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Fillers CASE STUDIES
Fillers
Our Surgical Team recognizes that every face is unique and therefore employs a customized injection plan when performing facial filler injections on patients. Unlike other injectors, he utilizes a multi-layered injection technique to fill in areas experiencing hollowing and/or volume loss from the inside out. Our Surgical Team first uses Radiesse to build deeper hollows and wrinkles as a scaffold; this provides a base for the superficial on-lay of Restylane or Juvederm. This unique filling approach allows for complete correction and natural, aesthetically pleasing long-lasting results.
Areas commonly injected with Radiesse filler include:
- a)the nasolabial folds
- b)the cheeks
- c)nasojugal creases
- d)prejowls
- e)orbital rims
- f)the nose.
Our Surgical Team routinely corrects many nasal contour irregularities with facial fillers, termed non-surgical rhinoplasty, that would otherwise require nasal surgery.
Areas commonly injected with Restylane or Juvederm include:
- a)the eyelids
- b)superficial nasojugal and nasolabial folds
- c)the lips (the only filler indicated to improve lip contour and fullness)
Our Surgical Teami’s extensive training and unparalleled artistic eye allow him to deliver consistently outstanding results to patients of all ages. Facial fillers remain a great alternative for patients seeking immediate results with minimal downtime. In order to appreciate what Our Surgical Teami’s fillers can do for you, please contact our office at (949) 506-2026 for a complimentary consultation.
Procedure
Filler material (Radiesse or Juvederm) used as an injection material facial filler to augment facial/nasal contour or to improve wrinkles.
Length
15 Minutes
Anesthesia
No sedation (local anesthetic only)
Place of Treatment
Office procedure room
Side Effects
a) Bruising/Swelling: Temporary bruising and swelling may occur but is rare and temporary and subsides within a few days
b) Numbness: Patients may have a temporary loss of sensation in the cheek region due to swelling after surgery. The numbness always disappears within a few days .
c) Asymmetrical cheeks: An uneven appearance of the cheek may result if the cheek is asymmetric prior to injection. Your surgeon will make all attempts to compensate for any asymmetry by using different positioned and volume of filler.
Risk
a) Hematoma: will rarely occur as Our Surgical Team pre-injects with a local anesthetic that constricts neighboring blood vessels.
b) Blindness: is a rare phenomenon. Our Surgical Team has never had a case of blindness; this is because as a surgeon he is very knowledgeable of the anatomic structures; in addition injection into an artery (the route of filler getting into the ocular artery) and thrombosis is unlikely as he always pre-injects with a local anesthetic solution that constricts the neighboring vessels.
Recovery
Patients may feel slightly sore for a couple hours following this procedure.
Duration of Results
You can expect to see results for up to 6 months with Juvederm and up to a year and a half for Radiesse.
FREQUENTLY ASKED QUESTIONS
How often do I need to perform my facial fillers?
The duration of facial fillers is dependent on the medium used to fill the wrinkle, fold, contour defect, or deflated lip and/or cheek. The most effective and safe fillers on the market currently are Radiesse and Restylane/Juvederm. The Radiesse product is made of coral material found on the ocean floor. The coral is modified to mimic bone like substance. As such it lasts longer than traditional filler materials, and is excellent for the cheeks, between the eyebrows (glabella), chin, and laugh lines (nasolabial folds and marionette lines) which are overlying bony prominences. Radiesse will last approximately one year. Restylane and Juvederm are both a matrix that is made to mimic a naturally occurring protein that preserves space between cells acting much like a sponge or cushion. As such, Restylane and Juvederm are ideal for filling of areas that are meant to be soft such as the lips. Restylane and Juvederm last approximately one year.
What happens if I do not like the effect of the filling?
For Juvederm and/or Restylane the patient has up to three days to mold the substance if the effects are not desirable. For Radiesse which is a firmer filler, there is a 24 hour period of moldabiltiy. It is prudent for the patient to be seen by their physician within these time periods so that any molding of the substances can be achieved to correct for asymmetry and/or undesired overfilling.
What happens if I don’t like the effects of the filling agent after the filler has set in and is no longer moldable?
First, Restylane/Juvederm and Radiess facial fillers have a lifespan and will absorb if you are patient. The lifespan for Restylane/Juvederm and Radiesse are 6 months and one year respectively. Second, steroid injections locally can be performed to reabsorb any areas of undesired prominence. Patients will observe reabsorption of areas injected 2 to 4 weeks following injection. Of note, areas around the eye are not safe to be injected with steroids.
Do I lose sensitivity following injection?
