Fillers

Dr. Riyaz Hassanali offers a variety of filler options to satisfy your unique needs. Below we discuss the basics of soft tissue fillers, as well as the specific fillers available at the Advanced Cosmetic Surgery Center.

For more information, visit the American Society for Dermatologic Surgery or the American Academy of Dermatology.

What are soft tissue fillers?

Soft tissue fillers are flexible substances that can be injected into the skin to improve the appearance of fine lines and wrinkles, plump lips, fill out hollow cheeks, improve scars, elevate deep folds, and repair various facial imperfections. The result is a smoother, more youthful appearance with minimal “downtime” and maximum safety. A variety of soft tissue fillers including bovine collagen, one’s own fat, and donor tissue, have greatly expanded the anti-aging treatments of dermatologists. Since filler substances do not involve major surgery, and are generally cost-effective, men and women are using these youth enhancing techniques more than ever.

What can soft tissue fillers do?

The aging process generally causes a loss of volume in fatty tissue as the underlying collagen and elastin fibers begin to deteriorate. This most commonly occurs around the eyes, mouth, cheeks, the jaw line, the brow, and bridge of the nose. These age-related changes produce crow’s feet, laugh lines, folds and furrows on the forehead, and “hills and valleys” on the lower third of the face. Soft tissue fillers have the unique ability to fill and contour an aging face, allowing the dermatologist to sculpt and restore vitality to your appearance.

How do soft tissue fillers work?

A filler substance is injected beneath the surface of the skin where it corrects the line or wrinkle by temporarily plumping and smoothing out the skin depression. Fillers can also be placed into the lips to create a fuller, more youthful look, or in the hollows of the cheeks to reduce a gaunt appearance. Facial scarring from acne or injury also responds well to soft tissue filler techniques.

What are the ABC's of fillers?

Dermatologists have developed a variety of filler substances to address a wide range of cosmetic flaws as well as the needs and expectations of the individual patient. Each filler brings subtle, distinctive benefits. Some provide longer-lasting results, others allow for more precision with fine lines, and still others can gradually bring the face into better overall balance creating an overall rejuvenated appearance. Soft tissue fillers are often considered a first line against aging skin and are frequently used in combination with other techniques for facial rejuvenation.

Filling substances commonly used by dermatologists are:

Collagen – Introduced nearly 20 years ago, bovine collagen is one of the fillers that has proven effective over time. Some patients may be allergic to collagen produced from a cow, and therefore will receive a test dose. Its human-derived counterpart offers an alternative to patients who are allergic to animal products.

Botulinum toxin – While technically not a filler, very tiny amounts of botulinum toxin are injected into specific facial muscles to immobilize or relax the underlying cause of lines and wrinkles associated with expression. It is commonly used to improve forehead creases, furrows between the eyebrows, and crow’s feet.

Fat – Removed by a mini liposuction procedure from other parts of the body such as the thighs, buttocks, or stomach, one’s own fat has been used for years to reduce deeper wrinkles and contour the “hills and valleys” associated with an aging face.

Fascia lata – Originally used to raise deep scars, small pieces of human fascia (the material just under the fatty tissue) are inserted under the skin to plump it. Fascia lata allograft has recently become available in an injectable form and is used to improve scars, augment lips, and smooth wrinkles. It does not require prior skin testing and can be used in patients with bovine collagen allergies.

Implants – Polymers and collagen-related implants offer a longer-lasting option for shoring up deep facial grooves and folds, particularly around the mouth, nose, and lips. The material is inserted under the skin as strips, threads, or hollow tubes that serve as a permanent filler. These substances can also form the foundation into which other injectable fillers may be added.

What should I expect during and after treatment?

The soft tissue filler process is relatively simple, and can be performed in your dermatologist’s office. Before beginning treatment, and depending upon the choice of filler, your doctor may administer skin tests to determine if you are likely to have an allergic reaction to the filling substance. Prior to the procedure, your face is cleaned and a topical anesthetic may be applied to the treatment areas. A very small needle is used to inject the filler directly into the wrinkle. You may feel a stinging or burning sensation as the filler is being inserted. A series of treatment sessions may be necessary to fill and smooth the lines and wrinkles, or raise a depressed scar up to the level of the surrounding skin. Immediately after the procedure there may be some temporary swelling, redness, or minor bruising at the injection sites. This usually subsides and fades quickly. Makeup can be applied immediately after the treatment.

