Dermal fillers are a great option for treating wrinkles and hollow areas associated with facial aging. Today, there are many different types of dermal fillers to choose from:
Hyaluronic acid (HA) based dermal fillers
The most popular class of dermal fillers is based on Hyaluronic acid (HA), a sugar found naturally in human skin. By binding water molecules, Hyaluronic acid based products add volume under the skin to smooth wrinkles and folds, plump lips, and remove scars. The effects of dermal fillers usually last between 6 and 18 months.
Sculptra is made from poly-L-lactic and is used to correct shallow to deep nasolabial folds (i.e., smile lines), contour deficiencies, and other facial wrinkles. Sculptra works by both filling in lines and wrinkles and by stimulating the body to produce new collagen and underlying tissue, thereby creating a fuller, more youthful appearance.
Radiesse is a safe, FDA-approved dermal filler that restores a natural, youthful look. Used primarily to treat areas with obvious signs of facial aging, Radiesse rebuilds your skin’s foundation and restores your youthful look. Its unique contouring ability allows practitioners to treat large areas of the face in one procedure.
Kybella is the first and only non-surgical treatment approved by the FDA for treating fullness under the chin (double chin). Kybella causes the rapid destruction and absorption of fat, leaving a firm jawline without the necessary recovery time of other treatments like liposuction or neck lift surgery.
Myth #1 – Botox and fillers are the same thing.
Contrary to popular belief, Botox is not a filler. Botox causes the muscles to relax so the appearance of fine lines and wrinkles decreases whereas dermal fillers actually add volume to your face to fill out those extra folds of skin. Though both Botox and dermal fillers serve similar purposes, the treatments reach the desired results through distinct physical alterations.
Myth #2 – Everyone will notice I’ve gotten fillers.
This is a fear for many individuals because they have witnessed how the media torments celebrities and other public figures based on their personal choices about cosmetic procedures. Although you may be worried that you will look drastically different or fake after receiving dermal fillers; however, there could be nothing further from the truth. Dermal fillers, when administered by a certified and experienced professional, provide natural-looking results that still deliver the plumping you desire.
Myth #3 – Fillers are extremely painful.
We understand many people have a particularly acute fear of needles, but there is nothing to be afraid of when it comes to fillers. Most providers apply topical anesthetic before the treatment which helps to minimize significantly any discomfort. Many fillers are mixed with lidocaine to ease any discomfort that the initial injection might cause.
Myth #4 – You can’t undo a cosmetic treatment.
This might be the case in many other cosmetic treatments but dermal fillers have a lot more flexibility. If you decide to use the naturally-derived hyaluronic acid as your dermal filler, then this can be reversed almost instantaneously. By injecting hyaluronidase, HA filler can be automatically reversed because it breaks down the hyaluronic acid under your skin quickly. Most dermal fillers are temporary, lasting sometimes as little as three months, so you are not making a lifelong commitment by trying them out.
Fascinating Facts on Fillers
#1 – Fillers can stimulate collagen growth so over time so you may require less injections later on than when you first started.
#2 – The effects of most fillers are temporary, some of them being reabsorbed into the body after three months. If you seek a more permanent solution, there are a few types of fillers that can last several years.
#3 – It need not only be used for facial rejuvenation. It can be used to smooth wrinkles and hide veins in the hands. Many practitioners even suggest fillers to support droopy earlobes.
#4 – Side effects and complications are extremely rare with dermal fillers.
#5 – It would take quite a lot to over-do it when you are working with a qualified professional; you won’t get anywhere near looking overdone unless you opt for too many syringes of fillers all in one session.
#6 – A common (but flexible) rule for fillers is one syringe per decade. Get three syringes at thirty years old, four at forty years old, and so on and so forth when you have a treatment session per year. The syringes can be spread across various areas (including off-label ones) such as lips, smile lines (nasolabial folds), cheek depressions (cheek hollows and malar volume loss), jowls (marionette lines), and temples (for hollowing).
