Dermal Fillers

Dermal fillers help to diminish facial lines and restore volume and fullness in the face.

As we age, our faces naturally lose subcutaneous fat. The facial muscles are then working closer to the skin surface, so smile lines and crow's feet become more apparent.

The facial skin also stretches a bit, adding to this loss of facial volume. Other factors that affect the facial skin include sun exposure, heredity and lifestyle.

What dermal fillers can do

• Plump thin lips

• Enhance shallow contours

• Soften facial creases and wrinkles

• Improve the appearance of recessed scars

• Reconstruct contour deformities in the face

• Decrease or remove the shadow of the lower lids

Dermal fillers can be very helpful in those with early signs of aging, or as a value-added part of facial rejuvenation surgery.

What dermal fillers can't do

For some patients, surgery such as a facelift, brow lift or eye lift may be the best approach. Nonsurgical rejuvenation treatments, such as soft tissue fillers, cannot achieve the same results, but may help delay the time when consideration of a facelift becomes appropriate. It is important to remember that dermal fillers are temporary treatments for facial aging and that ongoing treatments will be needed for long-term results.

Cost

The total cost of dermal fillers depends on the amount and type of filler, but can range from $450 to $850. Dr. Rhee uses Allergan products including Juvederm, Volbella, and Voluma, as well as products such as Radiesse.

Types of fillers

Hyaluronic acid

Brand names include: Juvederm, Volbella, Voluma

Hyaluronic acid injections can be used to improve the skin's contour and reduce depressions in the skin due to scars, injury or lines.

Hyaluronic acid is a natural substance found in your body. High concentrations are found in soft connective tissues and in the fluid surrounding your eyes. It's also in some cartilage and joint fluids, as well as skin tissue. It is extracted and reformulated and now has become one of the most popular kinds of injectable fillers. If the term sounds familiar, it's because the same substance is often injected into the aching joints of people with arthritis to ease pain and provide extra cushioning.

Calcium hydroxylapatite

Brand names include: Radiesse

Calcium hydroxylapatite is found naturally in human bones and is a mineral-like compound.

It is biosynthetically produced, which means that no animals or animal products are used. This lowers your risk of an allergic reaction and no skin testing is required. This type of dermal filler is known to produce a very natural result, doesn't migrate and side effects are rare. This dermal filler was first used in dentistry and reconstructive surgery and has a long safety record.

Recovery

Recovery time varies for each patient and for each type of filler injected. You can resume most activities right away, but it is generally recommended that you avoid intense physical activity for the first 24-48 hours to minimize swelling and bruising. Be sure to discuss your specific recovery plan with Dr. Rhee prior to scheduling your injections.

Your initial appearance after treatment with any dermal filler may include:

• An "overfilled" appearance to treated areas

• Swelling or bruising ranging from mild to severe

• Temporary numbness or redness

• Palpable lumps or hard areas at the injection sites

• Hypersensitivity reaction that can seem like an allergic reaction with hives and swelling

Most conditions can be alleviated with topical icing and massage and will improve within a matter of hours or just a few days. Some reactions may require more aggressive treatment with medications or injections. Be sure to discuss your recovery and treatment plan with your physician.

Risks

The decision to use fillers is extremely personal. You will have to decide if the benefits will achieve your goals and if the risks and potential complications of dermal fillers are acceptable.

Dr. Rhee and his staff will explain, in detail, any risks.

You will be asked to sign consent forms to ensure that you fully understand the procedure, as well as the risks and potential complications.

Severe complications from dermal fillers are uncommon. Potential risks vary depending on the specific filler used and the relative permanence of the filler substance and include:

• Acne-like skin eruptions

• Asymmetry

• Bruising, bleeding from the injection site, swelling

• Damage to the skin that results in a wound and possible scarring

• Infection at the injection site

• Lumps

• Palpability of the filler under the surface of the skin

• Skin rash with itching

• Skin redness

• Under- or over-correction of wrinkles

• Blindness

• Skin necrosis (ulceration or loss of skin from disruption of blood flow)

These risks and others will be included as part of your reviewed consent.

It is important that you address all your questions directly with Dr. Rhee. Although good results are expected from your procedure, there is no guarantee that you will be satisfied with your results. Because significant complications can occur from dermal filler injections, it is important to be in the care of a board certified plastic surgeon like Dr. Rhee who understands the risks and is trained and prepared to deal with any complications that may occur.

In some situations, it may not be possible to achieve optimal results with a single procedure. Most fillers do dissipate over time. To maintain your correction, you will need to consider repeating the injection process at intervals.