Procedures: Dermal Fillers

Types: Restylane®, Restylane-L®, Perlane®, Perlane-L®, Juvederm® Voluma, Juvederm® Ultra and Ultra Plus, Sculptra®, Radiesse®, Belotero

Dermal fillers are delivered by injections to add volume to the face or to plump up scars, marionette lines, laugh lines or lips.  They are a popular form of skin rejuvenation to soften fine lines and restore youthful contours. Results greatly depend on the skill and experience of the physician.

As with most injectable treatments, you are relying not only on the physician’s intimate knowledge of the physiology of the skin and underlying muscle structure, but also on her aesthetic sense, skill, and ability to deliver an appropriate and natural-looking result. Injectable treatments are often viewed unfavorably exactly because there are a lot of poorly executed examples in plain view on people’s faces.

The physicians at Union Square Laser Dermatology are internationally acclaimed experts in the use of dermal fillers, with a reputation for achieving natural results that do not advertise that the patient “had work done.”

Tear-trough fillers

Dr. Chapas has received recent attention for her technique with fillers in the tear trough area under the eyes. This procedure provides a non-surgical alternative to rejuvenation of the tear trough, which can acquire a hollow look as a result of age-related fat loss.

Our verdict: Tear trough fillers can offer more natural results at lower risk than alternatives like fat transfer or fat grafting, but due to the nature of the skin in this area, considerable skill is required to achieve natural results while avoiding problems such as lumps or unevenness.

Dr Chapas used this tear trough filler treatment to reduce hollowness and fine wrinkles (the effect is subtle so you may want to review a higher resolution photo):
tear trough filler 1 Dermal Fillers

Types of Dermal Fillers

The current FDA approved fillers contain one of 3 key ingrededients: hylauronic acid, calcium hydroxyapetite, and Poly-L-lactic acid.

Hylauronic Acid

Hylauronic Acid fillers are composed of natural sugar-based substances that bind to water and give the skin a natural plumpness. The sugar molecules attach to each other by chemical crosslinks to make smaller and larger size particles to target finer and deeper wrinkles.  Hylauronic acid fillers are eventually dissolved by the body’s enzymes within 6-12 months. There are several brands of hylauronic acid fillers including:

Restylane® for fine lines and Perlane® for deeper lines. These are very versatile fillers, and at Union Square Laser Dermatology we have developed our own proprietary techniques and injection strategies to achieve subtle but cosmetically pleasing results.

Juvéderm® Ultra and Juvéderm® Ultra Plus are used to fill fine and deep wrinkles respectively. Juvéderm is the only hylauronic acid filler that has been FDA approved to last up to 1 year after a single injection.

Juvéderm® Voluma is the only FDA-approved filler to correct age-related volume loss in the mid-face and can be used to fill and lift the mid-face and cheeks and to reduce nasolabial folds. Juvéderm Voluma uses a new cross-linking technology to bind the hyaluronic acid molecules that not only produces the lift and fill needed for mid-face applications, but also contributes to its long-lasting nature. Studies have shown that with optimal treatment, results can last up to 2 years. Like other hyaluronic based fillers, Voluma is well tolerated with minimal side effects.

Juvéderm® Voluma XC used to fill and lift the mid-face and cheeks and reduce nasolabial folds:
voluma before and after Dermal Fillers

Our Verdict: In the right hands, Juvéderm Voluma™ XC can give a subtle but cosmetically significant lift that helps restore facial contours and reduce nasolabial folds, making our patients look up to 5 years younger!

Calcium Hydroxylapetite

Microspheres of calcium hydroxyl appetite can be used to correct deep wrinkles and folds. The skin creates a long lasting scaffolding around this substance, which gives improved appearance to wrinkles for up to a year. The filler Radiesse® is the only product on the market containing calcium hydroxylapetite.

Radiesse® volumizing filler used to reduce wrinkles in the mouth area of a male patient:
radiesse male before and after Dermal Fillers

Poly-L-lactic acid

Poly-L-lactic acid found in Sculptra® injections is a longer-lasting alternative for individuals with more significant volume loss. A series of injections performed over several months can help to restore a youthful appearance in those experiencing a loss of facial fat. Clinical studies have demonstrated results lasting up to 2 years.

 For more information on the latest fillers, read more from Dr. Chapas on the Huffington Post.