No one likes to look in the mirror and see fine lines, wrinkles and sagging skin. Facial aging happens to everyone, but not necessarily at the same time or in the same way. Aging in the face is the result of a combination of factors. Genetics plays its part, as do lifestyle choices such as smoking, but one of the main reasons that we begin to look “older” is due to a loss of volume. Think about it. We refer to people who look young as having a “baby face”. Why? Because they still have a lot of roundness or fat through the mid-face that our eye perceives as youthful. Furthermore, their skin is plump so they don’t have fine lines and wrinkles.
Fillers are a great non-surgical procedure for turning back the clock by literally filling in areas where volume has decreased with time. Specific fillers address specific concerns. These concerns can range from sunken cheeks and deflated lips, to fine lines and wrinkles around the eyes and mouth, to deeper grooves across the hands, forehead, temples and in the nasolabial folds. Fillers may also be used in advanced treatments to help improve aged and sun-damaged skin.
Board certified plastic surgeon Dr. Sean Doherty is a master at combining different fillers to achieve a completely rejuvenated look for your individual needs. His goal is to deliver the kind of subtle, natural looking result that is imperceptible. No one should know that you’ve had “work” done unless you decide to tell them. He will often combine fillers with Botox® as part of a non-surgical facelift. It is important with any procedure to see an expert with the skill and training to deliver exemplary results. Filler that is placed incorrectly is not only unsightly, but can actually be dangerous.
What are Dermal Fillers?
Fillers is a catch all term for a range of products that provide volume in order to fill in fine lines, wrinkles, deep grooves and hallows. Most are made of hyaluronic acid which is a naturally occurring substance in the body. The results of filler are not permanent. In general, fillers like Juvéderm Voluma® that are designed to treat areas with volume loss such as the mid-cheeks tend to last the longest. In some patients, the results can even last for two years.
Galderma and Allergan are the two largest manufacturers of hyaluronic acid or HA fillers. Each makes a wide range of products to treat different areas of the face. One of the advantages of HA fillers is that the results are reversible. Sculptra® and Radiesse®, on the other hand, are a bit different. Sculptra® is a bio-stimulant and is made of a synthetic, biodegradable polymer that stimulates the body to produce new collagen. For this reason, the results are slower to see, but more long-lasting than HA fillers. Radiesse® is made out of Calcium Hydroxyapatite and is ideal for jawline contouring.
Dermal Filler Options
Dr. Doherty is proud to offer his Boston area patients the full range of filler options. These include:
- Restylane® KYSSE
- Restylane Lyft®
- Restylane Defyne®
- Juvéderm Ultra®
- Juvéderm Ultra Plus®
- Juvéderm Voluma®
- Juvéderm Vollure™
- Juvéderm Volbella®
- Sculptra® Aesthetic
The right one for you is going to depend on your anatomy, surgical history, needs and lifestyle. During your initial consultation, Dr. Doherty will listen closely to what bothers you about your face. He will assess your skin tone and elasticity or “bounce back”. Together, you will discuss your facial aging goals both immediate and long-term, and then come up with the best treatment plan for you.
Best Uses for Individual Dermal Fillers
The main difference between the wide array of HA fillers is weight. Some fillers are made of large molecules, making them better for sunken cheeks, while others are made of small molecules, making them better for fine lines.
Restylane®: Is best for treating mild wrinkles in the nasolabial folds, marionette lines around the mouth, shallowness under eyes and certain smile lines.
Restylane Lyft®: Is a mid-dermal HA filler that’s ideal for deeper facial folds and wrinkles such as those in the mid-face, cheeks, temples and in the nasolabial folds.
Restylane Defyne®: Is a more robust filler, similar to Lyft, but one that delivers a more subtle effect. It is ideal for moderate issues with the mid-face, cheeks and nasolabial folds.
Restylane® KYSSE: Is a cross-linked formulation that was specifically designed for the lips to provide structure without adding too much volume. It is also a nice choice for addressing any lines around the mouth or on the lips.
Juvéderm Ultra®: Is the lightest weight cross-linked formulation in the Juvéderm family, ideal for providing contour and volume to the lips and treating fine lines around the mouth.
