The Everything Guide To Skin Fillers

 

Photo: Imaxtree

 

Okay, let’s face it – though we may have a soft spot for razor sharp cheekbones, hollowness is not really anyone’s cup of tea. That said, allow us to show you the light and introduce you to the wonderful world of dermal fillers. With this noninvasive anti-aging treatment, you can not only fill out wrinkles in under an hour but also restore lost facial volume or even add new fullness.

While many of us may be wary of the overfilled lip situations of early 90s TV dramas (looking at you Melrose Place) that are associated with generous amounts of collagen fillers, you should be happy to know they went the way of shoulder pads and for the most part are no longer around. In fact, fillers have evolved to include much more technologically advanced solutions and techniques. Using either naturally-derived or synthetic ingredients, they are now injected into the skin with minimal discomfort. Results and how long they last can vary depending on the type of filler used and the formula within a brand’s range that is chosen.

 

WHAT DO DERMAL FILLERS TREAT?

  • Indentations in the skin from scarring (acne, etc): fillers can create a more even complexion by reducing the appearance of these scars by adding volume in the areas of depression.
  • Hollowness in the cheeks, temples, and around the eyes (one of the causes of dark circles): fillers can assist with restoring the lost volume in order to help make the face look more full and therefore youthful.
  • Fine lines that form underneath the eyes, named “periorbital” lines: These are often among the first signs of aging that appear on the face due to the delicate nature of this skin.
  • Deep wrinkles that run from the nose to the mouth, commonly called laugh lines or “nasolabial” folds: fillers will help smooth out these lines, making them much less apparent.
  • Thin or thinning lips: fillers will help make them plumper and when done well can result in natural looking fullness.
  • Lip lines, the tiny lines that extend around the edges of lips and marionette lines, the crease that runs from the mouth edge through to the chin can be diminished.
  • Aging hands that have lost their youthful plumpness.
  • Dry or dull complexions caused by environmental factors, lifestyle as well as the skin’s reduced  ability to produce the same amounts of collagen and oil as we age.

 

WHAT IS THE DIFFERENCE BETWEEN FILLERS AND BOTOX?

A common misconception is that Botox and dermal fillers are the same thing, although the process is similar as both treatments use injections to target aging concerns, how they work and the results they produce are very different. Botox causes the muscles beneath the skin to relax and prevents them from contracting, this not only smooths the surface out but as it limits the movement that leads to the wrinkles in the first place may also help prevent them from forming in the future. Botox is commonly used to treat moderate crows feet around the eyes and lines between the brows and forehead in general. On the other side of the coin, as we have discussed above, fillers focus on restoring lost volume or adding fullness and, as a byproduct help reduce the appearance of wrinkles.

Check out our in-depth guide if you’re interested in exploring more about the anti-aging benefits of Botox.

The most common wrinkle fillers used today can be broken down into 3 different types: Hyaluronic acid, Synthetic and Autologous.

 

HYALURONIC ACID FILLERS

Hyaluronic acid fillers are among the most popular type out there and are used to smooth out wrinkles, restore volume, and sometimes augment lips. Your body naturally produces Hyaluronic Acid, so when injected, it isn’t considered to be a foreign substance and therefore can penetrate deeply without a high risk of allergy or other safety hazards. The way this type of filler works, is it attracts and binds to water molecules in order to help plump the skin.

 

POPULAR BRANDS

 

BEST FOR

  • Fine lines, specifically around the eyes (periorbital area), lips, and mouth (Belotero Soft, Restylane Silk)
  • Volume restoration for cheeks, lips, and under eyes (Beletero Balance, Beletero Volume,  Juviderm Voluma XC, Juvéderm Ultra XC, Restylane, Restylane Silk)
  • Deeper wrinkles including marionette lines and nasolabial folds (Belotero Balance, Belotero Intense, Juvedérm XC, Restylane & Perlane )
  • Hydrating skin and restoring radiance (Belotero Hydro and Restalyne Skinboosters alternatively known as Restalyne Vital)

 

RESULTS

Temporary (6–12 months) 

Studies show that hyaluronic acid fillers improve collagen reproduction for up to one year after the last injection, with best results showing around the 8 month mark.

 

SYNTHETIC FILLERS

Comprised of either artificial ingredients or a combination with more natural ones, these fillers are popular for the longer lasting results (2 years+) when compared to other injectables. They target the second layer of the skin (dermis), the key support structure of the skin, in order to promote collagen production and help restore volume. The three most popular brands include Sculptra made up of micro-speres of Polylactic Acid (the same compound used in dissolvable stitches),  Radiese that incorporates  Calcium Hydroxyapatite (what makes up your bones) with an aqueous gel and finally Artefill, composed of a mix of Polymethylmethacrylate (microscopic cement beads)  with Bovine Collagen.

 

POPULAR BRANDS

Semi-permanent (1–2 years)

 

Permanent (5 years+)

*length of studies used for FDA approval but it actually lasts longer

 

BEST FOR

  • Deep wrinkles
  • Scars
  • Severe volume loss
  • Sagging

 

RESULTS

The increased collagen production benefits for Sculptra and Radiesse have been supported through studies and although the results may not be as long-term as with permanent fillers they still show a considerable impact.

