Dermal Fillers

From the collagen fillers of the ‘80s to the hyaluronic acid fillers of the early 2000s, the first dermal fillers were probably best known for their ability to soften wrinkles, folds, and creases. These days you may also have heard that dermal fillers can safely be used to plump up the skin, add volume, and even lift the face.

Over the last couple of years, however, dermal fillers — and their applications — have evolved further still, completely revolutionizing the aesthetic world. Of all the tools in our aesthetic toolbox, dermal fillers have the greatest capacity to enhance a person’s appearance. In the hands of an expert injector, fillers can be used not only to restore a youthful balance to the face, but also to shape and contour the face to highlight its beauty.

Areas that can be enhanced with dermal fillers

  • Cheek fullness
  • Smile lines or nasolabial folds
  • Tear troughs or undereye hollows
  • Lip lines or smoker’s lines
  • Downturned mouth corners
  • Jowls/jawline
  • Chin/profile shape
  • Lip shape and fullness
  • Puppet or marionette lines from mouth corners to jawline
  • Hollow temples
  • Hands
  • Earlobes
  • Deep and fine lines

Lisa’s approach to dermal fillers

During your consultation with Aesthetic Nurse Practitioner, Lisa, you will discuss your specific goals and areas of concern. Because every person is different, Lisa does not use a cookie-cutter approach to dermal filling, but rather creates a customized treatment plan for each individual. Lisa will analyze your face and skin, and make recommendations based upon your particular needs.

Lisa is known for her calm, gentle, meticulous technique, and her supportive, caring manner. She coined the phrase “NorCal Natural” to describe the look her patients desire: refreshed and natural, never “done” or “frozen.” In addition to her skillful expertise, Lisa’s innate artistic aptitude and perfectionism draw patients to her care. Some of Lisa’s beliefs include:

More is not always better – Overtreatment will lead to an unnatural appearance. A gradual approach is more likely to result in favorable results. More treatments can always be done, but excessive treatment is harder to correct.

Replace volume – Aging leads not only to sagging tissue but also deflation and volume loss. That is why adding volume is important for true rejuvenation. Surgical lifting procedures are therefore much more likely to result in excellent outcomes if enhanced with replacement of lost volume as well.

Avoid permanent fillers – The dermal fillers that Lisa uses are long-lasting but do eventually become metabolized by the body. Although this means that retreatments are necessary in order to maintain improvements, this is actually a good thing. Since the face changes over time, the ideal location, type, and amount of filler needed will change as well.

Lisa is an expert in the use of blunt-tipped microcannulas. This gentle, advanced technique allows for less bruising and swelling, due to the smooth, rather than sharp, tip of the microcannula. During your consultation, Lisa will be able to recommend the fillers and techniques that are best suited for your unique needs and desires.

Hyaluronic acid fillers

The dermal fillers that Lisa offers are soft, smooth, gel-like substances made of hyaluronic acid or HA. HA is already naturally present in our skin, so is not considered “foreign” by the body. Hyaluronic acid’s properties make it a highly effective choice for dermal filling. For example, HA attracts water, giving the skin a hydrated, soft appearance. HA also adds structure and support, boosting your skin’s own production of collagen and reversing the signs of aging and sun exposure.

  • Juvederm®
    • Ultra®
    • Ultra Plus®
    • Volbella®
    • Vollure®
    • Voluma®
  • Restylane®
    • Defyne
    • Lyft
    • Refyne
    • Restylane
    • Silk

Try the JUVÉDERM® 3D Visualizer

Is there a non-surgical facelift that works?

A: Nothing can replace a facelift.

There are alternatives such as fillers (“liquid facelift”), skin resurfacing or skin care, but nothing can replace the repositioning, lifting and fixation that occurs during a facelift. You can think of a facelift as a “curative” treatment while some other non-surgical approaches are more “Band-Aid” solutions.

Will Restylane be damaged by IPL or Refirme?

A: It is safe to have IPL and/or Refirme if you have Restylane.

This is actually a fairly common combination of treatment for patients in my practice. There are minor risks for each procedure independently, but no evidence that these risks increase when both treatments occur in the same patient.

Are These Tear Troughs, and What Can I Do About Them?

A: HA fillers can be used.

Sometimes tear troughs are genetic and can appear at an early age. HA fillers can be injected into the cheeks/tear troughs to smooth any pronounced hollowing. Conservative and gradual addition of fillers can help to enhance this area with minimal risk if done by a trained professional.

Was Restylane Injected into a Vein/Nerve?

A: Follow up with your practitioner.

You may be feeling pressure on a nerve for a number of reasons, including swelling or the product, or possible trauma to the nerve from the needle. This rarely causes permanent damage. Follow up with your practitioner so that he or she can evaluate you in the office. In most cases this resolves on its own, and if the product is applying pressure, a neutralizer can be used to dissolve it.

Why Do I Look Worse After Juvederm?

A: Follow up with your physician.

Unfortunately, some patients experience bruising and an undesirable result following treatment with a tear trough filler. You may be experiencing a Tyndall effect from the Juvederm, whereby the filler reflects light, resulting in a bluish tinge.

Have your practitioner reassess the area and discuss what some of your options are. Now that you are three weeks post-procedure, a follow-up is necessary.

What About this Persisting Juvederm Lum

A: There is a very slight chance the filler is still there.

In rare instances, the Juvederm filler stays around for longer than expected. Have your injector use a small amount of hyaluronidase to see if it will respond.

If it does not respond, you can look into other solutions with your provider.

What about Juvederm Removal with Hyaluronidase Injections?

A: Hyaluronidase only breaks down hyaluronic acid.

Hyaluronidase does not dissolve collagen — only hyaluronic acid. If not used conservatively, it can break down natural hyaluronic acid in the skin, giving the appearance of increased loss in volume.

Using conservative amounts and starting slow are the keys to minimizing excessive hyaluronic acid breakdown.