Types of Fillers
Fillers like Juvèderm® and Restylane® are made up of biocompatible hyaluronic acid. An advantage of these fillers is that they can be dissolved if the results are not ideal or if there is a complication. Other hyaluronic acid fillers include RHA, Versa, and Belotero.
Radiesse® is a filler made from calcium hydroxyapatite, which is generally a thicker substance and cannot be dissolved.
Sculptra® is more of a biostimulator than a filler. It is made of PLLA (Poly-L-Lactic Acid) and stimulates collagen production in order to volumize hollowed areas on the face. Typically several treatments of Sculptra, spaced out about 1 month a apart, are recommended. It can take months to see the fill results of Sculpta treatment because you are relying on your body to create the volume.
Regardless of which filler discussed above is used, the effects will subside over time. Therefore, repeat injections are typically required in order to maintain the results.
Candidates for Fillers
Ideal candidates for filler treatment are those who desire adding small amounts of volume to specific regions of the face. In certain cases, lines and skin quality can also be improved with fillers.
How Filler Treatment is Performed
We use both microcannulas and needles to perform filler injections, depending on the region being treated and the goals. Unlike a needle, a microcannula has a blunt tip and is less likely to cut through blood vessels and nerves during the injections. This makes the procedure less painful and typically reduces bruising and swelling. In addition, microcannulas may decrease the chance of injecting filler into blood vessels, and thus reduce the risk of more significant complications. Using a microcannula is an advanced technique, and requires extensive experience to achieve optimal results in many areas of the face. Although we most commonly use a microcannula, we use a needle technique when greater precision is required or when augmenting the surface of bone.
We use gentle technique and several types of numbing options to ensure utmost patient comfort during the filler treatment. Topical numbing creams and cold air from our cryo-chiller can be applied before the procedure. In addition, a numbing injection can be performed to make the treatment completely painless. The numbing injection itself is associated with very minimal pain. Most patients are surprised with how little discomfort is associated with our filler treatments.
How to Prepare for Filler Treatment
It is recommended to avoid medications and supplements that thin your blood in order to reduce the risk of bruising. Ensure to consult with your prescribing physician before stopping any medications. Schedule your filler treatment during a time that it is OK if you happen to develop bruising.
We are conveniently located to serve Beverly Hills, West Hollywood, & Los Angeles. However, we are available to help with coordinating your stay if you are an Out-of-Town Patient.
What to Expect After Fillers
Common side effects include bruising and swelling. Some areas, such as the lips, are more commonly associated with swelling. You may be recommended to sleep elevated the night after your procedure and reduce salt intake for several days in order to reduce the amount of swelling. In addition, you may be recommended to avoid strenuous activity for 1 to 3 days after your filler treatment to also reduce swelling.
How often do I need to undergo filler treatment for maintenance?
This is very case dependent. It depends on the type of filler being used, the location being treated, and each individual’s response to the filler. Depending on all the various factors, you may be recommended to have repeat treatment within a few months or to wait at least a year or longer. Undergoing filler treatments too frequently can lead to facial distortion and increased complication. Therefore, being treated by an expert injector who cares about your long-term appearance is critical. It is common for me to tell a patient to slow down or hold off on filler treatment.
Does filler treatment hurt?
We pride ourselves in making the filler treatment experience as comfortable as possible. We takes our time and utilize various numbing techniques to ensure you have little to no pain.
Nasolabial Fold Filler
Softening the laugh lines
View case Details ▼
Filler treatment can be performed at the nasolabial folds in order to smooth the appearance of laugh lines. I typically use an advanced technique with a microcannula to break down the bands at the folds while injecting the filler, which further softens the laugh lines. Occasionally, a needle technique is used conservatively to help treat finer lines.
Since there is significant movement at the laugh lines during facial expression, it is ideal to use a filler that has elastic characteristics. In certain cases, multiple depths are treated in order to achieve the most natural and rejuvenating result. Depending on the thickness of your skin and the depth of your nasolabial folds, the most ideal product is selected specifically selected for your case.
By using the proper filler and expert technique, the filler integrates well into your tissue and provides a very natural result.
Under Eye Filler
Improving the contour under the eyes
This patient had difficulty finding an injector who was comfortable treating her under eyes due to her very thin skin. We were able to achieve her goals by using a microcannula and the proper filler to create a very natural and refreshed appearance.
A microcannula was used to volumize this lovely patient’s tear troughs and slightly lift her cheeks. Her under eyes now appear more youthful and well-rested. In addition, the nasolabial folds also appear smoother after the under eye filler treatment.
Filler was strategically placed at the under eye region to provide an overall more refreshed and rejuvenated appearance.
View case Details ▼
Filler treatment of the under-eye region creates a more refreshed and overall rejuvenated look. This treatment directly improves the contour under the eyes, but can also slightly lift the cheeks and soften the laugh lines. Although this is an excellent treatment, it is not appropriate for everyone. The most ideal candidate has hollowing at the under eye region. If there is significant lower eyelid fat bulging (which may give the appearance of hollowing under it), treatments other than filler are usually recommended.
Considering the thin skin and complex anatomy at the under region, it is imperative to have this procedure performed by an expert. Improper filler treatment in this region can lead to lumps and puffiness that persists for months or years. Using the correct type of filler and injecting the filler at the right depth is imperative to reduce the risk of chronic swelling, lumps, and the Tyndall effect (bluish/dark hue to the skin) while achieving adequate volumization.
We most commonly use a microcannula for treating the delicate under-eye region with filler. This significantly decreases swelling and nearly eliminates bruising in most patients.
Improving the volume and contour of the lips
View case Details ▼
Filler treatment of the lips can help add volume, enhance contour, and improve symmetry. I perform a comprehensive analysis for each individual patient to select the most ideal filler and to determine the ideal amounts of filler at the various regions of the lips. By creating individualized treatment plans, optimal results and a very natural appearance can be attained.
The lip is one of the areas of the face that has the greatest swelling after filler treatment. It can take several days (sometimes up to 1 to 2 weeks) for enough swelling to resolve to achieve a natural result.
Contour change of the nose
View case Details ▼
Filler treatment of the nose, also known as a non-surgical nose job or liquid rhinoplasty, is a lower-cost and lower-downtime alternative for those who may have otherwise considered surgical rhinoplasty. In the right candidates, this treatment can improve asymmetry and irregularities along the bridge of the nose making it appear smoother and straighter, raise the bridge of the nose correcting an overly scooped appearance, help camouflage a dorsal hump on the profile view, and/or lift up a drooping nasal tip. The filler is injected at the tip and along the bridge of the nose in tiny amounts. The most ideal candidates are those who benefit from adding volume to the nose and those who require small changes.
Filler treatment of the nose is off-label because the filler is being used at a location of the face that is not specified in the FDA’s approved packaging label. Treatment of the nose requires an advanced technique and should only be considered if performed by an extensively trained licensed medical professional.
Sculpting a more defined jawline
View case Details ▼
Filler treatment of the jawline can help those looking for a more sculpted, defined chin and jawline. This treatment can sharpen the jawline and build upon a small chin helping to restore lost definition in these areas. Proper placement of the filler in these areas can help camouflage the jowls in those experiencing the first signs of facial sagging.
The patient in this case sample had 1 syringe of filler. Although an additional syringe of filler would have further improved jawline contour, it was felt that a single syringe was an appropriate balance in her case. Greater volumes of filler can create an undesired look from the frontal view (widening of the lower face) and increase the risk of both short-term and long term complications. Many factors are considered when determining the ideal type and amount of filler for each case.