FACIAL FILLERS

This newer, and gradually expanding innovation in Facial cosmetic enhancement is receiving greater attention monthly. Do not confuse the use of Facial Fillers with Fat injection, which is still a controversial technique in Cosmetic surgery. The use of Fillers for facial rejuvenation is a "work in progress" being performed by reputable Plastic Surgeons, and Dermatologists with progressive innovations being tried and gradually introduced. Most important, one's outcome is particularly operator dependant. Different Doctors may achieve different results based on the type of filler substance and that Doctor's experience and technique. It should not be considered trivial treatment as when done in cosmetic spas by other than Doctors. So "buyer beware".

Facial Fillers divide into two general categories based on the substance being used. None of these have been found to be allergenic at this time. The first type of substance produces an immediate 'result' or contour change in the specific wrinkle, crease or depression injected. The Doctor (and patient) sees the result achieved right then. Products such as 'Juvederm' or 'Restylane' are of this category. The second type of filler is composed of micro granules of biocompatible substances suspended in saline. When injected just below the skin each micro granule becomes embedded microscopically in site and is gradually encased by the natural scar producing cells (of our body) which slowly build up a layering and thickening case.

This gradual biological process induces thickening and "filling" at the area or depression where injected. But the induced filling may take 10 to 20 weeks to appear. Each patient may react differently. The initial outcome must be awaited and monitored before knowing how effective it is. One must under correct to prevent excessive fill once the reaction is complete. When observed at maturity more filler is usually injected in two or three sequences to reach a desired endpoint of satisfaction. Two of these substances in current use are 'Radiesse' and 'Sculptra'.

Each type is intended for a different use. The first, such as Juvederm is useful for filling fine lines or furrows which occur with ageing particularly at the naso-labial folds, lower corners of the mouth downward (called 'marionette lines'), or fine line wrinkles of the mid cheeks, or forehead. These substances are too thick to fill upper lip lines. The second type of scar inducing filler is being used to build up areas of facial fat atrophy which may progressively occur with ageing. Such atrophy may occur in our cheekbones or temples and in certain skin diseases.

In my own experience I have been very happy with results using Juvederm. This filler achieves immediate visible results and permits cautious under injection as to avoid over fill and artificial puffiness of the face. It's result lasts 4-6 months in most patients and they are usually pleased to return for boosters as it gradually absorbs. I am very pleased with it's use and it has become the 'Filler' of choice in my practice!

I have tried the use of 'Sculptra' (gradual fill inducer) with six patients, but have been disappointed by minimal if any results in this group. In several patients I've carefully repeated their injections at three and six months without any improvement.. Many reputable Doctors do report good results. If interested, ask your Doctor about his or her experience.