The natural process of aging can have an affect on the facial skin, fat, bone structure, and muscles; with changes in one tissue layer having an impact on the others. Multiple other factors, such as sun exposure, smoking, heredity, and lifestyle, can also contribute to the early signs of facial aging.
As we age, natural substances such as collagen, elastin, and hyaluronic acid that give youthful skin its structure and appearance, are gradually lost. Collagen loss results in the thinning of the middle layer of skin (dermis), whereas loss of elastin and hyaluronic acid reduces the skin’s ability to retain elasticity and moisture, respectively. Aging also leads to the loss of facial volume as a consequence of the redistribution and degeneration of facial fat, and the resorption (loss) of the facial bone structure. The combined effect of the structural changes in the facial soft tissues are responsible for the signs of the facial aging, which may include:
- Greater visibility of bony landmarks, lines and wrinkles
- Prominence of transverse forehead lines
- Nasolabial folds (the facial creases between the nose and mouth)
- Hollowing of the mid-face (loss of cheek prominence)
- Changes in the area around the mouth (vertical lines, lip thinning and flattening)
- Development of marionette lines (lines or wrinkles that extend from the outer corners of the mouth down toward the chin)
Injectable dermal fillers can provide men and women with a temporary, non-surgical solution for softening facial lines and restoring the features of a youthful face. Although injectable dermal fillers do not stop the aging process, they may help delay the need for more invasive procedures, such as a facelift or brow lift.
Before & After photographs shown on this site are actual patients of Dr. James Lee who have given their permission to have their photos published online. They are for illustrative purposes only; individual results vary. We do not guarantee outcomes and no prediction of outcome is implied. Individual healing characteristics and unexpected complications can affect the outcome of any surgery.
2. ideal candidates
Injectable fillers can be used to:
- Address nasolabial folds
- Improve marionette lines
- Correct “lipstick lines” around the mouth
- Enhance the volume of the cheeks
- Enhance the volume of the lips
- Improve forehead frown lines (when used in conjunction with Botox®)
Ideal candidates for facial injectable filler treatment include healthy individuals who are concerned with a mild to moderate degree of facial aging who desire a more refreshed and youthful appearance to their face. Candidates should also have realistic goals with regard to the results that can be achieved with injectable fillers.
3. the procedure
- Injectable dermal/facial filler procedures are performed during an office setting.
3.1. FACIAL ASSESSMENT AND MAPPING
- Dr. Lee will evaluate your facial appearance and skin tone and examine the areas of your face to be augmented/treated.
- Strategic points on your face may be marked as the desired injections sites for the filler.
3.2. CLEANSING AND ANESTHETIZING
- The injection sites will be cleansed with an antibacterial agent.
- Either a local anesthetic cream or injection, or both, will be used to numb the skin so that you will be as comfortable as possible throughout the procedure.
- Multiple injections are often necessary to fill wrinkles or recessed scars.
- Lip enhancement with dermal fillers also requires multiple injections in order to:
- Distribute the filler for enhanced lip fullness; and,
- Treat areas such as the vermilion border (the boundary in between the white and red lip) or cupids bow (the double-curved central portion of the upper lip).
- The process of injecting, massaging the injection site, and evaluating the results is repeated until the desired results are achieved.
- Depending on the number of areas to be treated, the entire treatment process may be as short as 15 minutes, or as long as an hour.
4. TYPES OF INJECTABLE FILLERS
Dr. Lee most commonly uses hyaluronic acid fillers as they are both effective and safe, and associated with very a low complication rate.
4.1. HYALURONIC ACID FILLERS (JUVÉDERM® & RESTYLANE®)
- Hyaluronic acid is a naturally occurring substance found in your body that helps maintain facial fullness and skin elasticity. It also plays an important role in the way our skin looks, feels, and functions.
- These fillers are effective for adding volume to thin lips and filling facial creases between the nose and mouth (nasolabial folds) and in the jowl area (marionette lines).
- Hyaluronic acid may also be effective for the treatment of surface wrinkles and concave grooves under the eyes (nasojugal grooves) and in the forehead region.
- JUVÉDERM® is a family of facial hyaluronic acid fillers that can refresh your appearance by smoothing away unwanted lines and bringing back the natural contours of your face.
