Facial Filler Injections (Including Juvederm, Restylane, Voluma, Belotero and Radiesse) in New Jersey For Facial Rejuvenation
Contact SOMA Skin & Laser at 973-763-SKIN (7546) for a dermal skin filler consultation
About Dermal Skin Fillers
SOMA Skin & Laser offers facial filler injections, such as Juvederm Voluma, Juvederm Ultra, Juvederm Ultra Plus, Juvederm Volbella, Juvederm Vollure, Restylane, Belotero and Radiesse, for rejuvenation and the treatment of wrinkles. Many facial fillers (including Juvederm products, Restylane and Belotero) are a form of hyaluronic acid. Hyalronic acid is a naturally occurring substance in the body, which can be injected to smooth wrinkles and restore youthful volume. Injection of facial fillers, such as Juvederm, is one of the most popular non-surgical cosmetic procedures in the United States. In the facial filler injection procedure, the skin filler material is injected into areas that require volume enhancement. This can be a specific wrinkle or defect, or the entire mid-face to restore the rounded contours of youth. The lips are commonly treated with skin fillers to restore volume lost to aging and create a fuller lip. The most commonly treated areas are the wrinkles around the mouth and nose (nasolabial fold), the mid-face (cheeks), and lips, but other areas and defects can be treated as well. With Belotero and Juvederm Volbella finer, more superficial lines can be treated as well, such as vertical lip lines or the tear trough area. For more lift, such as the cheeks, Voluma is a good choice. Voluma is intended for deep placement to correct age-related volume loss in the midface. With optimal treatment, natural-looking results last up to 2 years. Radiesse provides more lift than most hyaluronic acid fillers, and is especially useful in the mid-face and cheeks, but unlike hyaluronic acid fillers, Radiesse cannot be dissolved.
The results of skin filler injections are, generally, not permanent and must be repeated every few months to maintain the rejuvenating effect. Skin filler injections are done with a fine needle. Some skin fillers, such as Juvederm products, contain a local anesthetic, while for others a topical anesthetic agent or ice may be applied first to the skin for numbing. Skin filler injections are an excellent first step into the world of cosmetic procedures. Skin filler injections are also an excellent complement to Botox for the treatment of dynamic wrinkles, and rejuvenating laser procedures. At SOMA Skin & Laser, all skin filler injections are performed by a board-certified dermatologist.
Dermal Fillers For Men
Men can benefit from soft tissue fillers, such as Juvederm or Belotero, to restore volume, especially in the mid-face area and at the nasolabial folds. Men can also benefit from augmentation of the jawline, creating a more masculine firmer jawline. Augmentation of the brow to create a stronger more masculine appearance is also popular.
What are dermal fillers?
Dermal fillers, or skin fillers, are materials injected into the skin to reduce the appearance of wrinkles. There are a number of approved dermal fillers on the market, including: Juvederm, Restylane, Belotero, Radiesse, and Sculptra. The most popular dermal fillers are derived from hyaluronic acid. The discussion below is general and not necessarily relevant to each individual product.
Dermal skin fillers are substance injected into or below skin to augment or replace volume. The result for most fillers are seen immediately, but it may take several visits to achieve the correct correction; some older fillers lose some volume quickly, so “over-correction” used to be common practice, but should not be the case today. There is usually no down-time due to the procedure, though bruising or swelling can occur. Most fillers are not permanent, with results lasting about six months. There are many choices, as listed above.
What is hyaluronic acid?
Hyaluronic acid is a naturally occurring glycosaminoglycan found in the dermal matrix of all species without interspecies variability.
What is the ideal skin filler?
No one filler is “ideal” for every application. The general attributes of the ideal filler are:
-Natural look and feel
-Does Not migrate
-Easy to implant
What are the categories of dermal skin fillers?
- polysaccharides such as hyaluronic acid
- Protein products such as human collagen, bovine collagen, and fascia lata; these are rarely used today.
How are dermal skin fillers injected?