Are there any possible risks?

All medical procedures carry some risk. However, soft tissue fillers are generally considered a safe and effective procedure. Apart from an allergic reaction to the injected substance, side effects are few and typically relate to the local injection.

How long does the improvement last?

The length of time the improvement lasts depends on the type of filler used, the areas treated, and the ability of the patient’s skin to use the materials. Results are generally long-lasting with touch-up or maintenance treatments required after three to six months. Occasionally, touch-up treatments may be needed sooner. Correction of acne scarring tends to last longer.

Fillers we offer

Restylane

The answer to lasting wrinkle correction is Restylane.

Restylane® has been used in more than 1.5 million treatments in over 60 countries and is now approved in the U.S. for the treatment of facial wrinkles and folds.

Restylane® is a safe and natural cosmetic dermal filler that restores volume and fullness to the skin to correct facial wrinkles and folds, such as nasolabial folds.

Restylane® is a cosmetic dermal filler made of hyaluronic acid, a natural substance that already exists in the human body. The hyaluronic acid in Restylane® is a crystal-clear gel called NASHA™ or Non-Animal Stabilized Hyaluronic Acid. NASHA is completely biocompatible with human hyaluronic acid.

Restylane® maintains its shape using the body’s own moisture. The hyaluronic acid in Restylane® is hydrophilic or “water loving.” As hyaluronic acid gradually degrades, each molecule binds to more water and over time, the same volume can be maintained with less hyaluronic acid. This ability of hyaluronic acid to bind to water is what helps provide lasting results.

Unlike rooster-derived hyaluronic acids and bovine collagen products, Restylane® is free from animal proteins. This limits any risk of animal-based disease transmissions or development of allergic reactions to animal proteins.

After your treatment, you might have some redness or swelling. This will normally last less than seven days. Sunbathing and cold outdoor activities should be avoided until any redness or swelling disappear. If you are pregnant, breastfeeding, or under 18, you shouldn’t use Restylane®.

Juvederm

Everyone Will Notice But No One Will Know.

JUVEDERM® injectable gel is a smooth gel filler your doctor eases under your skin to instantly smooth out those wrinkles or folds that look like parentheses along the side of your nose and mouth. Results aren’t just instant, they’re so smooth and natural, everyone will notice but no one will know.

Your doctor or healthcare professional can tell you which JUVEDERM® formulation is right for you: JUVEDERM® Ultra injectable gel, optimally formulated for versatility in contouring and volumizing wrinkles and folds, or JUVEDERM® Ultra Plus, a robust formulation for volumizing and correcting deeper wrinkles and folds. Look smooth and natural with JUVEDERM® injectable gel.

JUVEDERM® injectable gel is produced through HYLACROSS™ technology creating a high degree of cross-linking and promoting duration for up to 6 months or longer.

HYLACROSS™ technology results in a smooth consistency gel, which is a primary factor in the long-lasting, smooth, natural look and feel that is a hallmark of JUVEDERM® wrinkle correction.

Sculptra

Sculptra™, also known as the “liquid facelift”, works by filling in both lines and wrinkles and by stimulating the body to produce new collagen and underlying tissue, thereby creating a fuller, more youthful appearance. Sculptra™ (poly-L-lactic acid) has been safely used outside the United States since 1999 in over 150,000 patients under the trade name New-Fill™.

Facial fat loss, or lipoatrophy, is the loss of fat beneath the skin, which can result in sunken cheeks, indentations, and hollow eyes. Sculptra™ is a safe, synthetic, and biocompatible material that is injected below the surface of the skin in the area of fat loss. It provides a gradual and significant increase in skin thickness, improving the appearance of folds and sunken areas. No skin testing is required.

Results are natural-looking and appear gradually over a few weeks’ time. While the results of other fillers such as Restylane® and Cosmoplast last only a few months, Sculptra™ can last two years or more because it causes the body to stimulate its own collagen. Side effects of the procedure are minimal, other than short-term swelling and redness.

Proven Studies

A recent clinical study showed that the treatment results last for up to two years or longer. Some minor touch-up treatments may be needed to maintain the desired effect. The most common side effects with any injection include bleeding, tenderness or pain, redness, bruising or swelling. These side effects generally last, on average, 3 to 17 days.

During the Sculptra™ procedure, the area being treated is numbed with topical numbing cream and given a series of injections. The material used in Sculptra™, poly-L-lactic acid, is a synthetic version of the substance that is naturally produced by muscles during exercise. This particular material has been utilized in plastic and reconstructive surgery for more than 20 years.

