Dermal Fillers

Dermal fillers are injectable gels of varying densities (viscosity) and compositions. Dermal fillers are the injector’s tools for non-surgical facial sculpting. They are used to restore lost volume in an aging face, to modify or refine facial features, to lift sagging skin, smooth lines, fill scars, and to improve facial balance and proportion.

TYPES OF DERMAL FILLERS

Dermal fillers composed of hyaluronic acid (HA) are the most favored fillers (Restylane, Juvederm). HA is a naturally occurring substance in our bodies. HA is the key molecule in moisture retention for skin, connective tissue and in the eyes. HA keeps skin hydrated, supple, smooth and volumized.

HA fillers provide instant, natural-looking results. The wide range of HA filler densities and textures, particularly those of the Restylane collection, also provides an extensive menu from which to choose for the most natural-looking results. For example, a water-like filler consistency is a perfect choice for natural lip enhancement (Restylane Kysse). A dense filler is best for heavy lifting and reshaping, such as lifting cheeks (Restylane Lyft) or augmentation of a weak chin (Restylane Defyne). Then, there is the range of HA filler options between the two to address deep folds, fine lines, and lines in areas of high mobility such as smile lines and lip lines (Restylane-L, Restylane Silk, Restylane Refyne, Restylane Contour).

Other advantages of HA fillers include high safety and biocompatibility profiles, and the ease at which HA fillers can be dissolved with an enzyme. To be quickly dissolvable is an important characteristic for fillers in case of an adverse event or if the results are unsatisfactory. For instance, semi-permanent and permanent fillers carry risks that HA fillers do not: they require surgical removal; some adverse reactions that can occur with more permanent fillers can be delayed by months or years.

Sculptra Aesthetic is classified as a dermal filler; however, this poly-L-lactic acid (PLLA) based product works as general volumizer, or bio-stimulator. Sculptra is not a site-specific filler as the others are. Sculptra strengthens skin support structure, increasing volume and “lift” where injected.

The microscopic PLLA particles that make up Sculptra are biocompatible, biodegradable, synthetic material that also are medically used for dissolvable sutures. When these PLLA microparticles are injected, our own collagen is triggered and bundles around these microparticles. As the PLLA particles break down and are completely replaced by our own collagen, skin’s underlying support structure is rehabilitated, smoothing, and lifting skin. The process is gradual and natural-looking.

Weak skin support structure with sparse collagen

Collagen replaces PLLA microparticles Skin support is strengthened, lifted, smooth

 

Sculptra progression from baseline to 18 months.
Results can last over 2+ years.

Another by-product of Sculptra is the “Sculptra Glow.” As collagen is stimulated and skin is strengthened, there is visible improvement in skin quality, smoothness, and luminosity.

While dermal fillers are the injector’s tools for non-surgical facial sculpting, they are not the only requirements for successful outcomes with dermal fillers. An injector must also have precision technical skills and artistic sensibilities for successful outcomes. A keen knowledge of facial and vascular anatomy keeps treatments safe. Artistic sensibilities allow differentiation to maximize individual beauty and to produce natural looking results.

Common Uses for Dermal Fillers

Fill and sculpt cheeks. (Restylane Contour, Restylane Lyft, Sculptra Aesthetic)

Few treatments can provide such instant gratification as filling cheeks and restoring lost bone mass in cheekbones. Fillers in these areas instantly improve face shape and restore facial youthfulness. Filling the upper cheek area can also soften undereye hollows and reduce the depth of nasal labial folds.

 

Fill temple hollows and lift drooping brows. (Restylane Contour, RestylaneL, Restylane Refyne, Sculptra Aesthetic)

Loss of facial fat pads, bone mass, and skin volume causes the cascade of visible aging. Depressed temples are one of the most obvious characteristics of facial aging. Filling temples restores support, improves face and eye shape, lifts outer brows, improves eyelid creases, and softens crow's feet.

Restore lip shape, smooth lip lines, and restore lip volume. (Restylane Silk, Restylane Kysse, RestylaneL)

Balance is key for perfect lips. The goal of lip filler is natural-looking, smooth, hydrated, defined lips.

As we age, lips become deflated, lined and lose definition. Dermal fillers replace volume in deflated lips, restore definition of flattened philtra columns, reshape lips, and fill lip lines. For both youthful and aged lips, dermal fillers improve symmetry, shape and overall balance of facial features. Of special note: Disproportionate lips disrupt facial balance.

 

Chin and jawline sculpting. (Restylane Defyne, Restylane Lyft, Restylane Contour, Sculptra Aesthetic)

Strategic placement of dermal fillers can improve facial shape and give a crisper, more youthful definition to the jawline.

Using dermal fillers to enhance a weak chin, change chin shape, length and projection improve profile and frontal facial views.

Improve nasolabial folds and marionette lines. (Sculptra Aesthetic, Restylane Defyne, Restylane Lyft, RestylaneL, Restylane Refyne)

As we age, we lose skin support. Skin falls forward as facial fat pads flatten and separate, skin volume decreases and bone loss weaken facial structure. The result is deepened naso-labial folds and marionettes.

The most natural-looking outcome when addressing these areas is to first address the areas contributing to the deepening of these areas. In other words, chasing folds and wrinkles with dermal fillers does not yield the most natural looking results. After facial and support structure are replenished, the use of dermal fillers in these areas for added refinement and lift looks most natural.

Rejuvenate aging hands.

A quick and effective remedy for thin skinned, veiny, old looking hands is a few syringes of Restylane Lyft. Restylane Lyft adds density to skin, holds moisture and conceals visible veins.

Improve neck lines. (Restylane Refyne, Restylane Silk, Sculptra Aesthetic, Dysport)

Dermal fillers can instantly lift horizontal neck lines. Dysport can relax the vertical ones, smoothing and tightening the neck.

Smooth chest wrinkles. (Sculptra Aesthetic)

Sculptra Aesthetic works to repair and lift skin support structure to smooth chest wrinkles.

Repair earlobes. (Restylane Lyft, RestylaneL)

Even earlobes become thin, stretched, saggy, and wrinkled over time. Adding dermal filler into earlobes quickly restores youthful lobes, even props up earrings to where they are meant to be.

 

Full face rejuvenation with dermal fillers can be life changing.