Soft Tissue Fillers
According to the American Society for Aesthetic Plastic Surgery, the use of hyaluronic acid (HA)-based dermal fillers are the fastest growing non-invasive cosmetic procedure performed in the United States. Dermal fillers are used to fill lines and diminish skin folds in the face, add volume to the lips, and are now increasingly used to restore volume to larger areas including the cheeks and temples. Their popularity with patients has grown due to their instant, natural, predictable feel and appearance. Fillers are also attractive for their ability to be injected easily in the clinic setting with little to no downtime. For surgeons, fillers are equally attractive for their use as an artistic, refined technique to soften contours and restore facial volume and harmony leading to a more youthful appearance. Fillers can be used alone or in conjunction with skin resurfacing or surgical procedures, but are most often used together with other injectables like the neuromodulator BOTOX®.
Why is volume important?
Loss of facial volume is one of the earliest biological changes leading to an aged facial appearance. Volume loss may result from the normal aging process but can be accentuated with loss of body weight. Even in young, athletic patients with lean, fit bodies, diminishing facial soft tissue volume can result in facial hollows and wrinkles that make them appear older than their age-matched peers.
Volume has historically been an under appreciated contributor to facial aging. At one time facial cosmetic interventions centered primarily on surgical techniques like face lifting. While surgery remains an excellent option to reposition and tighten soft tissue along with removal of excess skin, these techniques did not historically improve volume below the surface. The results were often skeletonization of the face with a dreaded “operated” or “done” look. However, with growing understanding of the factors involved in facial aging has come a heightened appreciation for the volume and position of facial soft tissues. Today, there are a greater number of refinement techniques that can be used in concert to help restore and then maintain youthful, natural facial volume.
What options are available to restore or increase facial volume?
There are a number of techniques employed to restore facial volume and a more youthful, vibrant appearance. Fat grafting with a patient’s own soft tissue can provide long-lasting, natural results, but is also more invasive. Injection augmentation provides the least invasive option with no downtime and can be performed in the clinic setting.
In the past, filling substances like collagen and silicone were used to restore areas of volume deflation. However, these had a number of drawbacks. Collagen, for example, required pre-treatment allergy testing to ensure adverse reactions to the material did not occur. Once injected, it was also short lived, lasting for as little as 6 weeks to several months. In the case of silicone, the body can have an adverse reaction to this material, and, once injected, it cannot easily be removed without invasive surgical excision and the risk of permanent tissue damage.
With the growing demand from both patients and physicians for less expensive, natural, long-lasting, hypo-allergenic, and safe dermal fillers, the pharmaceutical industry continues to pioneer new, innovative products that help restore youthful, natural facial volume. The majority of these are currently comprised of hyaluronic acid (HA), an attractive substance because it already exists throughout our skin and connective tissue, helping to soften contours and provide buoyancy to our soft tissues. Examples of current HA products include JUVÉDERM®, JUVÉDERM VOLUMA®, Restylane®, Perlane®, and BELOTERO BALANCE®. There are also non-HA fillers that are approved for specific indications as well. These include RADIESSE® and Sculptra®. All of these options are available in San Antonio, and Dr. Stallworth is experienced in administration of them all.
Are fillers safe?
In experienced hands, FDA-approved fillers are extraordinarily safe. However, there are some inherent risks with the use of fillers. Fortunately, the vast majority of these involve temporary swelling, especially in the lips, and the risk of bruising at the injection site. These dissipate within hours to a week after the injection. There may also be small lumps or bumps at the injection sites that smooth in the short term after injection. There are the potential for more severe reactions, though, especially if administered by a novice injector or one who is unfamiliar with facial anatomy. For these reasons, it is imperative to seek a skilled and certified injector to help decrease risk and maximize the benefit of a filler injection. As a board-certified Facial Plastic and Reconstructive Surgeon, Dr. Stallworth will discuss these risks and answer your more detailed questions during your consultation.
How long do fillers last?
The effects of soft tissue fillers are immediate. Depending on the material used, results typically last on average 9-12 months. The results will not disappear immediately, but rather slowly fade over time as the material is broken down naturally in the body. Areas that have increased mobility and a rich blood supply, like the lips and tissue around the mouth, tend to fade faster than other areas in the face. In addition, fillers with a larger molecular size and meant for greater volumization, like JUVÉDERM VOLUMA®, are found to last much longer. During your consultation with Dr. Stallworth, he will discuss the timeframe you should expect depending on the injection site and filler used.
Who will do my injection?
Dr. Stallworth double board certified Facial Plastic Surgeon who personally performs all injections for his patients. He does not utilize nurse injectors or clinic staff to carry out these procedures. Schedule an appointment today to determine if fillers are right for you!