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DERMAL FILLERS

Juvéderm™, Restylane®, Radiesse®

As we age, signs of change appear. Age Spots, gray hair, and wrinkles begin to appear on our face. Fortunately, we now have alternatives to radical facial plastic surgery. Those age spots can be removed. Most common treatments are injections and dermal fillers. Dermal fillers used at the Medical Aesthetic Center are Restylane L, Restylane Silk, Restylane Lyft, Radiesse, Juvederm, Belotero Balance and Voluma.

Dermal fillers can be used to fill in those deep lines around your mouth, or plump thin or creased lips from aging or smoking. Weathered hands can look youthful again. Injectable cosmetic fillers can improve your facial appearance and achieve a more youthful look.

Dermal fillers can be used to fill in those deep lines around your mouth, or plump thin or creased lips from aging or smoking. Weathered hands can look youthful again. Injectable cosmetic fillers can improve your facial appearance and achieve a more youthful look.

As we age, we experience volume loss in the face. Gravity also adds to this “aged” look by causing areas of the face areas to droop, resulting in grooves, lines and shadows. Fillers are a safe and effective choice for replacing soft tissue volume loss. Fillers like Juvederm®, Restylane®, and Radiesse® can restore the face to a more youthful appearance. Fillers may also be combined with Botox to enhance the cosmetic results.

JUVÉDERM™

What Is JUVÉDERM™ Injectable Gel?

As we age, our skin changes. Over time, the natural volume of youthful skin begins to diminish as wrinkles and folds form. But, with Juvéderm™ injectable gel, you don't have to just sit back and let it happen! Recently approved by the FDA, Juvéderm™ injectable gel is a “next-generation” dermal filler. The smooth consistency gel helps to instantly restore your skin's volume and smooth away facial wrinkles and folds, like your "smile lines" or “parentheses” (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth).

Juvéderm™ is a smooth consistency gel made of hyaluronic acid—a naturally occurring substance in your skin that helps to add volume and hydration. Your healthcare professional eases Juvéderm™ injectable gel under the skin to provide a smooth, natural look and feel—so everyone will notice (but no one will know)! In fact, studies show superior results of Juvéderm™ compared to a collagen-based dermal filler.* And, almost 90% of all study volunteers who were treated with both Juvéderm™ injectable gel and another dermal filler* preferred Juvéderm™! In addition, Juvéderm™ injectable gel is the first FDA-approved hyaluronic acid dermal filler that is proven to be safe and effective for persons of color.

How JUVÉDERM™ Works

Juvéderm™ injectable gel is a nonsurgical, physician-administered treatment. Your healthcare professional eases Juvéderm™ under the skin using a fine needle to augment, or fill, the soft tissue of the dermis—the dense inner layer of skin beneath the epidermis—to add volume and diminish wrinkles and folds. Juvéderm™ injectable gel is used most effectively for those wrinkles and folds in the lower third of your face, like your "laugh lines," "smile lines" or "parentheses" (nasolabial folds), or "marionette lines" (oral commissures).

Gel flows easily into the skin during the injection process and provides a smooth, natural look and feel—so everyone will notice (but no one will know!) Juvéderm™ injectable gel is the only filler available with this smooth consistency gel—other existing hyaluronic acid dermal fillers Juvéderm™ is a "next-generation" filler. It is made from hyaluronic acid—a naturally occurring substance in your skin that helps to hydrate and add volume. Hyaluronic acid may diminish with age, contributing to the formation of wrinkles and folds. Juvéderm™ injectable gel works to correct this by restoring hyaluronic acid in your skin, helping to smooth wrinkles and folds.

A unique manufacturing process

Juvéderm™ employs its unique manufacturing process to provide the highest concentration of cross-linked hyaluronic acid of any currently available hyaluronic acid dermal filler for long-lasting results. This advanced manufacturing process also works are made of granular consistency gels.

What to Expect During Treatment

Because Juvéderm™ injectable gel is a simple, nonsurgical treatment, there is minimal recovery or downtime. So you can make an appointment to stop by your healthcare professional's office for treatment on the way home from work or the gym, or even while the kids are at soccer practice—and get right back to your life. Here's what to expect when you visit your healthcare professional's office for treatment. (Please note that although this experience is typical, the routine at your healthcare professional's office may be different).