Preparing for facial filler
Truth be told, there isn’t a whole lot of necessary preparation for facial filler. However, it’s key to note that some bruising (at the injection site) and possible swelling may occur. Therefore, it is wise to schedule your appointment at least two weeks before an important event.
To help prevent bruising, avoid blood-thinning medications, including pain relievers and supplements like fish oil for a week prior to your appointment. (Also, smokers have an increased likelihood of bruising.) You may wish to take the holistic supplement Arnica Montana several days leading up to your procedure, as this helps to minimize the chances of bruising, as well.
Here’s what you can expect during your dermal filler appointment:
Assessing your condition
During your consultation, our cosmetic injector specialist will carefully evaluate your skin condition and facial appearance. This will include your skin tone, as well as the features of your face that would look better augmented. Such areas will be marked appropriately to serve as guide during the actual treatment later on.
During your treatment
During your treatment, you will be made comfortable, and a topical numbing cream will be applied. The numbing cream will be removed after an appropriate amount of time, and your aesthetic nurse injector will cleanse and prepare your skin for treatment. You will feel a pinch upon initial injection and will feel some pressure as the product is delivered. Many of the dermal filler products have a numbing agent in them, so you will continue to feel less of the treatment as it goes on. Most patients find the treatment very tolerable. Your aesthetic nurse injector may manipulate the product as needed.
Going through recovery
Once the necessary filler has been administered, your skin is cleansed again to remove any markings. While you may feel some discomfort, swelling, or tenderness in the area, ice packs and pain medications usually do the trick.
Dermal fillers are a no downtime procedure. After treatment, you’ll be able to leave our offices immediately. You’ll be able to drive yourself home. Many patients actually head right back to work. Redness, tenderness, and swelling can occur, but typically are minor and fade over the course of a few days. Makeup can be applied to cover any redness you may experience. It is important that you do not push or press on the treated areas. It is important that you do not disturb the areas where the product has been placed.
Note that the dermal filler treatments are dosed in syringes, and each area of the face differs in how much product is needed to achieve full correction. No two people will have the same dosing. It is more helpful to think of dermal fillers in terms of results, versus actual syringes used. Volumize treatments do take time to reach efficacy/settle in, typically 3 – 4 weeks. Typical duration of dermal fillers is anywhere from 6-18 months, depending on the product used. While it would seem logical to request only the longest lasting dermal filler product, not all dermal fillers are suited for the same areas. Your aesthetic nurse injector will determine which product will give you your best outcome.
How Long Will It Take Me To See Results After Dermal Filler Injections? After getting dermal filler injections, you will be able to immediately see some results, however, it will take about 48 hours to see the full effect. The results will typically last from 6-18 months depending on the area being treated and body’s metabolic rate. After this period of time, you will need to receive fillers again to maintain your rejuvenated appearance. If you opt to stop getting injections at any time, your appearance will just revert to its original state.
How Long Will The Results From Dermal Fillers Last?
Dermal fillers fade very slowly and gradually, so for the vast majority of patients, results should last between 6 and 18 months. After approximately 6 to 18 months, the effects of the dermal filler gradually weaken, until your skin returns to its natural state. The specific amount of time dermal fillers last varies depending on the patient’s skin, the treatment area, one’s metabolic rate, and the type of product used.
As treatment with dermal fillers is temporary, they require touch-up injections for maintenance, and eventually repeat injections. At Avissa Skin, our experienced practitioners will determine the ideal time interval for your follow-up treatments, and develop the optimal injectable regimen to suit your needs. Alternatively, if you decide not to maintain your new appearance, the results will gradually disappear over time.
How Long Is The Recovery From Dermal Filler Injections?
After receiving your dermal injections, you might experience some mild redness, swelling, tenderness, bruising, or itching. These effects should clear up in less than 7 days (or 14 days for lips). Redness can be concealed using foundation or concealer. In general, most patients experience little or no downtime – which means you can return to work and continue with your usual daily activities.
How Much Do Dermal Filler Injections Cost?