Sculptra™ achieves excellent results in treating all parts of the face including the areas around the eyes and lips, between the mouth and nose, cheeks and neck. It adds volume to the cheeks, to folds around the chin, and to hollow areas around the eyes.

Following your initial visit, it may appear that Sculptra™ worked immediately because some swelling will occur from the injections. The swelling goes down and the water is absorbed by your body. Sculptra™ takes time to gradually correct the depression in your skin. Your health care provider will see you again in a few weeks to decide if you need more Sculptra™ injections.

Be clear with your physician about your medical history and your expectations. Sculptra™ should not be injected while you have an active skin infection or inflammation in the treatment area, or if you are allergic to any of the ingredients in the solution.

Facial fat loss, or lipoatrophy, is the loss of fat beneath the skin, which can result in sunken cheeks, indentations, and hollow eyes. Sculptra™ is a safe, synthetic, and biocompatible material that is injected below the surface of the skin in the area of fat loss. It provides a gradual and significant increase in skin thickness, improving the appearance of folds and sunken areas. No skin testing is required.

Results are natural-looking and appear gradually over a few weeks’ time. While the results of other fillers such as Restylane® and Cosmoplast last only a few months, Sculptra™ can last two years or more because it causes the body to stimulate its own collagen. Side effects of the procedure are minimal, other than short-term swelling and redness.

Radiesse

THE NEXT GENERATION IN LONGER LASTING WRINKLE CORRECTION

WHAT IS RADIESSE®?

RADIESSE® is a safe, FDA-approved dermal filler that restores a natural, youthful look and lasts longer than the former leading filler. This convenient treatment fills and corrects smile lines, Nasolabial Folds and wrinkles around the nose and mouth. RADIESSE® is made of unique calcium-based microspheres suspended in a natural gel that is injected into the skin through a simple, safe and minimally invasive procedure.

HOW DOES RADIESSE® WORK?

RADIESSE® works with your body, below the skin’s surface. Tiny calcium-based microspheres form a “scaffold” to support and stimulate the growth of your own collagen. Over time, the calcium-based microspheres gradually break down and are safely and naturally absorbed by your body. RADIESSE® does more than just temporarily fill-in facial folds and wrinkles – it rebuilds your skin’s foundation and restores your youthful look, without the risks associated with a permanent implant.

HOW SOON CAN I EXPECT RESULTS?
HOW LONG WILL THE RESULTS LAST?

The results are immediate. RADIESSE® typically lasts a year or more, longer than the former leading filler, saving you time and money. Since results may vary, be sure to discuss your expectations with your doctor.

IS RADIESSE® SAFE?

Yes. Hundreds of thousands of patients have experienced RADIESSE® and more than 4,000 physicians worldwide have been trained to provide RADIESSE® treatments. Through years of clinical studies and independent research, RADIESSE® has proven to be safe and effective. With RADIESSE®, you get FDA-approved, safe, clinically tested reliability.

HOW IS A RADIESSE® TREATMENT PERFORMED?

RADIESSE® is injected into the skin through a simple, safe, convenient procedure. Typically administered in a doctor’s office, with the use of a local anesthetic, RADIESSE® treatments have little to no downtime, with most patients returning to normal activities soon after treatment.

HOW MANY TREATMENTS WILL I NEED?

Many patients will achieve their desired result after just one visit. Because RADIESSE® is a longer-term cosmetic enhancement, and to ensure your satisfaction, your physician might schedule a follow-up visit, where a touch-up treatment may be recommended.

ARE THERE ANY SIDE EFFECTS?

Normal, injection-related reactions, such as mild irritation, swelling, itching, bruising, or tenderness at the injection site may occur. These conditions typically resolve on their own.

IS RADIESSE® PERMANENT?

No. Treatment results are long-lasting, but not permanent. The calcium-based microspheres gradually break down and are safely and naturally absorbed by your body so you will have none of the risks associated with a permanent implant.

HOW MUCH DOES IT COST?

RADIESSE® treatments are customized for each patient so the price varies. In general, the cost of RADIESSE® is comparable to similar procedures. And because RADIESSE® is long-lasting, you’ll also save money…and time. Please consult your physician to discuss your RADIESSE® treatment plan.

For more information on RADIESSE®, go here.

Perlane

*Info coming soon*