Patients may observe transient numbness following injection with facial fillers but this is caused by localized swelling and will subside over a few weeks. Rarely, a sensory nerve may be injured by the needle used to transfer the filler. A nerve injured in this fashion will regrow and return sensation within a few months.
Can I stack the facial fillers (use both for the same area, i.e. wrinkle)?
It is possible to stack facial fillers in an attempt to correct deeper wrinkles. When performing stacking techniques, the Radiesse filler, which is firmer, is injected into the deeper plane and the Restylane/Juvederm filler is injected into the more superficial plane. The Radiesse in essence acts like a scaffolding for the Restylane/Juvederm filler. This technique allows for correction of stubborn wrinkles or deeper wrinkles.
It has been observed that in patients who have undergone four or more sessions using facial fillers, that some permanent correction may occur. This is because each time a filler is injected, some scar tissue is layed down by the body secondary to the irritation of the area injected. This scar tissue is actually beneficial in that it is typically smooth and provides for permanent correction of the treated area.
Is there a limit to the amount of filler (number of syringes) that I can use?
There is no limit to the number of filler syringes that a patient may use. However, due to the cost of the syringes, patients are advised to consider fat grafting as another option if they will require more than four syringes for correction of a deformity/wrinkle. Since the fat is obtained from the patients body, the filler material is unlimited and thus the patient must only pay for the surgical fee and not the filler material.
PATIENT SPECIFIC QUESTIONS
How often do I need to perform my facial fillers?
The duration of facial fillers is dependent on the medium used to fill the wrinkle, fold, contour defect, or deflated lip and/or cheek. The most effective and safe fillers on the market currently are Radiesse and Restylane/Juvederm. The Radiesse product is made of coral material found on the ocean floor. The coral is modified to mimic bone like substance. As such it lasts longer than traditional filler materials, and is excellent for the cheeks, between the eyebrows (glabella), chin, and laugh lines (nasolabial folds and marionette lines) which are overlying bony prominences. Radiesse will last approximately one and a half years. Restylane and Juvederm are both a matrix that is made to mimic a naturally occurring protein that preserves space between cells acting much like a sponge or cushion. As such, Restylane and Juvederm are ideal for filling of areas that are meant to be soft such as the lips. Restylane and Juvederm last approximately six months.
What happens if I do not like the effect of the filling?
For Juvederm and/or Restylane the patient has up to three days to mold the substance if the effects are not desirable. For Radiesse which is a firmer filler, there is a 24 hour period of moldabiltiy. It is prudent for the patient to be seen by their physician within these time periods so that any molding of the substances can be achieved to correct for asymmetry and/or undesired overfilling.
What happens if I do not like the effects of the filling agent after the filler has set in and is no longer moldable?
First, Restylane/Juvederm and Radiesse facial fillers have a lifespan and will absorb if you are patient. The lifespan for Restylane/Juvederm and Radiesse are 6 months and one year respectively. Second, steroid injections locally can be performed to reabsorb any areas of undesired prominence. Patients will observe reabsorption of areas injected 2 to 4 weeks following injection. Of note, areas around the eye are not safe to be injected with steroids.
Do I lose sensitivity following injection?
Patients may observe transient numbness following injection with facial fillers but this is caused by localized swelling and will subside over a few weeks. Rarely, a sensory nerve may be injured by the needle used to transfer the filler. A nerve injured in this fashion will regrow and return sensation within a few months.
Can I stack the fillers (use both for the same area, i.e. wrinkle)?
It is possible to stack facial fillers in an attempt to correct deeper wrinkles. When performing stacking techniques, the Radiesse filler, which is firmer, is injected into the deeper plane and the Restylane/Juvederm filler is injected into the more superficial plane. The Radiesse in essence acts like a scaffolding for the Restylane/Juvederm filler. This technique allows for correction of stubborn wrinkles or deeper wrinkles.
Can I get any permanent correction using facial fillers?
It has been observed that in patients who have undergone four or more sessions using facial fillers that some permanent correction may occur. This is because each time a filler is injected, some scar tissue is layered down by the body secondary to the irritation of the area injected. This scar tissue is actually beneficial in that it is typically smooth and provides for permanent correction of the treated area.
Is there a limit to the amount of filler (number of syringes) that I can use?
There is no limit to the number of filler syringes that a patient may use. However, due to the cost of the syringes, patients are advised to consider fat grafting as another option if they will require more than four syringes for correction of a deformity/wrinkle. Since the fat is obtained from the patient’s body, the filler material is unlimited and thus the patient must only pay for the surgical fee and not the filler material.