Before you go: Some doctors recommend that you avoid any medications that can prolong bleeding, such as aspirin and non-steroidal anti-inflammatories (NSAIDS), for at least a week prior to treatment in order to reduce the risk of bruising and bleeding at the injection site. Ask your healthcare professional what he or she recommends.

When you arrive: If this is your first visit, your healthcare professional will ask about your medical history, including any allergies you may have or medications you may take, and will tell you more about wrinkle treatment with Juvéderm™. Juvéderm™ injectable gel does not require an allergy test.

Determining your treatment needs: Your healthcare professional will examine the soft tissue of your face to assess the depth of wrinkles and folds to determine your treatment. Juvéderm™ injectable gel is available in two formulations—Juvéderm™ Ultra for versatility in contouring and volumizing facial wrinkles and folds, and Juvéderm™ Ultra Plus, a robust formulation for volumizing and correcting deeper folds and wrinkles. This allows your healthcare professional to better tailor treatment to your unique needs. Your healthcare professional may even take pretreatment photographs so you can see the difference after treatment!

Before the procedure: Although anesthesia is not required, your healthcare professional may use topical or injectable anesthesia to numb the treatment area first.

The procedure: Your healthcare professional will ease the Juvéderm™ injectable gel under your skin to augment, or fill, wrinkles and folds. Following the injection, your healthcare professional may gently massage the treated areas. The procedure is quick and easy. The injection itself usually takes only about 15 minutes.

After the procedure: With Juvéderm™, there is minimal recovery or downtime.

For the first 24 hours following treatment, you should avoid strenuous exercise, excessive sun or heat exposure, and consumption of alcoholic beverages in order to help minimize the risks of temporary redness, swelling, and/or itching at the treatment sites. After the treatment, some temporary injection-related reactions may occur, including redness, pain, firmness, swelling, and bumps. Studies have shown that these are usually mild to moderate in nature and clear up on their own in 7 days or less. If you experience swelling at the injection site, you can apply an ice pack for a brief period. Your healthcare professional will tell you when makeup may be applied after your treatment.

Seeing results: You should see an immediate improvement in the treatment areas. Most patients need one treatment to achieve optimal wrinkle smoothing, and the results last up to 6 months or more. However, results may vary and correction is temporary. Supplemental “touch up” treatments may be required to achieve and maintain optimal results.

JuvedermVoluma

As you age, it's not just about lines and wrinkles. Your cheeks can lose volume and skin may begin to sag. JUVÉDERM VOLUMA® XC is the firstand only FDA-approved injectable gel to instantly add volume to your cheek area to correct age-related volume loss in adults. It can provide you contour and a subtle lift for up to two years with optimal treatment.

What is Voluma?

JUVÉDERM VOLUMATM XC injectable gel is a smooth, colorless hyaluronicacid(HA) gel that contains a small quantity of local anesthetic (lidocaine). HA is a naturally occurring sugar found in the human body. The role of HA in the skin is to deliver nutrients and help the skin retain its natural moisture and softness. The addition of lidocaine helps to improve the comfort of the injection. JUVÉDERM VOLUMATM XC injectable gel is manufactured using VYCROSSTM technology to give a specialized smooth-gel filler that produces long-lasting results at the treatment site. JUVÉDERM VOLUMATM XC is delivered by an injection into the cheek and surrounding area of the mid-face to correct volume and fullness.

What does it do?

As you age, the cheek area loses its youthful shape. The cheeks flatten out and the skin may begin to sag. JUVÉDERM VOLUMATM XC injectable gel is designed to temporarily reverse these signs of aging. It is a gel that is injected into the cheek area to lift the skin. It temporarily adds volume to the cheek area and results in a smoother contour and more youthful appearance to the face. Figure 1 shows the treatment areas for JUVÉDERM VOLUMATM XCWhat should I expect following the procedure?

