As we age, our bodies produce less collagen every year after our twentieth birthday. Collagen is responsible for providing our skin’s underlying structural support. This decline, along with sun damage and other factors, leaves our face with areas of volume loss. This volume loss declares itself in sunken cheeks, creases and lines, and an overall older appearance.
Dermal fillers return some of that lost volume. At Northwestern Med Spa, we offer a variety of dermal filler options for our patients.
Dermal fillers do exactly as their name says — they fill in areas that have sunken or are showing signs of volume loss. When a filler is injected beneath a crease, such as a smile line, the filler simply returns volume to the area, pushing the skin back upwards and erasing the crease.
Dermal fillers are used to return volume. Natural fillers are made from hyaluronic acid, a naturally occurring substance in the body that is responsible for hydrating and plumping the skin. When a natural filler such as Juvéderm® is injected into an area, the hyaluronic acid binds with nearby water molecules and plumps and firms the skin.
Synthetic dermal fillers are made from other materials such as calcium microspheres (Radiesse®). They both fill in volume immediately and can increase the body’s collagen production in the injection area to extend their results for a longer period.
Dermal fillers are used on the lower two-thirds of the face, typically from the under-eye area through the chin. They are also used to return volume to the backs of the hands. Fillers may return volume to these problem areas:
Our team at Northwestern Med Spa has extensive experience and training with the different fillers we offer. Once you tell us what areas you want to target, we’ll discuss which fillers are right for the job.
These sessions take 30 minutes to an hour, depending on the area we are treating. Many fillers have lidocaine in the formulation, but we can apply topical numbing cream or lightly ice the injection area prior to the injections if you would like. There is no recovery or downtime, although you can experience bruising and swelling which is different for each individual.
Here are the fillers we offer and where they are used
We offer all five dermal fillers in the Juvéderm® family. Each filler is hyaluronic acid-based and is intended to address a different area of the face and replace decreased volume. Juvéderm® results last up to one year, except for Vollure™, which lasts 18 months.
We offer all five dermal fillers in the Restylane® family. Like Juvederm®, all of these fillers are hyaluronic acid fillers and intended for different areas of the face.
Radiesse® is a synthetic dermal filler that targets the lower face. Instead of hyaluronic acid, Radiesse® consists of calcium hydroxylapatite (CaHA) microspheres that are suspended in a water-based gel. Radiesse® works to add volume in two ways. First, when it is injected it provides immediate volume and wrinkle correction as the microspheres add structural support under the skin. Then, as the body begins to absorb the gel and breaks down the CaHA microspheres, this reaction triggers the body to produce new collagen in the injection areas. Radiesse® is particularly suited to address smile lines, marionette lines, pre-jowl folds, drooping corners of the mouth, and chin wrinkles. Radiesse® results last around one year, but it can boost collagen production longer than that.
Sculptra® is a synthetic filler that is made from poly-L-lactic acid (PLLA), which works within the skin to replace lost collagen. Sculptra® is effective for the typical lines and creases that develop around the mouth: parentheses lines, marionette lines, nasolabial folds, and chin wrinkles. Sculptra® is injected deeper than most fillers, into the deep dermal layer. Sculptra® is injected in three sessions over the course of three to four months. Like typical fillers, Sculptra’s gel initially provides volume where injected and pushes the depressed area back upward, but this is only temporary. After a week or so, the wrinkle can reform to a lesser degree, but this is when Sculptra® really works. Microparticles of PLLA work within the deep dermis to rebuild lost collagen and provide structural skin support. As the PLLA is absorbed, a collagen framework is created. This reinforced collagen structure provides a foundation that gradually restores the look of fullness to deep wrinkles and folds. This new collagen framework provides results that last up to two years.
Bellafill® is a synthetic filler. It consists of a mix of 80 percent collagen and 20 percent polymethyl methacrylate (PMMA) microspheres. PMMA is a biocompatible material that has been safely used in medical implants and other devices for over 65 years. Bellafill® works in two ways- first using the collagen in the filler and then the PMMA microspheres. The collagen shows first, immediately adding volume to the skin to lift and fill smile lines and acne scars.
As the body begins to absorb the collagen, the PMMA microspheres kick in. Once injected along with the collagen, the PMMA microspheres remain in place and create a matrix that supports new collagen production in your skin. So, in addition to the filling aspect from the injected collagen, Bellafill® also stimulates your body to create new collagen, which rejuvenates and fills the skin for years.
Neuromodulators like BOTOX work by relaxing the muscle they are injected into. Certain types of wrinkles are formed by muscle contractions under the skin — crow’s feet at the outside of the eyes, the 11’s between the eyebrows, and forehead lines. These are called dynamic wrinkles. BOTOX blocks the nerve messages that are sent from the muscle to the brain, so the brain never receives the message to contract the muscle. The muscle stays relaxed and the wrinkle doesn’t form above it.
Fillers have no effect on dynamic wrinkles formed by muscle contractions. Fillers work on what are called static wrinkles. These are wrinkles caused by sun damage, declining collage production, environmental factors, and personal habits such as smoking. Static wrinkles are on display at all times. Fillers are injected beneath the wrinkle, crease, or area of volume loss, and they simply return volume and push the skin back upwards, erasing the wrinkle or returning volume.
You can see the duration of the results with each filler described above. Fillers have various lifespans before the body absorbs the filler material. These results run from around six months with Restylane® Silk to a year for most of the Juvederm® fillers and the other Restylane® fillers. Juvederm® Vollure and Radiesse® can extend those results for 18 months and possibly longer (depending on the collagen production triggered by Radiesse®).
Generally, the lifespan of your results with hyaluronic acid fillers runs from around 6 months up to 18 months. Sculptra® and Bellafill® can provide a boost in collagen production for two years and longer.
The most commonly observed side effects with fillers are swelling, redness, pain, bruising, headaches, tenderness, lump formation, and itching at the injection sites. These are typically mild in severity and usually resolve themselves in seven days with smile and marionette lines, and within 14 days on the lips.
Because hyaluronic acid is a naturally occurring substance in the body, there are very few reactions to Juvéderm® and Restylane® products. Occasionally, lumps or granulomas can form near the injection sites. This side effect can be reversed with an injection of hyaluronidase, an enzyme that speeds up the natural degradation of the hyaluronic acid in the filler.
As with all fillers, the expertise of your injector is important to achieve the best results and avoid side effects. The entire team at Northwestern Med Spa has training and extensive experience with each of these fillers.
If the filler used was one of the Restylane® or Juvéderm® products, these fillers can be instantly neutralized with the injection of an enzyme called hyaluronidase, as described above. There are other modalities we can use to help reduce the response of unwanted fillers as well.