Soft Tissue Fillers for Facial Rejuvenation

Introduction
Aging of the skin and superficial soft tissues is due to a combination of factors, including ultraviolet radiation, genetics, gravity, facial expression, sleep position, and/or tobacco use. Collagen, elastin, fat, and bone diminish over time leading to loss of youthful volume of the face, structural changes of the bony foundation, and wrinkling, sagging of the skin.  Soft tissue fillers are a key component in maintaining or creating a youthful face. With the available FDA-approved products in the United States,

Filler Selection
Several injectable fillers have received FDA-approval for cosmetic use in the United States, each with unique properties capable of providing the results you desire.  Some fillers have properties that restore volume and achieve a lifting effect. Some fillers are designed to erase and smooth wrinkles or creases in the skin. Some fillers result in immediate volume restoration, while other fillers restore volume over time by stimulating natural collagen production. Some fillers are temporary, while others are permanent. Some fillers are composed of natural substances while others are composed of bio-compatible substances.

Below are the most common fillers used in the United States listed by ingredient. For specific details, please click on the link of each product:

1. Hyaluronic acid (Juvederm Voluma, Juvederm Volbella, Juvederm Ultra & Ultra Plus, Restylane/Restylane Silk , Restylane Lyft , Belotero)

2. Calcium hydroxyapatite (Radiesse)

3. Autologous fat grafting

4. Polymethylmethacrylate (Artefill)

5. Human collagen (Cosmoderm, Cosmoplast)

6. Porcine collagen (Evolence)

7. Poly-lactic acid (Sculptra)

8. Microdroplet Silicon (Silikon 1000)

What should I do before treatment?
Before treatment, your provider should review your medical history, including allergies and medicines. If you are taking blood thinners, ask your doctor if it’s safe to discontinue prior to filler treatment. Filler treatment is contraindicated in certain situations and should be reviewed prior to treatment.

Do filler injections hurt?
The procedures are well tolerated. Various methods for comfort are available including gentle nerve blocks, topical numbing cream, cooling of the skin, and/or mixing of anesthetic solution with the filler.

What is the recovery time?
The majority of patients have none to minimal down time. Occasionally, a bruise may develop, which resolves in a few days. If you take a blood thinner medication, ask your doctor if it can be discontinued prior to filler treatment. There may be some swelling noted after the procedure, which can be minimized with ice and rarely lasts more than a day.