Juvéderm Ultra Plus®: Is slightly heavier in weight and best for boosting volume in the nasolabial folds, marionette lines and heavier facial lines.
Juvéderm Voluma®: Is the heaviest of the new Vycross technology fillers and was specifically designed to plump up the mid-face and cheek area.
Juvéderm Vollure™: Is a medium weight Vycross filler that is ideal for treating the deep creases between the nose and mouth. When placed correctly, it can both “lift” the face and add volume. This product is great for creating facial structure without significant swelling or puffiness.
Juvéderm Volbella®: Is the lightest weight Vycross filler. It’s best for lip injections and treating fine lines around the lips and eyes as well as the crepiness that can occur around the mouth and lower face.
Radiesse®: Is a different type of filler in that it is made from Calcium Hydroxyapatite. It is a robust filler that is best used for jawline enhancement.
Sculptra® Aesthetic: Is different from the HA fillers in that it actually causes the body to produce collagen in the treatment area so the results are long-lasting. It was designed for restoring volume to the mid-face, but can also be used to plump up the temples and chin, and restore definition to your jawline. It requires multiple treatments, and then upkeep.
Recovery from Dermal Fillers
Facial Fillers are done in the office and typically take under 30 minutes. Dr. Doherty will numb the treatment area with a combination of a topical numbing agent and ice. He will then use a very fine needle or a blunt cannula to make multiple small injections where needed. You can expect some mild redness at the injection sites, but these fade quickly. You may have some post-op bruising and swelling, but there is no downtime associated with fillers. Most patients feel perfectly comfortable scheduling the procedure during their lunch hour. With HA fillers, the results will take about 2 weeks. With Sculptra®, the results may take a few months. You may also need more than one Sculptra® treatment in order to achieve your goals. All of this will be discussed with you in detail during your initial consultation.
To find out more about fillers with Dr. Sean Doherty at his Boston or Brookline, MA office, contact us today or call (617) 450-0070 to schedule a consultation.
Injectable Fillers FAQ’s
Injectables is an overall term for any non-surgical procedure that involves injecting a product into your face or body. This includes Botox®, Kybella® and fillers.
The great thing about fillers is there is such a wide range of options for treating different issues and areas of the face, neck and hands. However, this makes it literally impossible for me to give you an accurate idea of the cost of a filler procedure without first examining you in person. I need to assess your skin and tissues, and discuss your goals before I can come up with the proper treatment plan for your individual needs. Fillers range from $750-$1,000 per vial. I am always up front with my patients about injectables cost so once I examine you, I should be able to give you a more accurate quote. The other thing to keep in mind with an injectable such as filler or Botox® is that the results will not last forever. You will need to keep up your treatments in order to maintain your results. Again, this is something that we will discuss in detail during your initial consultation.
Not in the hands of an experienced injector. However, it is important to remember that any injectable is a medical procedure. And yes, when placed improperly, there can be dangerous side effects from fillers. So, make sure to see a board certified plastic surgeon or cosmetic dermatologist for any injectable procedure. It is worth the extra money in the long run.
Most patients describe their fillers procedure as being more uncomfortable than painful. However, every patient has his or her own pain tolerance. In general, the area around the nose is the most sensitive which is why Dr. Doherty will pre-treat this area with a topical numbing agent. Any post treatment discomfort is easily alleviated with an over the counter pain medication such as Tylenol.
In the past, we didn’t have the array of different weight fillers that we do today. So, oftentimes, a too heavy filler was placed in the lips giving them a puffy, fish-like appearance. Today, there are a number of options for re-volumizing the lips with completely natural looking results. For patients who are worried about appearing overdone, Dr. Doherty will typically start with Juvéderm Volbella® which is extremely subtle. The effect is almost like a permanent lip gloss. Then, if you want more plump, he will add another product like Juvéderm Ultra® or Restylane®.
Both are good at restoring lost volume to the mid-face, cheek area. The right one is really going to depend on the patient. Not every patient wants a permanent result, especially as we live in a time of constantly changing fashion. Discussing options with a board certified plastic surgeon is always advised.