There are several possible methods. In the multiple puncture technique, the needle, bevel up, is injected at an angle to the skin of approximately 30 degrees. Multiple injections are made to fill the desired area. In the microdroplet technique, tiny quantities are injected in different planes in the defect. In linear threading, the needle is placed almost parallel to skin and injections made while withdrawing the needle; this may provide too shallow placement for some materials.
For each filler the physician must consider the use, means of injection, proper plane of injection, and desired overcorrection (if any).
Injections can be painful, especially in the central face and perioral areas. Topical anesthesia or ice for 15 minutes prior may be sufficient. Nerve block or regional anesthesia may sometimes be required. Newer fillers include a local anesthetic, obviating the need for ice or pre-treatment with a topical agent.
How should the patient be counseled before the dermal skin filler procedure?
For each dermal skin filler, the patient should be advised of the risk/benefit ratio (see each specific product for details), and informed of the expected duration of effect. The patient should be instructed to avoid aspirin for 7-10 days prior to the procedure and other NSAIDs for 3 days. The patient should be asked to complete a questionnaire with relevant information, including: medications, history of hypersensitivity reactions, history of herpes facialis, medical history, whether she is pregnant or lactating, any history of autoimmune disease, and importantly what are the patient’s expectations from the procedure and what morbidity is tolerable (e.g. erythema, swelling etc…).
How should the patient be evaluated before the dermal skin filler procedure?
The cause of wrinkles and facial damage must be assessed. Are the lines dynamic or static? Is there photodamage, gravitational pull, or aging. Aging results in loss of subcutaneous fat and the prolonged results of the pull of gravity. Photodamage results in breakdown of supporting skin structures, such as collagen and elastin, and can also lead to skin cancer. Evidence of trauma, disease, inflammation, or prior surgery should be sought.
Assessment includes the size, depth, location, and integrity of adjacent structures for each wrinkle. Non-facial sites, such as dorsum of the hands, should be inspected as well. All amenable defects should be noted: rhytides, distensible scars (e.g. acne or traumatic), and the vermillion border of the lip and the oral commisure.
How should the patient be counseled after the dermal skin filler procedure?
Ice and/or compression can be applied to minimize bruising. It may be helpful to sleep with the head elevated for the first several nights after the procedure in order to minimize edema and ecchymoses. Antiviral medications should be considered for perioral injections in patients with a history herpes labialis. See the SOMA Skin & Laser post-skin filler patient handout.
Generally, who should not receive dermal skin fillers?
The dermal skin filler products have not been tested in pregnancy and breast feeding. Dermal skin fillers should not be injected into an infected or inflamed site. It should not be used in patients with abnormal hemostasis or allergy to any component. Dermal skin fillers should generally not be used in the glabellar area (see below). Caution should be exercised when using dermal skin fillers in thin or atrophic skin; the material may be detectable. Each product must be be injected at the specified depth.
Generally, what are the adverse effects of dermal skin fillers?
The list of possible adverse effects is long. Some are technique-dependent and some due to reactions to the product. Possible adverse effects include: asymmetry; purpura/hematoma; erythema; edema; induration; pruritus; tenderness; dysesthesia; lumps, cysts, abscess; discoloration; intermittent swelling; necrosis; scars; allergy; infection; and extrusion.
Severe adverse effects include: blindness, cerebral infarcts, and fat embolus. These devastating complications can occur with injection into the glabellar and periorbital area, which are supplied by the internal carotid artery. Dermal skin fillers should be avoided in these areas. Arteriole occlusion manifests as immediate burning and a dusky appearance. If this occurs, the injection must be stopped immediately. Topical nitroglycerine or dimethylsulfoxide (DMSO) may help increase blood flow to area. Hyaluronidase can be used to dissolve hyaluronic acid fillers, and should always be on hand. Rarely, connective tissue diseases have been reported to occur with the use of bovine collagen. However, investigatory FDA panels found no evidence of a link. In any event bovine collagen is rarely used today.
Skin filler injections are priced by the syringe but specials, promotions and discounts on skin fillers are sometimes available, so call and schedule a consultation.