The cost of dermal filler injections depends primarily on the amount of dermal filler injected, which in turn depends on the amount of product you require to achieve a significant result. At your consultation at Avissa Skin, your unique facial features will be assessed, your concerns will be taken into account, and a treatment plan will be developed. At this point, you will be told the exact amount of filler you will require.
Are Dermal Filler Injections Painful?
Most patients only experience mild discomfort. As the needles used for dermal fillers are very fine, the amount of pain experienced by patients is minimal and the procedure does not require anesthesia. It should also be noted that many of the dermal filler products available today contain Lidocaine, a local anesthetic, to minimize your discomfort. Topical numbing creams can be used to further minimize discomfort when injecting sensitive areas.
Are Dermal Fillers Reversible?
Fortunately, there is the option of completely reversing the results you obtain from Hyaluronic-Acid based fillers if you are not happy with the results. A solution called Hyaluronidase is simply injected into the treatment site which effectively dissolves the filler within approximately 24 hours.
At What Age Should I Start Getting Dermal Filler Injections?
The age at which you start using dermal fillers depends entirely on the type of issue you’d like to address. While severe wrinkles and folds typically become evident well into middle age, fine lines appear much earlier. Moreover, there are a number of issues which dermal fillers are very effective at addressing, that are not always related to aging, such as a sunken appearance, thin lips, and wide jawbone. In general, however, dermal filler products should not be used in individuals under 18 years of age.
Are Dermal Filler Injections Safe?
Dermal fillers are approved by the FDA, and have an excellent safety track record. Additionally, the dermal fillers used at Avissa Skin in Ann Arbor are all Hyaluronic Acid-based, which is a substance that naturally occurs in our bodies, and has been used for over 20 years for arthritis treatment, wound repair, and eye surgery.
Dermal fillers are very similar in composition to the Hyaluronic Acid that naturally exists in your body, as such it is very unlikely to induce an allergic reaction. To reduce the risk of complications and ensure your safety, your practitioner will review your medical history, including allergies and medications, at your initial consultation to determine whether you are an appropriate candidate for fillers.
The most common complications associated with fillers include receiving results other than you had intended, tiny lumps or irregularities under the skin, and prolonged redness. After receiving dermal filler injections, patients prone to cold sores may develop an outbreak. Those with HSV-1 should therefore be treated with a course of antiviral medication prior to the procedure. More serious complications such as infection and tissue necrosis are exceedingly rare.
Contraindications include but are not limited to the following:
- Pregnancy, trying or breastfeeding
- Severe allergies or a history of anaphylaxis to components of the particular filler or local anesthetics
- Blood thinning medications within the last week
- History of surgical face lift
- Recent COVID/Flu vaccine or positive COVID test
- History of keloid scarring or abnormal wound healing
- Poorly controlled medical conditions (i.e. diabetes, vascular)
- Impaired immune system and/or use of immunosuppressive medications
- Active inflammation or infections (e.g. cysts, pimples, rashes or hives).
- Impaired judgment, psychological conditions, and substance or alcohol abuse
- Patients with unrealistic expectations
Compliance with the recommended pre / post-care instructions as well as recommended follow-up visits by your practitioner are crucial in minimizing the risk of side effects and complications. It is your responsibility to inform your practitioner of your most recent sun exposure, new medications, or changes in medical history before each treatment is performed.
Before Your Treatment
- You may not be pregnant, trying to be pregnant, or lactating.
- It is not recommended to have a dermal filler injection treatment less than 2 weeks before a big event.
- You should not schedule any vaccination or invasive procedures for 2 weeks before or after treatment with dermal fillers. These include but are not limited to COVID/Flu vaccine, dental dental work, lesion excision or biopsy, surgery of any kind, tattoo or permanent makeup.
- History of surgical face lift of any kind will lead to denial of dermal filler treatment to the midface or cheek region.
- Inform your practitioner if you have a history of medication allergies, history of anaphylaxis, and any other medical conditions.
- If you are prone to cold sores, it is recommended to take an antiviral medication for 3 or more days before and after your treatment.
