Injectable fillers are useful for treatment of established wrinkles or larger lines of facial aging, such as the nasolabial folds or marionette lines. Fillers can also restore volume to the face and can add structure as well. Depending on the type of filler and the depth at which it is injected, Beverly Hills plastic surgeon, Dr. Charles Hsu, can use injectable fillers to smooth fine lines on the surface of the skin, fill out deep lines, augment soft tissues (such as the lips), or even effectively augment facial bone structure.
Fillers vs Relaxers?
Wrinkle fillers differ from wrinkle relaxers, like Botox, which target muscles responsible for wrinkle development during movement and facial expression. Fillers target indents on the lower parts of the face, which are not caused by muscle movement. Dermal fillers physically fill under the skin to minimize the appearance of wrinkles.
Best Candidates for Fillers
The following are some common reasons why patients consider fillers:
Lines or wrinkles around the mouth, eyes, or forehead
To enhance the volume in areas such as the cheeks, jaw line, or lips
To repair scars and depressions in the skin resulting from acne, injury, or congenital imperfections.
The consultation allows Dr. Hsu the time to get to know his patient’s concerns and goals. Fillers differ in function, and the type of filler used depends upon the individual patient’s goals. In his practice, Dr. Hsu prefers using fillers that are moderately soft such as Restylane, Juvederm, or Radiesse. Once, Dr. Hsu has talked to the patient and evaluated their areas of concern, he can help the patient decide which dermal filler will be best for their treatment.
To perform the procedure, Dr. Hsu will use numbing cream as well as a very thin needle to minimize discomfort. Injections are very well tolerated and are one of the most popular procedures performed in our office.
After the procedure, most patients can see the benefits immediately. Fillers do cause some skin swelling, and the swelling can last for a few days after the injection. Patients who are planning to attend a public event or to be in front of a camera/filming soon are encouraged to have the procedure a week prior to their public appearance to allow swelling to resolve. The period of swelling will depend largely on the type of soft tissue filler received, though most swelling, bruising, and redness should dissipate within 7 – 10 days.
From Dr. Hsu
“Dermal fillers are another category of injectables which have been very popular for patients over the past 10+ years. As with the neuromodulators, I feel that dermal fillers can give excellent results when used conservatively. There are specific areas of the face that I feel dermal fillers can be used very successfully, and the choice of the areas varies from patient to patient. For some patients, the first signs of facial aging are in deepened nasolabial folds; for other patients, it is the marionette lines that bother them more. Often times, patients aren’t sure which area should be prioritized for treatment, and I will often help them decide based on my judgment.
Patients often ask me which dermal filler they should choose. In my opinion, the answer is that in the big picture, the brand is not important -- the injection technique and the surgeon’s judgment as to how much filler to use, and where to place it, is all much more important than the specific choice of filler. Most fillers accomplish very similar things and in my experience, I have found many to be interchangeable when injected correctly. That being said, I do generally have some preferences on which filler I like to use for different parts of the face, and for different patients. That is a very individual judgment that I make when I assess each patient.”
Frequently Asked Questions
What are the different type of fillers?
There are three types of fillers commonly used
Collagen-Based Fillers: Collagen is a naturally occurring protein that adds strength and structure to the skin.
Hyaluronic Acid-Based Fillers: Like collagen, hyaluronic acid is a naturally occurring substance and is primarily used to promote fullness and volume.
Calcium Hydroxylapatite: Heavier and denser than hyaluronic acid, this filler is injected deeper, underneath the skin, and does not usually cause immune or allergic responses because the material is usually found in bones.
How long do fillers last?
The length of results from dermal fillers is dependent on the type of injection received:
Collagen-Based Fillers: Results will last from 2-4 months.
Hyaluronic Acid-Based Fillers: Results vary, though most will last 6-9 months.
Semi-Permanent Fillers: Results will last between 12-18 months.
What are the different brands of fillers?
There are a number of filler brand names, but some of the most common are:
Hyaluronic Acid-Based Fillers: Restylane, Juvederm, Perlane, PREVELLE Silk, Hydrelle, Belotero
Collagen-Based Fillers: Cosmoplast, Cosmoderm, Evolence
Semi-Permanent Fillers: Sculptra, Radiesse