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Fillers

Unlike Botox which resolves wrinkles by relaxing the muscle under the skin, injectable fillers act like volumizer, plumping and lifting cheeks, chins, jawlines and grooves on temples when injected. It also fills deep grooves such as nasolabial folds and plumping thin lips. Everyone’s needs are different and different types of fillers work in different manner. Consult with our medical provider and we will customize treatment to achieve your desired results.

Time

40 ~ 60 min

Anesthesia

Topical Cream

Hospital care

None

Downtime

None

Recommended for

  • who wants to correct the nasolabial folds and overall facial wrinkles

  • Who wants to fill the hollow part of the cheek, pimple and lower jaw

  • Who wants to have define jawline

Types of Dermal Fillers - All listed FDA approved

  • Hyaluronic acid 

Brand such as Juvederm, Restylane, Belotero and Revanesse Versa

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Hyaluronic acid (HA) is a type of sugar that is naturally found in many types of body tissues, including skin, connective tissue, and joints. Among its many biological functions, HA is important in tissue hydration, joint lubrication, immune response, and tissue repair. In the skin, it is a major component of the natural skin barrier.

Hyaluronic acid has large water-binding capacity, it attracts moisture and expands when it is injected into the skin thus creating plumping effects that raises fine lines, wrinkles and folds. 

Depending on the manufacturers and product lines, physical and chemical properties of HA can be altered to influence their products’ performance and outcomes. Modifications include the particle size, degree of cross-linking between molecules, the concentration of HA, and the consistency and viscosity of the gel. These variations account for differences in the effectiveness, longevity, and appropriate injection sites of different HA dermal fillers. HA filler is biodegradable, which will last anywhere from 6~18 months. 

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  • Polycaprolactone (PCL)

Brand such as Elastine​

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Polycaprolactone is a biodegradable and bioresorbable an aliphatic polyester belonging to the poly-α-hydroxy acid group (same family as PLLA PGA).  polymers suspended in a carboxymethyl-cellulose (CMC) gel carrier that possesses collagen-stimulating properties. The PCL based filler has dual effects, immediate effect and sustained volumizing effects when injected. The immediate effect is related to the CMC gel by the filling capacity of the injected volume and the highly hygroscopic properties of CMC. The immediate effect is followed by a sustained effect of PCL which induce new collagen production. The mechanism of new collagen production is similar to PLLA. 

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  • Poly-L-Lactic Acid (PLLA)

Brand such as Sculptra 

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PLLA is a synthetic dermal filler. When it is injected, this microsphere irritates the area which subsequently increases fibroblastic activity which in return the body produces new natural collagen in the treatment area. PLLA filler is not filling the area on its own, by rather acts like a stimulant, which causes the skin to make more collagen by itself and produce long-lasting result for up to two years.

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  • Calcium Hydroxyapatite 

Brand such as Radiesse

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Calcium hydroxyapatite dermal filler is consist of  Calcium hydroxyapatite microshperes that are suspended in a watery carboxymethycellulose gel. Calcium hydroxyapatite is also naturally found in our bone. This type of dermal filler is a mineral compound which is usually used in filling moderate to severe creases and to improve contour of the face. This type of filler lasts between 12 and 18 months. 

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  • Polymethyl-methacrylate microsheres (PMMA)

Brand such as Bellafill

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Polymethyl-methacrylate is composed of biocompatible PMMA microspheres mixed with the bovine collagen. When this is injected, the bovine collagen is abosrbed by the body while the PMMA microsphere remain and stimulate your body to produce collagen. This can be used to correct smile lines and certain types of depressed acne scars. PMMA is considered a semi-permanant filler as results can last up to five years. 

Side Effects of Fillers

Dermal fillers are quite safe and most side effects are mild and resolve without treatment

  • Redness, swelling and bruising due to minor tissue trauma

  • Discomfort that can be reduced by using a filler with lidocaine or a topical anesthetic

  • Mild itching and/or rash

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More serious side effects that may require treatment are rare; these include:

  • Infections at the site of injection

  • Nodules from local tissue reaction

  • Filler migration or poor aesthetics 

  • Injury to blood vessels if accidentally injected into a blood vessel. This can lead to tissue death (gangrene) or blindness if a clot forms and move to the vessels that supply the eyes

What to avoid before your filler treatment

  • The most common side effect is bruising and swelling. It is NOT advisable to have injections less than 2 weeks before a big event.

  • To avoid bruising it is best not to take any pain killer or Nonsteroidal anti-inflammatory drug (NSAID) that act as blood thinners: Aspirin, Ibuprofen (Motrin, advil, motrin IB), Naproxen (Naprosyn, Aleve) and Nabumetone (Relafen). Try 

    • Celecoxib (Celebrex; NSAID only COX 2 inhibitor) or 

    • Acetaminophen instead: Tylenol

  • Cut out certain supplements. Vitamin E, fish oil, ginseng, gingko biloba, ginger, omega-3, St. John's wort and garlic pills are all blood thinners.

  • Avoid alcohol prior to treatment and for a few days after treatment since it is a blood thinner.

  • Sunburned skin is difficult to treat so avoid exposure to the sun.

  • Avoid waxing, bleaching, tweezing, or the use of hair removal cream on the area to be treated.

  • Avoid the use of Alpha Hydroxy Acids higher than 10% and avoid Retinoids.

  • Inform your clinician if you have a history of Perioral Herpes or facial sores to receive advice on antiviral therapy prior to treatment.

  • Always inform your clinician of all medications you may be taking as well as your medical history.

  • Do not use Botox and/or fillers if you are pregnant or breastfeeding, are allergic to any of its ingredients, or suffer from any neurological disorders.

  • It is advised that treatment with the homeopathic oral medication, Arnica Montana, begin the day before treatment to help promote healing and minimize bruising and swelling. Arnica is available at health food super markets such as Whole Foods.

  • Take Bromelain. Bromelain, a supplement derived from pineapple stems, may reduce bruising and swelling by breaking down blood proteins.

  • Incorporate foods abundant in bioflavonoids into your diet. Bioflavonoids help to strengthen your blood vessels and connective tissue. Foods rich in bioflavonoids include oranges, berries, grapes and green beans.

Post care after Filler treatment

  • There may be redness, bruising, swelling, tenderness and/or itching near the injection site immediately after the injection. Avoid itching, massaging or picking around the injection site. 

  • Your face may feel swollen for up to three days at the injection site. It will be settle down within a week and will look normal and natural. 

  • Ensure that your skin is kept clean and injection sites are disinfected to minimize the risk of an injection for the first few days.

  • You can apply natural anti-inflammatory oil such as emu oil to cope with the redness.

  • Avoid drinking alcohol or partaking in strenuous exercise, as it may result in additional bruising.

  • Until the swelling and redness have resolved, avoid intense heat in the treated areas. This includes sunbathing, tanning, saunas, hot tubs, or hot wax. Also avoid extreme cold such as skiing or other winter sports. 

  • You can use face cream that contains Phytessence Wakame extract, which is extracted from seaweed, inhibits the action of hyaluronidase, which will keep your HA filler lasting longer.

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