- To minimize bruising or bleeding it is best not to take any blood thinning or NSAIDs medications, vitamins, and supplements (unless otherwise prescribed by your doctor) for at least 3 days to 1 week before your treatment.
- If you have a tendency to bruise easily, you may start taking over-the-counter Arnica Montana tablets 3 days before your treatment.
- Do not apply potentially irritating products for 2 days before and after your treatment (e.g. tretinoin, retin-a, glycolic acid, hydroquinone).
- Avoid alcohol, caffeine, and cigarettes for 24-48 hours before and after treatment as they may contribute to increased swelling or irritation.
- Stay hydrated by drinking 8+ glasses of water daily to improve results & healing time.
- Always use an SPF 30 or higher containing zinc oxide and/or titanium dioxide for proper sun protection.
- Reschedule your appointment If you develop a cold/flu, cold sore, blemish, or rash, etc. in the area to be treated prior to your treatment.
- It is recommended that you wait at least 2 weeks after other cosmetic treatments such as lasers, peels, microneedling, or facials.
- Arrive with clean skin free of any lotion, oil, makeup, powder, or sunscreen.
Day of Treatment
- Notify your practitioner of any changes in your medication, health status, or personal activities that may be relevant to your treatment.
- Topical numbing cream for 30-45 minutes or regional nerve blocks may be administered to maximize your comfort during the procedure.
- You may experience a mild/moderate amount of tenderness and discomfort during your procedure.
- We ask that you wait at least 2 week after injection to assess the need for additional treatment to achieve desired results. Regular charge applies to all subsequent treatments.
After your treatment
- Immediately after the treatment, there may be redness, bruising, swelling, tenderness, and/or itching near the injection site. Avoid touching, rubbing, picking, or manipulating the injected area(s) for 6 hours after your treatment. This is normal and generally disappears within a few hours to a few days. If these symptoms last more than 3 days, please contact your practitioner.
- Do not massage the treatment area unless instructed to do so.
- Minimize excessive movement of the treated area(s) for 3 days after treatment to avoid potential migration of dermal filler products.
- If there is a visible bump, you may gently massage the area. You may feel lumpy and/or bumpy for a few weeks afterwards. This is normal. The key is not to see the lumps. You may also feel “firmness” which will soften and settle with time (usually 1-2 weeks).
- You may take Acetaminophen/Tylenol if you experience any mild tenderness and discomfort.
- You may take over-the-counter Arnica Montana tablets or apply Arnica Montana topical cream to help reduce bruising.
- Apply a cool compress to the treatment area (do not apply ice directly to the skin) for 10 minutes every half an hour on the day of treatment.
- Sleep on your back for the first few nights to relieve pressure on the area and avoid disturbing the filler.
- Avoid vigorous exercise, sun and heat exposure for 3 days after. (i.e., sunbathing or tanning bed)
- Avoid submerging head under water for a full 24 hours after midface treatment; this includes pools, beach, bathtub, hot tub, etc.
- Do not apply potentially irritating products for 2 days after treatment (e.g. tretinoin, retin-a, glycolic acid, benzoyl, hydroquinone).
- Try to avoid wearing makeup or lipstick until the day after treatment. Earlier use may cause pustules. If you must wear makeup, we recommend a good quality mineral makeup for the face or Aquaphor ointment for the lips.
- Continue to avoid blood thinning or NSAIDs medications, vitamins, and supplements (unless otherwise prescribed by your doctor) for at least 1 week after.
- Avoid scheduling any vaccination or invasive procedures for 2 weeks after treatment with dermal fillers. These include but are not limited to COVID/Flu vaccine, dental dental work, lesion excision or biopsy, surgery of any kind, tattoo or permanent makeup.
- Avoid cosmetic treatments such as laser, ultrasound, peels, facials or microdermabrasion for 2 weeks after.
- Schedule a follow-up appointment 14 days after your treatment for your practitioner to assess the outcome.
If you experience any side effects, such as prolonged discomfort or swelling, a histamine reaction, or infection, immediately contact your practitioner for proper assessment and care instructions.