Research indicates that ArteFill eventually becomes part of your own soft tissue, maintaining its integrity over years and may in fact help prevent  the formation of future folds as well as wrinkles.

 

REACTIONS

In all honesty when it comes to preventative anti-aging we’re a little hesitant about the use of more permanent dermal filler solutions as there are a number of complications associated with them that go beyond norm.

On an aesthetic note as you grow older your facial shape changes due the effects of gravity and volume loss but since the artificial ingredients in these type of fillers don’t “age” you run the risk of looking a little “unnatural” over time.  On a more healthcare note, as the body treats the synthetic ingredients as foreign objects it can lead to reactions inclusive of the formation of granules and lumping that may get infected. Be sure to tread carefully, do your in-depth research and check with your skincare practitioner before going ahead with this treatment.

 

WHAT YOU SHOULD EXPECT DURING A DERMAL FILLER TREATMENT?

When selecting the right kind of filler for your skin, it’s important to note the procedure, benefits, cost and downtime.

 

PRE-PROCEDURE

  • Avoid any blood thinners, alcohol, or ibuprofen before the treatment, as this may increase the risk of bruising after treatment.
  • Be sure to clear your schedule of any major events after the procedure, as you may have swelling or bruising that may not be so easy to cover up during the first few days.
  • You will meet with your skincare practitioner before the procedure to map out the areas of where injections will go; so be sure you allocate enough time for this.

 

PROCEDURE

  1. The injection sites will be cleansed before treatment begins and a photograph may be taken.
  2. In order to minimize pain a topical local anesthetic will be applied and left on for anywhere from 20-30 minutes.
  3. The doctor will then inject the marked sites, massage the filler into the skin, and evaluate the immediate results.
  4. In general there isn’t much pain post injection but you still may require an ice pack once done to deal with swelling and tenderness.
  5. After that you’re ready to go home!

 

LENGTH OF TREATMENT

  • The total treatment usually last around 1 hour, depending on the area being treated.

 

POST TREATMENT

  • Keep an ice-pack on hand at home if you feel or notice any swelling or tenderness on the injection sites.
  • Pain medication isn’t necessary after treatment, but you may take Tylenol if you feel discomfort. Ibuprofen is not recommended, as this may increase bruising.
  • Though we don’t recommend it, you can start to wear makeup a few hours after treatment – once your skin has calmed down.
  • While the dermal filler settles avoid any sudden movements or strenuous activity such as exercise the day of the treatment and for 24-48 hours afterwards.
  • Avoid UV exposure as hyperpigmentation may happen around injection sites until after the swelling and redness has subsided.  If you must go in the sun make sure to wear a good sunscreen.
  • Avoid anti-aging skincare treatments, exfoliation or rubbing the area for 1-2 weeks after the treatment.

 

DOWNTIME

After fillers you may appear a bit puffy and lines may appear more prominent. Don’t worry this is just temporary and usually takes from 2-4 weeks to subside.

  • Although you’re usually able to get up and go right after the anti-aging treatment, you may look noticeably swollen for the first 1-2 days.
  • Bruising is always a risk with any kind of injection in the skin, so if you are prone to it you may require more than the average 4–7 days to dissipate.

 

COMMON SIDE EFFECTS

  • Tiny lumps that generally go away by themselves may appear immediately after the treatment. If they don’t go away within a few weeks make sure to check in with your skincare practitioner.
  • Sometimes skin may become discolored with a bluish tint. This is known as the Tyndall Effect and usually happens when fillers are placed too close to the surface or in areas with thin skin like under the eyes in the tear trough.

 

A WORD OF CAUTION

Generally the dermal fillers mentioned here are safe for most people, though you should ask your skincare practitioner to do a patch test if you’re worried about allergic reactions, that consists of an injection into a small inconspicuous area (especially in the case of Artefill that contains collagen). Another caution is some brands (including Artefill, Juviderm, and Restylane) use Lidocaine in some of their formulas, which is a painkiller and may cause a reaction. Make sure to check in beforehand should you have any concerns.

 

A LOOK INTO AUTOLOGOUS FILLERS

Autologous fillers use cells or tissue taken from one part of the body that are then injected into another. One of the main benefits is since the cells are sourced from your own body chances of a allergic reaction are limited when compared to the likes of Collagen or Synthetic Fillers.  There are two main types of autologous filler, one that uses fibroblast cells (part of the body’s connective tissue that makes collagen and helps provide structural support) and the other that involves fat. Advances are constantly being made with this anti-aging treatment leading to results that last longer and also look more natural.

