Injectable fillers are used in treating established wrinkles or larger lines of facial aging (such as the nasolabial folds or marionette lines). Fillers can also restore volume to the face and can add structure as well. Depending on the type of filler and the depth at which it is injected, injectable fillers can smooth fine lines on the surface of the skin, fill out deep lines, augment soft tissues (such as the lips), or even effectively augment facial bone structure.
Fillers differ from Botox/Dysport/Xeomin, which are neuromodulators that target muscles responsible for wrinkle development during movement and facial expression. Fillers, by contrast, target indents on the lower parts of the face which are not caused by muscle movement. Dermal fillers physically fill under the skin to minimize the appearance of wrinkles. In practice, fillers are used for static wrinkles or wrinkles that are present even at rest such as the nasolabial folds, marionette lines, cheeks, lips, and bridge of nose. While fillers do not eliminate wrinkles entirely, they push the skin up to soften and alleviate wrinkles. These fillers help to make faces appear younger and more rejuvenated.
Good candidates for this procedure:
Patients with lines or wrinkles around the mouth, eyes or forehead
Patients desiring enhanced volume in areas such as the cheeks, jaw line or lips
- Patients with scars and depressions in the skin resulting from acne, injury or congenital imperfections
What to expect: Consultation
All cosmetic consultations are complimentary and serve as a great opportunity to gain further insight by voicing your concerns and having questions answered. During the initial consultation, Dr. Hsu will ask some questions to get to know you and determine if you are a good candidate for dermal fillers.
Dr. Hsu will first ask you about your specific goals for the filler procedure, including what areas of the face you would like to improve. He will also ask you about your general health history, including any existing medical problems, prior surgery, daily medications, allergies, and any smoking habits.
Dr. Hsu will then give you his assessment on whether you would be a good candidate for the procedure, and if so, how the plan should be individualized for your anatomy. In our practice, we offer a variety of fillers including but not limited to collagen, Restylane, Juvederm, Radiesse, and Voluma. Fillers differ in function, and the type of filler used depends upon the individual patient’s goals. In our practice, Dr. Hsu prefers using fillers that are moderately soft such as Restylane, Juvederm, or Radiesse. Since each patient's anatomy and surgical goals are different, you and Dr. Hsu will work together to reach optimal aesthetic results.
To perform the procedure, Dr. Hsu will use numbing cream as well as a very thin needle to minimize discomfort. The numbing cream is very effective and typically requires a wait time of at least 15 minutes to be effective. After the procedure, most patients can see the benefits immediately. Fillers do cause some skin swelling, and the swelling can last for a few days after the injection. Patients who are planning to attend a public event or to be in front of a camera/filming soon are encouraged to give at least a week prior to their public appearance to allow swelling to resolve. Injections are very well tolerated and are one of the most popular procedures performed in our office. The effects of the filler usually last from six to nine months.
Dr. Hsu's view on Injectable Fillers.
Dermal fillers are another category of injectables which have been very popular for patients over the past 10+ years. As with the neuromodulators, I feel that dermal fillers can give excellent results when used conservatively. There are specific areas of the face that I feel dermal fillers can be used very successfully, and the choice of the areas varies from patient to patient. For some patients, the first signs of facial aging are in deepened nasolabial folds; for other patients, it is the marionette lines that bother them more. Often times, patients aren’t sure which area should be prioritized for treatment, and I will often help them decide based on my judgment.
Patients often ask me which dermal filler they should choose. In my opinion, the answer is that in the big picture, that is not so important -- the injection technique and surgeon judgment as to how much filler to use, and where to place it, is generally much, much more important than the specific choice of filler. Most fillers accomplish very similar things and in my experience, I have found many to be interchangeable when injected correctly. That being said, I do generally have some preferences on which filler I like to use for different parts of the face, and for different patients. That is a very individual judgment that I make when I assess each patient.
There is such a large variety of dermal fillers to choose from (Juvederm, Restylane, Radiesse, Voluma, Sculptra, and many more) that the choice can be very confusing for patients, especially because you will find different people writing very strong opinions about the various products on the internet. I tell patients not to worry about that so much because I will choose the one that I think will work best for their goals.