SKIN DERMAL FILLERS AND BOTOX
GETTING RID OF LINES IN THE FACE
BOTOX
Injections of BOTOX, botulonism toxin, are currently the most commonly performed plastic surgery procedure in the United States. The small injection of the toxin, paralyze the muscles of the specific injection area for a limited 3-4 month period of time, preventing their movement, and hence preventing the deepening of the facial lines that occur as a result of the movement of such muscles. Typically these areas are the crow’s feet on either side of the eyes, the glabellar lines between the eyebrows, and the horizontal forehead lines. The tiny injections are quick and accompanied by temporary discomfort that is gone by the time the patient leaves the treatment room- not even bee stings- more like ant stings. If the material is injected into the wrong area of the muscles, there is a temporary loss of activity of these areas and some drooping of the area. In the hands of an experienced surgeon the likelihood of these events is very rare.
FACIAL SKIN FILLERS
Dermal fillers for lines of the skin or areas of the face can be broadly divided in to two types depending on the longevity of the materials.
There are those dermal skin fillers such as Collagen, Restalyn, Hylaform, Captique and Juvéderm that are based on collagen or hyaluronic acid, both materials that are found in our own bodies in abundance. These materials are jelly–like and are injected with the expectation that they will have an effect between 3 months (collagen) and 9 months (Juvéderm). They are particularly useful in the lips for lip enlargement.
Juvéderm®
One of the newest Hyaluronic Acid based skin dermal fillers is JUVÉDERM. This jelly –like material comes in single use 1cc syringes is ideal for enlargement of the lips and filling of the ”smoker’s“ lines around the mouth.
For more information about Juvéderm click here.
The second group, are material that are designed to last longer or even be considered permanent. These include, Radiesse, Sculptra, and the most recent of all, Artefill. These materials have different chemical structures; they can be likened to tooth paste in consistency. These dermal fillers are gaining in popularity due to their longevity.
Radiesse® is a dermal skin filler with a base of hyaluronic acid mixed with tiny specks of crystals found in our own bone, that allows the material to last longer before our cells breakdown the crystals. This typically lasts 1-1.5 years. Only experienced injectors can use this filler in the lips.
For more information about Radiesse click here.
Sculptra is another type of dermal skin filler that is injected into a different layer of the skin and increases the volume of the skin by stimulating a reaction in the skin that allows it to thicken. Typically it lasts 1-2 years. This also cannot be used in the lips.
Artefill is the latest dermal skin filler to have received FDA approval in the US, though it has been extensively used in Europe for many years. The base of collagen carries microscopic pellets of methyl-lmethacralate (plastic beads) that provide a permanent dermal filler for the skin of the face. Our bodies’ breakdown the collagen but the plastic beads form scar tissue around themselves that is permanent. It cannot be used in the lips, and requires skin testing to determine allergy to collagen by the patient which would preclude its use.
These newer materials have also allowed the treatment of the hands to provide for more youthful contours to the back of the hands, an area that has previously been difficult to treat for signs of aging. The biggest problem I have noticed with all these dermal skin fillers is making sure that patients know exactly what to expect and their limitations. It is easy enough to understand that some dermal skin fillers last longer than others. The difficulty is in understanding that some facial lines or body areas require more filler to even out than others. If you liken a facial line to a valley, depending on the depth of the valley you will need one, two three or even four syringes to fill the valley. One cannot expect one filler syringe to complete the job. It is a question of volume. The more filler that is injected the greater the result. However the cost can also become prohibitive in some cases and I will try to find the best and most conservative approach for my patients to achieve a balance between the excellent result we desire and the cost.
I hope this information has been helpful to you and given you some greater insights into the cosmetic plastic surgery options that are available to increase your quality of life.
For more information about dermal skin fillers for use in the face or hands please call Dr. Tavallali at 703-876-9400 or 301-907-3838.