- RESTYLANE® offers a family of products of hyaluronic acids that can help visibly reduce the signs of aging by smoothing and softening line and wrinkles, restoring loss volume in your cheeks to enhance the shape and definition of your face, your chin and jaw line. Restylane® can also be used to add volume to your lips to make them plump and full.
4.1.1. THE JUVÉDERM® FAMILY OF FACIAL FILLERS
- These products contain lidocaine (a local anesthetic) and varying concentrations of hyaluronic acid.
A. JUVÉDERM® VOLUMA®
- JUVÉDERM® VOLUMA® is specially designed to restore lost volume and enhance the cheeks and/or chin.
- Treatment results in a smooth, natural lift that last up to 2 years.
B. JUVÉDERM® VOLBELLA®
- Full lips with a defined border are often linked with youthfulness and beauty.
- As we age, our lips and surrounding area gradually lose definition and fullness.
- JUVADERM® VOLBELLA® is specially designed to contour and add fullness to your lips, regardless of whether your lips were naturally thin or full.
- It is the only facial filler clinically proven to last up to 12 months in the lips with a single treatment.
C. JUVÉDERM® VOLIFT®
- As we age, deep skin depressions may begin to appear in the form of smile lines that run vertically from the bottom of the nose to the corners of the mouth. These lines can affect our facial expressions, and may cause us to appear sad or older.
- JUVÉDERM® VOLIFT® is specially designed to restore a youthful, natural-looking smile by softening these lines.
- The effects of JUVÉDERM® VOLIFT® are clinically proven to last up to one year.
4.1.2. THE RESTYLANE® FAMILY OF FACIAL FILLERS
- The following Restylane® products contain hyaluronic acid and lidocaine (a local anesthetic) to help reduce pain during your treatment. All Restylane products are clinically proven to last up to 12 to 36 months.
A. RESTYLANE® REFYNE™
- This product is used to help reduce the appearance of moderate facial wrinkles and smile lines that run vertically from the bottom of the nose to the corners of the mouth also known as the nasolabial folds.
B. RESTYLANE® DEFYNE™
- This product is used to help reduce the appearance of severe facial wrinkles, nasolabial folds and the lines that begin at the corner of your mouth toward the chin also known as the marionette lines by replacing lost volume under the skin.
C. RESTYLANE® KYSSE™
- This product adds or restores volume by creating a long-lasting, natural effect that makes lips smooth and full.
D. RESTYLANE® VOLYME™
- This product is used to enhance or restore lost volume in areas such as your cheeks, chin or jaw line.
E. RESTYLANE® SKINBOOSTERS™
- This new filler improves the appearance and elasticity of the skin, gives it a smoother appearance and is used on the face, upper neck and top of hands.
5. THE CONSULTATION
Dr. Lee will perform a thorough medical evaluation during your consultation to ensure that you are suitable candidate for dermal filler injections. He will also revise your medication list as you may be asked to stop certain medications for a few days before your treatment.
After carefully assessing your facial anatomy and evaluating your aesthetic goals, Dr. Lee will review your available options and help you develop the best treatment plan for your desired results.
There is essentially no down time with dermal filler treatments. Most activities can be resumed almost immediately.
You may be advised not to wear makeup for up to 12 hours after your treatment and to not put pressure/massage the treated area. You may also be told to avoid the sun and cold temperatures, as well as saunas and steam rooms, for 2 weeks.
The treated areas may initially appear “over-filled”. You may experience temporary injection-related reactions such as mild swelling, pain, firmness, bumps, bruising, numbness, redness, and itching at the treatment site. These reactions are usually mild to moderate in nature and generally resolve in 7 days or less.
7. RISKS AND COMPLICATIONS
Complications from dermal fillers are uncommon. Potential risks vary depending on the specific type of filler used and the relative permanence of the substance.
- Acne-like skin eruptions
- Bruising at the injection site
- Infection at the injection site (rare)
- Contour irregularities (lumps)
- Palpability of the filler under the surface of the skin
- Skin rash with itching
- Skin redness/irritation
- Recurrence of wrinkles
- Most fillers dissipate over time; you will thus need to consider repeating treatment to maintain your results.
Dr. Lee will thoroughly discuss these risks (and possibly others) with you and answer any questions you might have prior to obtaining your consent for treatment.