Dermal fillers are popular for several reasons. Patients like that they can return to everyday activities immediately after getting most fillers. They like the immediate results that many types of fillers deliver. Patients also like that they can get this treatment during an office visit. Some fillers require a few office visits.

Dr. Pantea Hashemi at the University Skin Institute chooses FDA-approved fillers that integrate into the tissues to give you a natural result when the face is at rest and with movement.

Hyaluronic Acid (HA) fillers

The Juvederm® Family of Fillers

Juvederm is a family of products with a variety of formulations for different purposes, to temporarily reduce the appearance of aging by diminishing the look of wrinkles and creases. All of the Juvederm fillers contain lidocaine for comfort during injection.

Juvederm XC smooths moderate to severe wrinkles around the mouth, nasolabial folds (vertical lines that run from the corners of the nose to the mouth).

Juvederm Ultra XC is perfect for lip augmentation, and to fill vertical lip lines; to improve the appearance of fine to moderate lines and wrinkles and facial folds. Results last about a year.

Juvederm Ultra Plus XC is thicker and can correct deep lines and wrinkles and improve facial contours.  Results last about a year.

Juvederm Voluma XC is designed to restore age related volume loss in the cheeks. It provides lift and contours for a more youthful appearance. It lasts more than two years.

Juvederm Vollure XC is used to soften moderate to severe wrinkles and folds and smooth vertical lip lines and provide subtle volume enhancement in the lips.

Juvederm Volbella XC is specifically designed for the lip augmentation. It has been recently approved for tear trough treatment.

The Restylane® Family

Similar to Juvederm, the Restylane family of fillers are used to add volume and fullness to correct moderate to severe wrinkles and folds, and for lip enhancement.  Restylane is a clear gel of hyaluronic acid formulated to act like your body’s naturally produced HA, adding volume, lifting and smoothing wrinkles. It can last up to eight months, but some patients experience effects lasting for up to a year.

  • Restylane classic corrects nasolabial folds, marionette lines, undereye hollows and frown lines. Adds natural volume as it integrates into the tissues and attracts water to volumize.
  • Restylane Lyft is suitable to correct moderate to severe lines and wrinkles and for cheek augmentation. Effects last 6-12 months.
  • Restylane Silk is valuable to correct lip lines and for lip augmentation
  • Restylane Refyne is specially formulated to treat mild to moderate marionette lines that run from the corners of the mouth to the chin.
  • Restylane Defyne is specially formulated to correct moderate to severe marionette lines.
  • Restylane Kysse is specially formulated to augment the lips while maintaining the flexibility to lip movements. It enhances lip texture and color and diminishes upper lip lines (lipstick lines).

While Restylane and Juvederm are both hyaluronic acid products, and can be used to treat similar conditions, Dr. Hashemi may have preferences based on experience. After evaluating your skin and goals she will recommend the best choice for you.

The RHA® family of fillers by Revance Theraputics

The RHA family of dermal fillers is made using the most advanced HA science that mimics the HA naturally produced in the skin. Because it moves and acts like our tissues, it is perfect to treat dynamic wrinkles and deliver very natural results.

RHA fillers are the first HA fillers created to treat dynamic wrinkles without concern for unnatural results. RHA fillers are designed to adapt to facial movements without any limitation on mobility which leads to the most natural looking results.

Dynamic wrinkles are created from repetitive facial movements that express how we feel. Over the years, facial expressions such as frowning, squinting, brow furrows, and crow’s feet crease the skin and are classic signs of skin damage and aging. RHA fillers are proven to last up to 15 months.

Radiesse®

Radiesse is not an HA filler. It is a dual action dermal filler that adds volume to the face to diminish facial wrinkles and folds. Treatment can fill out the hollows in cheeks and smooth wrinkles. Radiesse is made of microspheres of Calcium Hydroxylapatite (CaHA) in a gel base.  It is biostimulatory, meaning once injected, it provides immediate volume and correction and stimulates the production of your own natural collagen. Over time, the gel is absorbed, and the body metabolizes the CaHA microspheres leaving behind only your own natural collagen.

Radiesse is an excellent option to plump your skin for immediate smoothing results and a long-lasting natural look. Effects last up to a year, but the new collagen helps to retain the improvements much longer

Sculptra

Sculptra or Poly-L-Lactic Acid is a biostimulatory filler that is FDA approved to gradually replace collagen loss on the face. It can be injected safely by an experienced injector  anywhere in the face but mostly it has been used in temples, midface and cheeks to restore the volume loss. It has been used off-label for many years on other parts of the body e.g. buttocks, chest and décolletage. It is one of the most long lasting fillers in aesthetic science as the result will be visible up to two to three years after treatment. The result is softer and more natural as the collagen is built up over a course of a few months.

Sculptra Aesthetic is not indicated for use in people that are allergic to any ingredients of the products or have a history of keloid formation.  Also it is not indicated during pregnancy and breastfeeding.

Dr. Hashemi can work with you to figure out the number of vials and treatment sessions needed to achieve your desired outcome. The average regimen is three treatments spaced out between three to four weeks.

What happens when I get a filler?

The procedure varies with the filler your dermatologist will use, the part of the body to be treated, and your medical history. Here are some general guidelines about what you can expect:

  • Most filler treatments take between 15 and 30 minutes and require one office visit.
  • Before getting the injections, you may need ice, an anesthetic applied to the skin, or a nerve block (an injection). This varies with the filler and area to be treated. Hands generally do not need anesthesia; lips often require a nerve block.
  • Your dermatologist will inject the filler into the area, often giving you several injections to produce the best results.
  • You may feel a stinging or burning sensation as the filler is injected.
  • A few fillers require allergy testing to make sure you do not have an allergic reaction.
  • If your own fat will be used as a filler, the entire treatment can often be completed in one day. You will first have a procedure called tumescent liposuction, which safely removes a small amount of fat from another area of your body. The fat removed from your body is then processed so that it can be injected into the area that needs more fullness.

What must I do after getting a filler?

Most patients can return to their everyday activities after leaving the office. To reduce any redness and swelling from the injections, your dermatologist may recommend icing the area for 15 to 20 minutes before you leave.

After leaving the office

  • Wait until the next day to exercise or do any other strenuous activity.
  • Stay out of the sun and do not use a tanning bed or other type of indoor tanning.
  • Avoid touching the treated area for three days, unless you receive instructions to massage the area.
  • One filler, poly-L-lactic acid, requires you to gently massage the treated area for about 5 minutes several times a day for 1 to 2 weeks. Your dermatologist will tell you if you need to massage the area.

Is there downtime?

This varies with the filler. Most fillers do not require downtime. Be sure to ask your dermatologist whether you will have downtime.

When will I see results after getting a filler?

This also varies with the type of filler. Most fillers plumb the skin, so they produce immediate results. A filler also can stimulate your body to produce collagen, but this takes time.

Will I look natural?

To get natural-looking results, the person injecting the filler must have expertise in placing the filler.

Dermatologists recommend not overdoing fillers. Your results will look more natural with a conservative approach. For example, patients who have very thin lips should not get dramatically fuller lips. Creating fuller lips in these patients could be extremely unflattering.

How long will the results from fillers last?

Most fillers offer temporary results and require repeat treatments to maintain the results. Temporary fillers offer one key advantage. These can be injected as needed to replace lost fullness. This is advantageous because no matter what we do, our skin continues to age.

Contact Dr. Hashemi at the University Skin Institute in Sacramento to schedule a consultation and discover all your options for facial rejuvenation.