Tired of looking tired? Or even worse, sad when you aren’t? The reason is typically a loss of fullness in the face. Before we turned 50, our faces were generally fuller and had less shadows. Because our skeleton was strong, there are well placed fat pads and the skin was thick with collagen. As we got older the skeletal platform of the face shrunk, fat pads become misplaced and we lost collagen in our skin, resulting in a sagging face that can make us look tired and sad. Fortunately, we now have the liquid facelift – fillers and stimulators that can restore fullness to the face, lift it back up – without surgery!
Hyaloronic Acid is a commonly used filler and poly-l-lactic acid is a stimulator. Restylane, Juvederm, Belotero and Voluma are common brands of hyaloronic acid. Sculptra is a brand of poly-l-lactic acid. Restylane, Juvederm, Belotero and Sculptra are FDA approved to smooth out the nasolabial folds, the crease that runs from the lower side of your nose to the corner of your mouth on both sides of the face. They are also called the “parentheses lines.”
As patients started getting these creases filled out, it became apparent that not everyone improved in appearance with this treatment. Physicians started to notice that with the elimination of the crease that creates a border between the lip area (the area under the nose including the skin above the red lip) and the cheek the patients were starting to look unnatural. At the same time it was observed that the loss of fullness in the cheek contributed to the crease and an aged appearance.
When the cheek area was treated with a filler or stimulator it had the effect of lifting the cheek back up, which also softened the crease and looked more natural as long as it was not over treated. Voluma is FDA approved to use in the cheek area. Sculptra has been approved for use in the cheek area since 2004. Hyaloronic acids are also used to plump up the lips and soften the vertical lines of the lips – the so called smoker’s lines. Restylane is FDA approved for treating the lips. Sculptra should not be injected into the lips. Sculptra can be used in the temples, and all of the products can be used in the chin area.
Sculptra is a stimulator as opposed to a filler. A stimulator is a product that stimulates the patient’s own cells to form collagen so that the improvement seen is not from the product but from the collagen that the product stimulates. Therefore, the improvement is not immediate, as it is with a filler, but is a slow, gradual improvement that lasts up to two years. A patient in their prime will, on average, require approximately four vials of Sculptra. These vials are not injected at one treatment but over the course of three treatments each, separated by about a month. Results typically peak at about 8 months from the first treatment. My liquid facelift patients have enjoyed the natural looking improvement and anti-aging effects of Sculptra.
The amount of filler and stimulator used is determined by the results the patient would like to achieve, as well as their budget. A professional can help guide you as to what can reasonably be achieved.
Side effects of fillers and stimulators include swelling, redness and bruising. Ice to the area after treatment can help to minimize bruising. It is best to schedule these treatments when your social calendar is not full. Bruises can be covered up with makeup.
While these liquid facelift procedures are considered cosmetic, they are still medical procedures that should be performed in a setting that maximizes best results and minimizes risks. Risks that are rare and that experts take great care to avoid include infection, lumpiness and nodules. After Sculptra treatments, patients are instructed to massage the areas of treatment five times a day for five minutes for five days to prevent nodules. Nodules are very rare when Sculptra is injected properly and the patient massages. Massage is not recommended after a filler treatment.
Risks of filler treatment include a bluish grey discoloration of the skin if it is placed too superficially. Restylane silk can be placed superficially with less risk of discoloration than other fillers. If the fillers are accidentally injected into a blood vessel or compress the blood vessels that are feeding the skin, there can be a temporary lack of blood flow to the skin, resulting in a breakdown of the skin called necrosis. Even more rarely, blindness has been reported, usually after injection of filler between the eyebrows which is why many will not inject in that location. Necrosis has also been reported there.
Fillers and stimulators are a great option for making you look as vibrant and alive as you feel. Just remember injectables are a medical procedure and just as you would get referrals before visiting a doctor, make sure you know something about the doctor or health professional that will be doing the injections BEFORE you book your appointment.
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