The world of facial injectable treatments can be overwhelming with all the options seen in print and TV ads. New injectable materials seem to come out almost weekly. Here is a run-down of the dermal fillers we most often use, where we use them, and some common side effects.
Hyaluronic Acid (HA)
The most frequently used dermal fillers are made of a material called hyaluronic acid (HA). Hyaluronic acid is a chemical structure found in our bodies — so most individuals tolerate the filler well, without side effects. The chemical structure of the molecule can be processed in different ways, giving us the ability to manipulate the thickness, the amount of volume and the longevity of the effects on your skin.
This versatility is important because, depending on your particular area of concern, you may desire one benefit of the treatment over another. For example, you may desire additional volume and want the treatment to last a long time, but not need fine lines to be treated. On the other hand, you may desire smoker’s lines around the mouth to be improved, but not want a lot of volume or swelling in the mouth area.
Hyaluronic acid fillers come packaged in a variety of forms: Juvederm, Volbella, Juvederm Ultra Plus and Voluma, Restylane, Restylane Silk, Restylane Refyne/Defyne, Lyft and Belotero. Your facial cosmetic surgeon will recommend the use of particular kinds of HA fillers based on the treatment area, as well as your desired outcome, preference, and experience.
Side Effects of HA
Hyaluronic acid is a water-loving (hydrophilic) product, which means one expected side effect is swelling. The degree of swelling experienced after HA treatment varies. You’ll most likely experience swelling on the first day after injections, with a drastic reduction after that.
Follow these tips to help reduce swelling during the first day and night after facial injections:
- Keep your hands off the area injected
- Keep your head elevated while resting and sleeping
- Limit alcohol and salt intake
- Use cold compresses on the affected area
Rarely, patients are hypersensitive to this product and can exhibit an allergic response. If you experience any significant swelling, itching or redness at the injected areas, you should contact your surgeon. The biggest benefit to HA fillers is that with another enzyme injection, they can be dissolved, making this filler reversible.
Other Types of Dermal Fillers
Although HA fillers are the most common, other fillers may be useful for specific treatment areas:
Permanent fillers, such as Artefill, can be helpful for areas with deep folds and are unlikely to change dramatically over time, such as the lines from the nose to the mouth (called nasolabial folds). The downside to permanent fillers is that if there is a reaction or a less than desirable result, the process is not reversible.
Radiesse is a temporary thickener made of a material called calcium hydroxyapatite. It’s longer lasting than HA fillers, and not dissolvable. Your plastic surgeon may recommend Radiesse for deeper injection areas such as the lines from nose to mouth (nasolabial folds), cheeks and deep temple injections. One risk of using Radiesse is possible injection into a blood vessel, which can affect blood supply to a specific area of skin, causing serious complications. In some cases, Radiesse injection made too close to the skin can cause lumpiness under the skin. When used correctly, however, this filler can be very beneficial for reducing deep folds and providing volume.
Sculptra is collagen-stimulator filler intended for patients who need to gradually increase volume in larger areas. Before injection, Sculptra is hydrated with water for 48 hours. It’s then injected in small doses throughout the tissues under the skin in the treatment area. You can expect it to take between three to six weeks to see full results. Benefits include a more natural-appearing result and gradual increase in volume rather than abrupt change. The downside is that results can take several months to become apparent.
Which Dermal Filler is Right for You?
A board-certified facial plastic surgeon with experience treating the face can help you determine the best derma filler treatment for your most bothersome areas. The best filler product will depend on the area of concern, the depth of the issue and the thickness of the material. The experienced cosmetic surgeons at Emory Aesthetic Center have years of experience with fillers and individual preferences based on those experiences. Feel free to ask questions, return for a second discussion or look at photos to help you make your decision. Ultimately, our goal is ensuring your best result.