 hours. Occasionally, there is mild bruising that typically disappears in three to seven days. Less common side effects include rash and itching more than 48 hours after treatment, persistent swelling or redness, and increased sensitivity at some or all injection sites.
Sculptra®
Sculptra contains a synthetic material, poly-L-lactic acid, which is injected to restore facial fullness and to treat nasolabial folds, sunken cheeks, deep wrinkles, or facial creases. For individuals with human immunodeficiency virus, Sculptra is approved by the FDA for restoration or correction of the signs of facial fat loss (lipoatrophy). For product information, view the following link: http://www.sculptra.us/us/.
The Sculptra procedure is performed for patients aged 35 to 60. It is most often performed with the use of a topical numbing cream and possibly a local anesthetic. Patients may experience minimal discomfort from the needle injection. The procedure can take 15 to 30 minutes. Patients return home within minutes after the procedure.
- Step One: The doctor may select numerous injection points for each area to be treated.
- Step Two: The doctor will identify the correct amount of Sculptra for the procedure.
- Step Three: The Sculptra filler is then injected beneath the skin, under the dermis and subcutis layer.
- Step Four: Patients will be advised to apply an ice pack to reduce swelling. Patients will also be instructed to massage the area to help promote even distribution of the material.
Results gradually become evident over the course of a few weeks.
Recovery
Normal activities can be resumed immediately; however, patients are advised to stay out of the sun. Touchup treatments may be required up to six times every six weeks to achieve an optimal result. If you experience unmanageable pain or symptoms that are progressive or abnormal, report it to the doctor immediately.
After your treatment, you might have some redness or swelling. This will normally last for only a few days, although everyone is different. Sun exposure should be avoided until any redness or swelling disappear.
Before and after photos of our Los Angeles Botox and Restylane patients are available in the office.
In addition to providing the above mentioned injectables and fillers, the surgeons at Beverly Hills Body also offer other facial procedures to enhance appearance. Visit our Los Angeles facelift, facial fat grafting, blepharoplasty, and brow lift pages to see the results attained by our Beverly Hills plastic surgery patients.
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