The most common side effects were temporary reactions at the treatment site such as tenderness, swelling, firmness, and lumps/bumps. These side effects generally lasted 2 weeks. Within the first 24 hours, you should minimize strenuous exercise and exposure to extensive sun or heat. Exposure to any of the above may increase temporary redness, swelling, and/or itching at the injection site. If there is swelling, you may place an ice pack over the swollen area.

Will I need more than one treatment to achieve my desired result?

We will schedule a 2 week followup and reassess to make sure that we achieved the desired goals. An additional syringe may be needed at this visit.

Does the correction last forever?

No. While individual results may vary, Voluma offers instant, natural-looking results that last up to 2 years with optimal treatment.

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Radiesse®

Radiesse® naturally and safely promotes growth of your own collagen through advanced microsphere technology. Smooth, pearl-like microspheres of calcium hydroxylapatite are dissolved in a soft gel which is injected into wrinkles, smile lines, marionette lines, cheeks, scars and other facial areas. These microspheres are slowly dissolved by the body into naturally occurring calcium and phosphate ions. In the skin Radiesse creates volume, resulting in a natural, youthful appearance. Because it does not need skin testing, gives a natural-looking appearance and last longer than most other fillers, many experts agree that Radiesse is now the filler of choice for facial contouring.

A Natural Look That Lasts

Radiesse® is a safe, next generation cosmetic dermal filler that lasts longer than the former leading filler. It is setting a new standard for the correction of facial lines and wrinkles, restoring a natural, youthful look in an easy, convenient treatment. Numerous medical studies have shown that Radiesse is a safe, longer lasting treatment to fill and correct smile lines, Nasolabial Folds and wrinkles around the nose and mouth.

Immediate Satisfaction, Long Lasting Results

The results of a Radiesse® treatment are immediate. Radiesse dermal filler typically lasts a year or more, longer than the former leading filler, saving you time and money. Since results may vary, be sure to discuss your expectations with your experienced Radiesse provider.

Safe and Effective

Radiesse® is made of unique calcium-based microspheres that are suspended in a natural gel that is injected into the skin through a simple, safe and minimally invasive procedure. Hundreds of thousands of patients have experienced Radiesse and more than 4,000 physicians worldwide have been trained to provide Radiesse® treatments. Through years of clinical studies and independent research, Radiesse® has proven to be safe and effective. With Radiesse®, you get safe, FDA Approved, clinically tested reliability.

How It Works

Radiesse® works with your body, below the skin’s surface, to stimulate the production of collagen and encourage tissue regeneration. It does more than just temporarily fill-in facial lines and wrinkles ? it rebuilds your skin’s foundation. You get immediate results and look younger, longer.

Radiesse® Microsphere Technology™

Radiesse® is made of very small, smooth calcium hydroxylapatite (CaHA) microspheres, which are suspended in a water-based gel carrier. As Radiesse® is injected, the gel and Radiesse® Microspheres form a “scaffold”, stimulating collagen production and encouraging tissue growth in and around the injection area. This “partnership” between Radiesse® and your own body creates a natural look, comprised of your own tissue and Radiesse Microspheres.

Over time, your body absorbs the gel carrier while collagen has started to grow and infiltrate the area, replacing the gel with your own, natural tissue. The Radiesse® Microspheres continue to provide the support and structure for your body to grow new tissue and collagen until the Microspheres are also safely and naturally absorbed into your body.

Why Choose Radiesse®?

Radiesse® is a safe, next generation cosmetic dermal filler that is setting a new standard for the correction of facial lines and wrinkles such as Nasolabial Folds. That's because clinical studies prove that Radiesse® lasts longer than the former leading filler to deliver a soft natural look that lasts.

Radiesse® cosmetic dermal filler can address many facial aesthetic and corrective needs. Because the results are natural looking and longer lasting, many patients turn to Radiesse to achieve a correction that revives and rejuvenates their appearance. No matter if your goals are to correct facial lines and wrinkles or to refresh your appearance, Radiesse® provides a safe, cost-effective and convenient treatment option.

