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NYC Dermal Fillers

Dermal Fillers with Dr. Nina Naidu

Dermal fillers can be a key component in facial rejuvenation. As we age, the effects of years of facial muscle movement and loss of volume become visible with laugh lines, thinner lips, and less volume in the mid-face. Facial fillers can help to restore volume, producing a smoother, fuller and more youthful appearance.

Many fillers, such as Juvéderm™ and Restylane™, are composed of hyaluronic acid, a natural compound which is normally found in our skin. It is best suited for injection into the creases around the nose and lips, and into the lips. The results last 8-12 months. Voluma™ XC and Restylane Lyft are FDA-approved for the correction of age-related volume loss in the midface, including over the cheekbones. Results may last for up to two years.

Dr. Naidu uses small needles to inject the filler into the deep layer of the skin or lips. The skin is gently and smoothly plumped, and creases and fine lines are filled in. When placed over the cheekbones, a natural fullness is noted. Fillers may be used alone or in conjunction with other procedures such as Botox®. The procedure takes 20-30 minutes to perform, and is done in the office under local anesthesia. The results are visible immediately. No dressings are necessary, and makeup may be worn the same day. Some patients experience bruising for several days after the injections, and therefore you should schedule your injection at least one week in advance of an anticipated event or meeting. Dr. Naidu performs all injections herself; the treatment is never delegated to an assistant.

Facial Fillers Introduction

As we age, our faces naturally lose volume and develop deeper creases and folds. Facial fillers can assist in restoring some of that lost volume. Dermal fillers are an injectable material which can be used to fill folds around the mouth, plump the lips, and add volume to other areas of the face.

What is the Difference Between BOTOX and Facial Fillers?

Botox is a medication which relaxes muscle contraction which can cause wrinkles, while dermal fillers add volume to an area which has loss fullness with age.

What is a Hyaluronic Acid Dermal Filler?

Dermal fillers can be made from hyaluronic acid, a natural substance found in our bodies. High concentrations are typically found in our skin, joint fluids, fluid around the eyes, and cartilage. It was traditional extracted from rooster combs but is now produced through streptococcal fermentation.

What Issues Can Hyaluronic Acid Dermal Fillers Address?

Hyaluronic acid fillers can add volume to the nasolabial folds (smile lines around the mouth), marionette lines (folds from the corner of the mouth to the chin), lips, around the eyes, deep scars, cheekbones, the fold between the eyebrows, the temples, and in some cases to smoker’s lines around the mouth. They are also used for non-surgical rhinoplasty.

Some of the most popular hyaluronic acid filler brands include:

Juvéderm products, which include Juvéderm Ultra, Juvéderm Ultra Plus, Volbella, Voluma, and Vollure.
Restylane products, which include Restylane-L, Silk, Refyne, Defyne, and Lyft.
Other brands of hyaluronic acid dermal fillers include Belotero.

When to expect to see results with:

Calcium Hydroxylapatite: you will see results immediately with one treatment.
Hyaluronic Acid: you will see results immediately with one treatment. There will be moderate swelling and firmness for one week, followed by softening of the material.
Polylactic Acid: you will require several treatments spaced about a month apart, and it may take 6 weeks to see results.
Polymethyl-Methacrylate Microspheres (PMMA): you will require several treatments and it may take 3 months to see your final results.

How Long Do Facial Filler Results Last?

Average length of time each facial filler’s results last:

Calcium Hydroxylapatite: can last as long as 1 ½ – 2 years.
Hyaluronic Acid: depends on the filler, but usually lasts from 6 – 18 months.
Polylactic Acid – can last 2-3 years.
Polymethyl-Methacrylate Microspheres (PMMA) – can last 5 years.

Who is a Good Candidate for Facial Fillers?

Patients who have noted volume loss in the face with aging and who have realistic expectations are good candidates for facial fillers. Fillers are not a substitute for surgery.

What Should I Expect During My Facial Filler Treatment?

During treatment, you will be evaluated and a plan will be formulated. Topical anesthetic and ice may be applied prior to injection. Ice will be applied following injection and you will be given written instructions and a follow-up appointment.

Is There Any Down Time After Facial Filler Treatments?

You may have bruising and swelling with any type of facial filler which can last 2-4 days. Plan to have your treatment done at least a week prior to any events.

Are There Any Risks and/or Complications I Should Know About?

Overall risks associated with dermal fillers include bruising, swelling, overcorrection, undercorrection, and very rarely, embolism to distant arteries, potentially resulting in permanent blindness.

Risks associated with:

Calcium Hydroxylapatite – this filler is not reversible
Hyaluronic Acid – these fillers can sometimes form small lumps which can usually be massaged out
Polylactic Acid – this filler is not reversible
Polymethyl-Methacrylate Microspheres (PMMA) – this filler can be visible under the skin

Dermal Filler FAQs

What side effects should I expect following a dermal filler treatment?

Following injection with dermal fillers, expect to be swollen and possibly bruised for 2-4 days, depending upon the site of treatment. Ice and elevation are recommended. The filler may feel firm for the first week, and then will soften by the second week.

Is having fillers injected using a microcannula better than with a sharp needle?

Microcannulas have a blunt tip and are longer than needles, so they are ideal for deep filling in areas which are prone to bruising. Short, sharp needles are best for superficial filling, as in fine lines around the mouth.

Are there any long-term effects associated with the use of hyaluronic acid fillers?

Hyaluronic acid fillers resorb in 8-18 months, therefore it would be unlikely to see long-term effects beyond this time. In rare cases, patients who have received fillers beneath the eyes can see persistent swelling after this time.

Which injectable filler works the best for treating troughs/hollows beneath the eyes?

A temporary filler with hyaluronic acid, such as Restylane, Volbella, or Belotero are considered to be ideal choices for the tear trough region.

Which filler works the best for augmenting the lips?

Temporary fillers with hyaluronic acid such as Restylane, Restylane Silk, Volbella, Restylane Refyne, Juvederm Ultra, and Juvederm Ultra Plus work best for lip augmentation.

I tend to develop cold sores, but I would like to have injections of filler in my lips; will my tendency to develop these sores affect my lip augmentation?

If you have a history of cold sores, let your injector know so that she/he can prescribe Valtrex prior to your injections. This should prevent recurrence following your lip injections.

How do they extract dermal fillers from the skin if you do not like the results?

If a hyaluronic acid filler has been used and you wish to reverse the results, hyaluronidase can be injected into the site. This is an enzyme which dissolves the product, and results are typically seen within 30 minutes.

Should I expect to have a lot of bruising after I have filler injections beneath my eyes?

Expect to have a moderate amount of bruising for 2-4 days after filler injections below the eyes, as the skin in this region is very thin. Ice, head elevation, and avoiding exercise for 24 hours will help in reducing the degree of bruising.

Where is the filler injected to address the hollows beneath the eyes?

Filler for the tear troughs under the eyes is injected directly onto the bone in very small quantities.

Could injectables be used in the temple area?

Fillers can be placed into the temple region to fill in hollowing which can occur with aging. The filler is placed directly onto the bone. Expect to need at least 1 ml of filler per side for complete correction in most cases.