Dermal Fillers

What are they? How many types of dermal fillers are there and what do they do? First off, it is important to understand that the loss of collagen, fibrin, elastin, bone and hyaluronic acid lead to the visible signs of aging. Collagen is found in the dermis and is the most abundant protein in the skin, making up 75% of this organ. This is also your fountain of youth. Collagen wards off wrinkles and fine lines. Over time, environmental factors and aging make it harder for your body to make collagen and can also break down collagen you already have. All of these changes lead to the appearance of loose, saggy skin as well creases and volume loss which are visible as we continue to age.

Currently there are 4 types of Dermal Fillers:

1.     Hyaluronic Acid (HA)

2.     Calcium Hydroxylapatite (CaHA)

3.     Sculptra: Poly-L-Lactic Acid (PLLA)

4.     Bellafill: Polymethyl Methacrylate (PMMA)

Hyaluronic Acid fillers are the most commonly used fillers and are made from a naturally occurring substance of the skin, called ‘Hyaluronic Acid’. This is a gel like substance, in which the collagen and elastin fibers normally sit, giving the skin it’s elasticity and resilience. HA Fillers are produced artificially, (not derived from animal products), and some are ‘cross linked’ to make them last longer. It is naturally, gradually and completely removed by the body over a time.

Dermal Fillers are injected under the skin using very fine needles or microcannulas. The goal is to lift, plump, and fill the aging face. We can soften overlying fine lines or wrinkles, or replacing volume lost.

Another advantage of all HA fillers, is that they are all reversible and if necessary, can be dissolved or “melted away”  with a special enzyme called Hyaluronidase.

Dermal Fillers typically last from several months up to a few years. Duration of the filler is dependent on multiple factors like: area injected, the type of product used, lifestyle factors, metabolic rate and genetics.

Dermal fillers can work very well in conjunction with Botox® often having a synergistic or enhancing effect and are typically used in combination.

Our master injector, Gustavo Aguilar MS, PA-C, uses only FDA approved products including the latest of hyaluronic acid fillers such as: Juvéderm (Ultra, Ultra Plus, Volbella, Voluma, Vollure), Restylane (L, Silk, Lyft, Refyne, Defyne), Versa and Belotero.

We also use a non-hyaluronic acid fillers called Radiesse™, Sculptra™ and Bellafill™.

Radiesse™ dermal filler is used to fill moderate to severe facial wrinkles and folds, such nasolabial folds as well as cheeks to lift and create a youthful appearance. Radiesse™ is composed of Calcium Hydroxylapatite, is naturally absorbed and removed by the body over a period of time, usually 18 months to 2 years.  It is very useful in re-volumizing areas of volume loss, creases, grooves and saggy skin. It should be noted that Radiesse cannot be dissolved with Hyaluronidase.

Sculptra™ is a PLLA type of filler known as a biostimulatory collagen inducer. This means that over time, Sculptra, will continue to attract and build collagen formation. Sculptra is an injectable cosmetic filler that can be used to restore facial volume lost due to aging or illness. It contains poly-L-lactic acid (PLLA), a biocompatible synthetic substance that stimulates collagen production. It can be used to treat deep lines, creases, and folds to give a more youthful appearance. It’s also used to treat facial fat loss (lipoatrophy) in people living with HIV.

The average treatment regimen consists of 3 injections over the course of three or four months. Results can last up to two years. Sculptra can be used to stimulate collagen production and fill the wrinkles on your hands, neck, decollete, face, arms and is commonly used for buttlifting as well as cellulite reduction.

Bellafill’s™ tiny, polymethyl methacrylate (PMMA) microspheres are suspended within a base of smooth collagen gel. Once injected, the collagen gel immediately reduces the look of smile lines. Over time, your body uses the microspheres in Bellafill to create a “scaffold” onto which your own natural collagen can develop. This collagen forms a foundation that adds volume to wrinkles, reducing their appearance – and giving you natural-looking results that feel soft and smooth for up to 5 years. Bellafill is also approved for the correction of moderate to severe facial acne scars on the cheeks in patients over the age of 21 years.

Do not use Bellafill in patients with:

  • a positive reaction to the Bellafill allergy skin test
  • a history of severe allergies, hypersensitivity, or anaphylaxis
  • an allergy to the anesthetic (lidocaine) in Bellafill
  • a history of allergies to any bovine collagen product
  • a tendency for thick scar formation (hypertrophic scars) and/or excessive scar formations (keloid scars)
  • current or planned desensitization injections to meat products
  • Bellafill is contraindicated for use in lip augmentation and injection into the vermilion or wet mucosa of the lip.
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