Radiesse® is becoming the dermal filler of choice for HIV Lipo-atrophy

Treatment Indications

Dermal fillers are being used more and more to help reverse the changes associated with aging. Dermal fillers can give a more natural appearance than surgical face lifts. Fillers such as Restylane®, Perlane®, Juvederm® and Radiesse® can be used either to fill in shallow skin wrinkles and lines or to go under the skin to fill out broad depressions like the nasolabial folds ("smile lines"). Juvederm® and Restylane® are also very useful to plump up the lips. More recently, they are proving helpful to fill in hollows and grooves in the region between the cheeks and the lower eyelids- those “dark shadows” under the eyes (called tear troughs).

As we age, we experience volume loss in the face. Gravity also adds to this “aged” look by causing areas of the face areas to droop, resulting in grooves, lines and shadows. Fillers are a safe and effective choice for replacing soft tissue volume loss. Fillers like Juvederm®, Restylane®, Perlane® and Radiesse® can restore the face to a more youthful appearance. Fillers may also be combined with Botox to enhance the cosmetic results.

How Are Fillers Administered?

Fillers are injected through small needles. All patients are first treated with numbing cream on the area/s to be injected. If the lips or nasolabial folds (smile lines) are to be injected, a numbing cream is applied, and then several small dental injections of local anesthetic are given to totally numb areas for a truly painless procedure.

The filler is then injected in the area/s of treatment. The actual injection only takes minutes. Ice is placed immediately after the injections. The treatment area/s usually swell somewhat but most patients are able to return to work the next day. Rarely, some patients experience more significant swelling. For this reason, a first time filler patient may want to be treated closer to the weekend. It is also a good idea to refrain from aspirin or drugs that delay clotting for 1-2 weeks to decrease bruising when injecting fillers.

With any area/s of dermal filler injection, it is better to achieve the desired look with optimal correction than to under treat and be unhappy with the lack of change. Patients with moderate to deep nasolabial folds (smile lines) may require a minimum of 2 syringes of filler 1 per each side, while lips and tear troughs may be restored with just 1 syringe. The biggest problem is under treatment or not using enough filler. A patient is better off saving up for two or more syringes than under treating the folds with a single syringe and have unsatisfactory results.

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Restylane®

Restylane® is cosmetic dermal fillers that replace lost volume and restore youthful contours to the skin to smooth away moderate to severe facial wrinkles and folds, such as the lines from your nose to the corners of your mouth (nasolabial folds). Restylane is the world's most used, most studied dermal filler, and has been used in over 70 countries and in more than 1.4 million treatments in the U.S Restylane® is made of hyaluronic acid. In the human body, natural hyaluronic acid provides volume and fullness to the skin. The hyaluronic acid in Restylane® has been modified slightly to last longer than the body's hyaluronic acid. The hyaluronic acid in Restylane® is produced by a biotechnical process.

Restylane® is hydrophilic or "water loving." The hydrophilic nature of this hyaluronic acid’s molecules and their three dimensional structure allow them to bind many times their own weight in water. As hyaluronic acid begins to degrade, each molecule binds to more water which helps to maintain its volume for about six months.

Restylane® is proven to deliver long-lasting results. Studies have shown that Restylane® lasts about six months. How long the aesthetic correction lasts can vary with the individual. Restylane® ® requires no pre-testing. Before being treated with Restylane® you should take a few precautions. Prior to treatment, avoid using aspirin, non-steroidal anti-inflammatory medications, St. John's wort, or high doses of Vitamin E supplements. If you have previously suffered from facial cold sores, discuss this with the doctor , who may prescribe a medication to minimize recurrence.

Restylane® is injected directly into the skin in small amounts by an ultra fine needle. As with all injections, some patients may experience slight discomfort.

What are the advantages of Restylane®

Restylane® is approved for treating moderate to severe facial wrinkles and folds.

Restylane® is Different from Botox® Cosmetic

Restylane® is a cosmetic dermal filler injected into the skin to smooth facial wrinkles and folds. In contrast, Botox® Cosmetic is a drug that blocks nerve transmission and relaxes the muscles that cause frown lines between your eyebrows.

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