 

AUTOLOGOUS FILLERS:  FIBROBLAST CELLS

This type of anti-aging treatment use your body’s fibroblast cells to promote collagen renewal and restore volume. Research indicates that it works especially well to reduce the appearance of static wrinkles (the ones that stay on the face even when expressionless) such as fine lines around the mouth.  Tissue is collected from behind the ear by a skincare practitioner and then sent over to a laboratory in order to “grow” (a process where the cell culture is multiplied over a course of 11-22 weeks) after that they are sent back to be injected into a patient over a course of 3 sessions spaced a few months apart. Cell collection only needs to take place once, for each additional treatment following the first the laboratory just needs to be contacted in order to grow more cells.

 

POPULAR BRANDS

  • LaViv is one of the only brands on the market that have FDA approval.

 

BEST FOR

  • Smile lines around the mouth border
  • Fine lines on the face
  • Brow lines

 

RESULTS

Temporary (6+ months) that usually show after the final session but more research is still needed to determine just how effective treatment is.

 

PRE-PROCEDURE

  • For the most part you will meet with your skin practitioner before the anti-aging treatment to discuss the areas that need to be targeted and where the fat will be taken from.
  • Local anesthetic may be used, so make sure to cover any allergies or concerns during your initial consultation.

 

PROCEDURE

  • Treatment areas will be cleansed and photographs may be taken.
  • A topical local anesthetic will be applied and left on for anywhere from 20-30 minutes.
  • The doctor will then inject the marked sites.
  • An ice-pack may need to be applied to manage tenderness.

 

LENGTH OF PROCEDURE

  • 1-2 hours, depending on the areas being targeted.

 

POST TREATMENT

  • Apply an ice-pack to any areas that have noticeable swelling or tenderness.
  • If the pain is intense enough take a Tylenol but avoid ibuprofen as it may increase bruising.
  • Although not recommended, makeup can be applied a few hours after treatment.
  • Avoid exercise and other strenuous activity for about 24-48 hours.
  • Minimize UV exposure and apply an effective sunscreen to avoid hyperpigmentation around injection sites.

 

DOWNTIME

  • There is no recovery time per-say but there might be some tenderness for 1-2 days after treatment.
  • For those more prone to bruising, expect marks to last more then the average 4-7 days.

 

COMMON SIDE EFFECTS

Although side effects are rare they may include the following:

  • Prolonged swelling and redness
  • Itching
  • Irritation

 

AUTOLOGOUS FILLERS:  FAT INJECTIONS

Also known as fat grafting, the treatment works through taking fat deposits from one part of the body, harvesting the relevant cells and injecting them back into areas that need added fullness. One of the main concerns with this procedure is reabsorption (breakdown) of the fat that has been grafted resulting in improvements that don’t last as long as expected. The reason this happens is that the grafted fat must gain its own blood supply in order to last for the longterm and this doesn’t always happen. Preventative measures that help to avoid this from happening include using smaller amounts of fat as well as using specialized technique and tools.  One such technique is the relatively new Structural Fat Grafting, in which microinjections of fat (0.1 cc) are used to gradually ‘build” layers on the face allowing for new blood vessels to grow more easily.

 

BEST FOR

  • Fine lines
  • Deep wrinkles
  • Hollow cheeks, temples and under eyes

RESULTS

Permanent (5+ years)

 

PRE-PROCEDURE

  • You will meet with your surgeon beforehand to discuss both the areas where fat can be taken from and those places that will be treated.
  • The process can be done under local or IV anesthetic, so make sure to cover this in your discussion as well.

 

PROCEDURE

  • After anesthesia and cleansing, the fat deposits are taken from areas of your body called “donor sites” (bottom, thighs, etc.) through a liposuction procedure.
  • This fat is harvested ensuring and injected into the “recipient sites”.

 

LENGTH OF PROCEDURE

  • 1-2 hours, depending on the areas being targeted.

 

POST TREATMENT

  • You will most likely have to wear surgical tape on the areas injected for about 5 days after the procedure.
  • Try to sleep with your head slightly elevated in a place you won’t be disrupted by your surroundings.
  • Avoid exercise for at least 1.5–2 weeks after the procedure.
  • After the initial check-in about 1 week after the procedure,  follow-ups will most likely happen with your doctor at one-month intervals.

 

DOWNTIME

After fillers, you may appear a bit puffy and lines may appear more prominent. Don’t worry this is just temporary and usually takes 2-4 weeks to subside.

  • Recovery times vary, but full recovery should be reached within 2–4 weeks
  • As with any kind of injection to the skin, bruising may happen. On average, discoloration fades between 3-7 days after treatment but if you’re more prone to bruising it may take up to 2 weeks to fully fade. Luckily new techniques such as those using micro-cannulas have not only increased accuracy and comfort but also helped prevent the occurrence of bruising!

 

SIDE EFFECTS

Although side effects are rare they may include the following:

  • Prolonged swelling and redness
  • Hematoma
  • Fat & skin necrosis

 

FINAL TIPS

As appealing as “instant” fullness can be, like with all anti-aging treatments tread carefully.  In order to best avoid complications be sure to pick a skilled skincare practitioner who listens to you about your aging concerns and works with you to get the results that you desire. Keep in mind that until we find the elusive fountain of youth the way to keep looking your best at any age is an anti-aging regimen that combines anti-aging treatments with effective skincare products.

 

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