Dermal fillers are primarily comprised of Hyaluronic acid (HA). HA’s are normally produced by the body and found in our joint fluid and in our skin and soft tissue. They are the substance that gives our skin its volume and fullness. When injected into wrinkled skin, the HA’s add fullness and reduce the prominence of wrinkles. Their primary use is filling lines (frown lines, lip lines, nasolabial folds, marionette lines, depressed acne scars) as well as temporary lip augmentation. The benefits of hyaluronic acids are rapid in onset and they typically last for six to nine months. Dr. Funcik can guide you in choosing the best treatment for your needs. (Please click here for Dr. Funcik’s personal approach to Dermal Fillers). Some patients may also consider Sculptra facial filler.
Dr. Funcik’s Philosophy and Approach to Hyaluronic Dermal Fillers
(Restylane®, Restylane Lyft®, Juvederm®, Belotero®, Voluma®, etc.)
The safety and effectiveness of hyaluronic dermal fillers have dramatically advanced the world of aesthetic medicine. While manufacturer advertisements emphasize the subtle inherent differences between each of these agents, their similarities are far more significant than their differences.
Originally, the benefits of hyaluronic dermal fillers were thought to only last for about 6 months. Experience has shown, however, that most hyaluronics last 9 months to a year or longer, and to a small but clinically relevant extent, they recruit some synthesis of your own collagen for long-lasting correction. Therein lies their greatest benefit, and our approach to administering hyaluronics is designed to capitalize on it.
Most hyaluronic fillers are administered using a 1-cc syringe (the size of a small sugar cube). To provide rapid correction, many physicians prefer to place several cc at one time. This may be what you desire, but most often, a better approach is to receive several 1-cc treatments over a period of time that allows for 1 to 4 months between injections.
While this alternative approach may not create instantly complete correction, it offers several clinical and economic advantages: It avoids over-correction and waste of the product; spreads out the cost; and prevents “filler face”—the unnatural, temporary stiffness brought on by a lack of natural movement. Perhaps the most important benefit to this approach, however, is that it allows the body time to make more native collagen, which results in correction over a longer term.
To illustrate these benefits, assume that identical twin sisters both have identical, deep nasolabial folds. Both twins receive 3 cc of hyaluronic, but while one twin is injected with 3 cc in 1 session, the other twin is treated over the course of 3 sessions, receiving 1 cc per session with 2 to 6 months between treatments. Although both twins were administered the same quantity of hyaluronic (3 cc), their results will differ. The first twin will have greater correction at outset, but she might also have “filler face.” And a couple of years later, she will be back near baseline, while the second, more patient twin continues to enjoy long-sustained improvement.
Occasionally, we see patients who have been disappointed by hyaluronics in the past, because the treatment was only of modest benefit. Often, we find that these patients may benefit by replacing lost volume with one or two Sculptra injections before applying hyaluronics, if their volume reduction is also significant.
Once hyaluronics have been in place for a month or so, they are generally very soft and non-palpable. When first injected, they are not visibly bumpy, but the injection does, of course, cause a bit of swelling, which can be a bit asymmetrical and is occasionally disconcerting. Once the swelling subsides, you will enjoy a nice, natural appearance.
In the weeks that first follow treatment, you will appreciate some slight, temporary, non-visible firmness when you carefully palpate the treated area. This is because the product is slightly more dense and more dehydrated than your native hyaluronics. Once it rehydrates naturally, it will become soft to the touch and offer an even greater degree of correction. This process can take from a couple of weeks to even a month or longer to complete, and it is no cause for concern. Some patients also choose to combine with lip injections Restylane Silk.
You may have been told a prevalent myth that fillers actually “lift” tissue. But to think about it logically, there is no way that by adding a substance of mass, we can actually defy gravity and lift anything—That is why we have never embraced the term, “liquid facelift.” Even so, hyaluronics are indispensable allies in softening, filling, and rejuvenating, whether used alone or in conjunction with surgery or muscle relaxers, such as Botox®. Most of our facelift patients benefit from fillers, and previous applications of fillers can enhance a lift performed at a later time.
Dr. Funcik is quite familiar with ALL hyaluronics on the market. He has often been the first to try newly introduced agents and is invited to train other injectors. And because 5 different manufacturers have asked him to provide training for their products, he has no loyalty to any one manufacturer – his loyalty is to you, his patient. Trust him to recommend the agent that is best suited to your individual concerns.