Using injectables to erase wrinkles and return volume to areas of the face isn’t a new idea. Fat and collagen were used in the past to inconsistent, mixed results. But when the FDA approved BOTOX® in 2002, everything changed. Today, injectables fall into two categories: neuromodulators (BOTOX and other brands) or dermal fillers. BOTOX® has another page on Dr. Evans’ site. This page is all about dermal fillers.
What is a dermal filler?
Dermal fillers are true to their name. They are injected under the skin beneath a wrinkle or area that has lost volume, and they “fill” in the area, pushing the skin back upward. Dermal fillers can fill creases such as nasolabial lines, return volume to sunken areas such as the cheeks, or add volume to the lips.
What are the different types of dermal fillers?
Dermal fillers are classified as either “natural” or “synthetic.”
Dr. Evans uses only natural fillers. These fillers are made primarily with hyaluronic acid. Hyaluronic acid occurs naturally in humans and many other animals. Its job is to hydrate, plump, and firm the skin, which it accomplishes by binding with nearby water molecules.
Synthetic fillers are made from different manufactured materials. These range from poly-L-lactic acid to calcium microspheres.
Types of dermal fillers Offered
Dr. Evans uses the two most popular and trusted names in dermal fillers — Juvéderm® and Restylane®. She offers the complete Juvéderm® line: Juvéderm® XC, Ultra XC, Volbella, Vollure, and Voluma; along with the original dermal filler, Restylane.
The original Juvéderm® dermal filler was approved by the FDA for the treatment of wrinkles, creases, and volume loss in June 2006. That original filler is now called Juvéderm® XC and it is used to address moderate nasolabial folds and parentheses lines. The success of Juvéderm® has led its manufacturer, Allergen, to add new products to the Juvéderm® line, each targeting different areas of the face — Voluma (cheek volume), Ultra (lip volume), Volbella (subtle lip volume), and Vollure (deep nasolabial and parentheses lines). You can read more on Juvederm here.
Restylane® was the first dermal filler approved by the FDA in December 2003. It had been in use in other countries beginning in 1996. Like Juvéderm®, Restylane® is a natural filler intended to address nasolabial and parentheses lines. You can read more about Restylane here.
How are dermal fillers different than BOTOX?
Patients often assume BOTOX® and dermal fillers are one in the same, but they actually do their jobs in completely different ways. Dermal fillers fill wrinkles and creases from beneath, simply adding volume and pushing the skin back upward. Dermal fillers are used on what are known as “static” wrinkles. These are the wrinkles that show themselves at all times. Smile lines, marionette lines, vertical lip lines, parentheses lines — these are all static wrinkles. Static wrinkles and areas of volume loss are usually due to sun damage, environmental factors, thinning of the skin with age, and decreasing collagen production.
BOTOX® is a neuromodulator, and it only works on “dynamic” wrinkles. These are wrinkles that form when we make certain expressions, such as frowning or squinting. The muscles involved in these expressions contract and over time create a wrinkle on the surface skin above. These wrinkles form mainly on the upper third of the face, the expressive area of the face. BOTOX® is not injected beneath the wrinkle, but into the muscle beneath it. BOTOX® then blocks the nerve message in that muscle, so the brain never receives the message to contract the muscle. Without the contraction, the wrinkle above the muscle doesn’t form. BOTOX® doesn’t fill wrinkles, and it has no effect on static wrinkles.
How long Do dermal fillers last?
The duration of your results with dermal fillers varies by the individual product. Plus, your individual metabolism plays a role. If the injection area involves a large amount of movement, such as the mouth area, the body can absorb the filler faster, as well.
These are some guidelines for filler results. Restylane® provides results lasting from 6-9 months. Juvéderm® XC lasts from 9-12 months. Juvéderm® Voluma XC is the longest-lasting hyaluronic acid filler, restoring cheek volume for up to two years. The other Juvéderm® fillers last between 9-12 months.
Can I receive dermal fillers and Botox during the same session?
Because dermal fillers and neuromodulators (BOTOX) work on different types of wrinkles in completely different fashions, they can be combined in a single session. For instance, you could use BOTOX® to treat your crow’s feet and Restylane® or Juvederm® to add volume to under eye bags in one session. Or BOTOX could remove the 11s between your brows, while Juvederm® Vollure adds volume to your lips.
Are dermal fillers painful?
At most practices, dermal fillers are injected with a needle, but Dr. Evans uses a cannula for these injections. This makes the procedure basically pain free. See below.
Why does Dr. Evans use a cannula for dermal filler injections?
Dr. Evans uses a blunt-tipped cannula for her dermal filler injections. This may seem odd — how can you get it under the skin in all the locations? This is the beauty of using a cannula instead of needle injections. Dr. Evans makes a single opening/port to insert the cannula. Once under the skin, she can then move the cannula into different areas to deliver the filler. She can use just two initial ports to access basically half the face with the cannula.
What are the advantages of using a cannula when injecting fillers?
There are many advantages to using a cannula to deliver fillers. Because cannulas have a blunt tip, they can’t puncture a vein, which can be a serious problem with needles. Also, the numerous needle injections needed to deliver the filler across the treatment area can cause bruising at each injection site, along with the obvious pain of the needle pricks. Dr. Evans also feels she can be more accurate using a cannula as opposed to a needle.
Advantages of cannula delivery:
- Minimal chance of puncturing a vein
- No bruising
- Minimal swelling
- Increased accuracy
- Only one needle prick (for local anesthetic to create port)