Fillers

WHAT ARE DERMAL FILLERS?

Fillers are a gel-like substance injected to improve the appearance of the treated area. They come in a variety of different formulations, each designed to achieve specific goals. Fillers have been approved for specific areas, though are often safely used “off label”. Choosing the right filler for the right purpose is critical to achieving successful results. For example, the same filler used to fill fine lines would be useless if used to lift a cheek, and vice versa.

WHAT ARE DERMAL FILLERS MADE OF?

The majority of today’s popular fillers consist of hyaluronic acid (HA) as the main ingredient. Hyaluronic acid is a naturally occurring substance in the tissues, and helps bind moisture, keeping the skin looking plump and hydrated. Examples of HA fillers include the Juvederm family of fillers (Juvederm Ultra, Juvederm Ultra Plus, Voluma, Volbella, Vollure), the Restylane family of fillers (Restylane L, Restylane Silk, Restylane Lyft, Restylane Refyne, Restylane Defyne), and Belotero. Other fillers have different main ingredients, and examples are Sculptra, which is poly-L-lactic acid (PLLA), and Radiesse, which is calcium hydroxyapatite.

HOW LONG DO FILLERS LAST?

Depending on the filler chosen, and the location injected, fillers can generally last anywhere from 6 months to 2 years. The more product that is used, the longer the effect is seen, however the early result can be overdone looking, and thus Dr. Patel does not recommend this approach.

Often the most beautiful and natural results follow a less is more approach. This does not mean invisible results, just that the filler is carefully and artfully placed, to create believable and beautiful contours.
The above mentioned fillers are all temporary, and that is a good thing. The face ages and if the filler stays stationary, the effect could be disastrous to the aging face.

WHICH FILLER IS BEST WHERE?

This is where the experience, knowledge, skill, and beauty aesthetic of the injector comes in, and Dr. Patel is a top injectors. Judgement and technique are what determine what results you will get from fillers. When you are deciding where to go, remember you are not buying the product itself. You are paying for all of the qualities your injector brings to the treatment.

Things like judgement and technique are not interchangeable person to person. If your injector brings little knowledge or skill to the table, you can expect your treatment to be inexpensive. If, however, you are concerned with high quality, artful results, and high safety, then your treatment will be priced accordingly.

WHO DOES THE INJECTIONS?

Dr. Patel personally does all dermal filler injections herself, and she and her team are available for any post-treatment questions you may have.

WHAT ARE THE MAIN RISKS OF FILLERS?

Certain things are natural side effects, rather than risks, and those include swelling at the site (temporary), possible bruising, and possible lumps during the healing phase (ones that you can feel more than see, and that go away once the swelling resolves).

Actual risks are the chance of a lump that does not go away once the swelling goes down (these can be massaged out by the doctor, or if need be injected with an enzyme to soften or get rid of the lump), asymmetry (usually pre-existing asymmetry is made better with filler, but if it is actually made worse, filler can be added or dissolved as needed to improve the symmetry, assuming it is a result of the filler and not the natural asymmetry of the patient), vascular compromise that can lead to skin discoloration (temporary or permanent), skin loss, or vision loss.

Skin loss and vision loss are the two worst possible risks, and while the percentage of patients experiencing these are very small, they are still possible. There are ways to avoid and/or treat vascular issues, but there is no guarantee they will not occur, and no guarantee they can be reversed.

WHAT CAN I EXPECT AT CONSULTATION?

Dr. Patel will go through a full history and focused physical exam to make sure you are a good candidate for treatment with dermal fillers, and then determine a comprehensive plan to give you the best results. If there is a restriction based on time, recovery process, comfort level, or simply finances, the plan is tailored to what is reasonable for the patient.

Sometimes this means treatment is spread out over time, with the areas that are most impactful treated first, and other areas a little later. During the consultation, photographs may be taken and the treatment plan illustrated on your images, in order to make sure you have a full understanding of what filler is recommended for which area and why.

The treatment plan illustrations can be saved onto an app and accessible to you after your consultation, to review at your leisure. (While the illustrations are often done during the consultation, please let us know at the start of the consultation to ensure your illustrations are saved and shared.)

You may come in requesting one particular area be treated, and leave with a treatment plan that is not what you expected. This is because no single area of the face is treated in isolation. When that approach is used, it often leads to dissatisfaction, as when you look in the mirror or others see you, they are looking at your face as a whole, not looking at one cheek, or just your lips, or just your chin, etc. The treatment must be done in a way that the face maintains or achieves harmony and balance, and Dr. Patel will do a full assessment to show you what that means for your face in particular.