Dermal Fillers

What are They?
Dermal fillers are injectable substances used to plump up skin, fill in lines and wrinkles, help correct recessed scars, and rejuvenate the face. They are commonly used to plump up the lips and remove deep creases that run from the nose to the corners of the mouth, and creases between the eyebrows. The injections are an excellent alternative to facelifts, for patients who want to look younger and fresher but don't want the cost or recovery time of surgery.

Why Get Them?
As we get older, a combination of our lifestyle (including diet and sun exposure), gravity, and genetics will begin to take its toll on our face. The collagen, elastic, and fat in our face begin to break down, which can make our faces look gaunt and tired. Wrinkles begin to form in areas where we use the muscles repeatedly to make expressions. The most common areas for expression lines are the nasolabial folds, "marionette lines" that run from the corners of the mouth to the chin, and wrinkles between the eyebrows.

Fillers will fill in those sunken or creased areas, returning your face to a more youthful look, and making you look more energized. The results are not permanent, so if you decide you don't like them, you simply don't repeat the treatment. If you want to look younger but aren't ready to commit to plastic surgery, dermal fillers are for you.

What Kinds of Dermal Fillers Are There?
There are a few different types of dermal fillers, each made of different ingredients. Your surgeon will help you select the filler that will best help you reach the look you have in mind. The three most popular types of dermal fillers are fat, collagen, and hyaluronic acid. Each of these fillers last about a year, at which point you will need to get re-treated.

Human Fat
The human fat used in dermal filler injections is analogous- meaning it comes from your own body. The surgeon will take fat from an area like your abdomen or thighs, clean it, and then inject it into the trouble spots on your face. This is an excellent option for people with severe allergies because your body won't react to your own tissues. Your body will reabsorb some of the injected fat, so the surgeon will have to overfill the injection site initially. This will make the area look swollen for a few days, until the body absorbs the excess.

Collagen
Collagen is a protein found in cow products or in human skin, and is commonly used to plump up the lips. It can also be used to counteract the look of mild to moderate creases in the face. It's a popular dermal filler option for patients who are maintaining their appearance after a facelift or other facial plastic surgery. For patients who are using cow-derived collagen (bovine collagen), there may need to be some pre-treatment allergy testing.

Hyaluronic Acid
Hyaluronic acid is a naturally occurring substance found in human connective tissues, and around the eyes. When used as a cosmetic injectable, hyaluronic acid acts as a cushion that inflates the tissues, while simultaneously drawing water to the surface of the skin. It can be used in the cheek areas to replace lost fat that is leaving you looking tired and gaunt, and can also be used to fill in lines, wrinkles, and folds. The result is a plumper, dewy, younger-looking face.

Who is A Good Candidate for Dermal Fillers?
A good candidate for dermal fillers will have a positive outlook and realistic expectations of the outcome of the procedure. He or she will be undergoing dermal filler injections resurfacing for personal reasons, and not to satisfy anyone else.

There is no "right" age for getting dermal fillers, but most patients are between the ages of 30 and 60. Older patients may find that their skin has lost enough elasticity that they don't get the results they want.

What Happens During My Consultation for Dermal Fillers?
During your consultation for dermal fillers, your surgeon will review your medical history to make sure you aren't on any medications or undergoing any treatments that might interfere with the injections. He will evaluate your skin and help you decide which filler is right for you.

If you decide on a filler made from animal products, you may need to undergo an allergy patch test to make sure you won't have any reactions to the injections. The surgeon will also go over the risks, and have you sign a consent.

How Are Dermal Fillers Done?
Dermal filler injections are usually a quick and easy procedure that you can do in the doctor's office while you're on your lunch break, or whenever you can find an hour or two in your schedule. You won't be put under anesthesia, so you can drive yourself home after the injections.

When you come in for your appointment, the surgeon will make small marks on your face to map out where the injections are going to go. Your skin will be cleaned, and there may be a topical numbing cream applied to the injection site. Some fillers are also mixed with painkiller to help with discomfort.

The injections are then administered, following the marks the surgeon made. When he is done, the marks will be removed. Some patients might be given a cold compress to help with any swelling.

What is Recovery Like for Dermal Fillers?
There is no real downtime after a dermal filler treatment, and you can return to your normal routine immediately after your appointment. You might notice some redness, bruising, or swelling, which will dissipate within 48 hours. You can use makeup to cover up any redness immediately after the appointment.

Avoid rubbing or massaging the injection site because this can cause the filler to shift position. If you are getting an injection of human fat, there will be an "overfilled" look that will begin to fade within a few days. Your recovery will be different if you had liposuction to harvest the donor fat.

Once the filler settles, the results will last up to one year.

What Are the Risks of Dermal Filler Injections?
Dermal fillers were the second-most popular non-surgical cosmetic treatment in 2011 (just after Botox injections), with over 1.2 million treatments given. There are very few complications associated with the procedure. The risks that do exist include infection, bruising, swelling, itching, migration of the filler, rash, or dissatisfaction with the results.

The best way to avoid complications is to select a Board Certified Plastic Surgeon for dermal filler injections. Board certified surgeons have the experience and training necessary to help you meet your goals with as few complications as possible. Following all your pre- and post-operative care instructions will also help prevent problems.

Will My Insurance Cover Dermal Fillers?
Most insurance companies will not cover cosmetic treatments like dermal filler injections. Contact your insurance provider if you have any questions about your coverage.