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Of all our posts, the one that has gotten the most buzz was about Botox 101 (First There Was Botox) So, in this post we’ll cover dermal fillers 101.  Hopefully you will find this one interesting as well. We’ll use this post as a springboard to talk about many interesting topics related to fillers .

Botox started a revolution in cosmetic surgery in the 1990′s. Dermal fillers started a revolution of their own in the mid 2000′s. Here’s the scoop on dermal fillers.

The first safe dermal filler was collagen. Collagen was injected into wrinkles to fill them out and smooth the skin. Collagen was the king of fillers until the mid 2000′s when hyaluronic filers came along.  Hyaluronic fillers last about twice as long as collagen and they are reversible.  For that reason hyaluronic fillers have replaced collagen, which is no longer available.  There are lots of different hyaluronic acid fillers.  The ones we like best are Juvederm and Restylane.  In future posts I’ll talk more about that.

Right around the time that Restylane and Juvederm became available, there was a major paradigm shift in how we view ageing of the face.  Good cosmetic surgeons started to understand that as we age, our faces loose volume.  We used to think that faces fell.  We now know that they deflate and sink inward.  I’ll talk about this in more detail in future posts.  For now just believe me, when we age, our faces loose volume.  That loss of facial volume is the main reason that most of us look older.  So, for most people, the best way to look younger is to add volume.

Before & After Juvederm Treatment

Voila! we have Restylane and Juvederm which are perfect to add volume to your face.  So rather than just using filler to erase wrinkles (which is nothing to sneeze at)  we now can also use them to add volume to our face. Adding volume in just the right places can subtract years from your appearance.

Hyaluronic acid fillers are so effective that they have become the second most popular cosmetic procedure in the US (Botox is number 1).

Let me tell you what to expect when you get a Juvederm or Restylane injection.

1. First you will need a consultation with your doctor. At that time he/she will ask you what you would like to improve about your appearance. Then, after an exam, you’ll find out if hyaluronic acid fillers are a good idea for you.
2. At that point, you can decide if you want to proceed with a treatment, or go home and think things over. Cosmetic treatments can be great, but they are elective. You should only go ahead if you are completely comfortable with what you have learned, and with your doctor. 
3. If you are going to have filler injections, particularly around your eyes, you may bruise.  You can reduce the chance of bruising by stopping medications that thin the blood for a week or two before the procedure.  Some common blood thinners are aspirin, Motrin (and all of its NSAID relatives like Advil), Vit E, and fish oil.  One very important point, if you were placed on a blood thinning medication by your doctor, talk to that doctor before stopping the medication, of course. 
4. If you decide to proceed, you’ll have numbing cream applied to the areas that will be treated.  If you are going have your lips treated, you may want a numbing injection (like the dentist would give you).  Lips can be very sensitive.
5. The doctor will then give you a series of small injections. The number of injections and location depends on what you and your doctor are trying to achieve with the treatment.
6. Then you can go home (or to work, or to wherever). You may have some redness, bruising or swelling right after the treatment.  It is best to avoid strenuous exercise for that day (you can bruise for a few hours after treatment and excercise can make that worse).  By the next day….back to the gym.
7. In our office we have our patients come back for an evaluation 2 weeks after their first treatment to be sure that everything is optimal. It is worth waiting that long because it make take the filler some time to get into balance with your body.  Initially, there may be some swelling in certain areas that look like lumps.  Those usually go away during the first week or two.
8. When you come back for your follow-up visit you may want to get a little bit more here or there to have the best possible result.
9. If there are any small lumps or bumps those can be massaged away by your doctor.  Or they can be instantly dissolved with a small injection of a medication call hyaluronidase.  We’ll talk more about hyaluronidase in future posts.
10. The Juvederm or Restylane usually lasts at least 6 months, in some areas of the face (like under your eyes) it lasts much longer. When it wears off you have the option to do it again.

That is my review of dermal filler basics. There is plenty of material for future posts. If you would like to learn more right now click here.