Injectables and Fillers

Injectable fillers are substances used in cosmetic procedures to plump thin lips, enhance shallow contours, soften facial creases and wrinkles, or improve the appearance of recessed scars.

Men or women who are seeking an improvement in facial lines or wrinkles may be good candidates for an injectable filler procedure.

You may not be a good candidate for an injectable procedure if you smoke, have recently quit smoking, or are exposed to second-hand smoke.

Before getting an injectable procedure, you will need to have a preoperative consultation with your surgeon. During the consultation, your surgeon will evaluate your general health status, discuss your options, examine and measure your face, and recommend a course of treatment.

The procedure will be described in detail, including risks and limitations. Photographs will be taken for before and after comparisons.

The surgeon will give you preoperative instructions as to what you can or cannot eat or drink before surgery, which medications you should take or avoid, and a list of things you will need to have on hand for your recovery. During your consultation, the surgeon will answer any questions you might have, so come to your appointment prepared.

Botox® (Botulinum Toxin Type A) combats wrinkles that are created when nerve cells release a chemical called acetylcholine. This chemical triggers a muscle contraction that creates wrinkles. Botox® disrupts the release of acetylcholine, which essentially paralyzes the muscle and stops the contraction. Results are fully evident within one week and remain for a minimum of three months.

Collagen is a natural protein that supports the skin. Injectable collagens derived from human cells include Cosmoderm® or Cosmoplast®. Zyderm® Zyplast®, and Artefill® are forms of bovine collagen. Collagen filler temporarily treats wrinkles, scars, thin lips, frown lines, and folds around the nose and mouth. Results last 2 to 4 months.

Hyaluronic Acid (Juvéderm™, Hylaform®, Restylane®, Perlane®, and Esthelis®) is a natural substance found in our bodies. It is used to plump thin lips and fill facial creases such as nasolabial folds (the crease between the nose and lip). It may also be appropriate for some surface wrinkles and indented scars. The results may last 6 months or longer.

Hydroxylapatite (Radiesse®) is a mineral-like compound found naturally in human bones, suspended in a gel-like formulation. It is the heaviest of facial fillers and is recommended to fill deeper creases such as nasolabial folds, marionette lines (lines that form below the corners of your mouth and run down onto the chin ) and frown lines, as well as to enhance fullness of the cheeks and other facial contours. Results can last 2 years or more.

Human fat, harvested from your own body, can be reinjected to enhance facial fullness, fill deep creases and to build up shallow contours. Fat injection requires a more extensive procedure than other injectable fillers because it uses liposuction to extract the fat prior to injection. Results last up to a year or more.

Your plastic surgeon will evaluate your face and skin tone, and examine the areas of your face to be injected.

Strategic points on your face may be marked as guides to the appropriate injection sites.

The injection sites will be cleaned with an antibacterial agent. Ice or a topical numbing agent may be offered to make you comfortable. In some cases, the injectable itself will contain an anesthetic agent. In other cases a local anesthetic may be administered to the treatment site.

The treatment takes only a few minutes.

After injection, markings will be cleaned and ice may be offered to alleviate any temporary discomfort. Makeup may be carefully re-applied so long as care is taken not to apply pressure to the treatment area.

You should be able to go home the day of your procedure.

During recovery from an injectable procedure, you may experience some mild swelling or bruising, temporary numbness or redness, or an "over-filled" appearance to treated areas. Cold packs are effective for reducing post operative swelling, bruising, and pain.

These conditions should improve within a matter of hours or just a few days. Where fat is the injected filler, they may persist for a few weeks.

Most people are able to return to the same day as the procedure.

Although injectable procedures are relatively safe, all procedures come with some risk. Potential risks of injectable procedures may include:

• Adverse anesthesia reactions
• Allergic reaction
• Bruising, numbness
• Redness, swelling, discoloration
• Lumping and granulomas (small areas of inflammation due to tissue injury)

Many of these complications can be avoided if you closely follow your surgeon’s instructions.

The cost of injectable procedures varies based on a number of factors including:

• Type and amount of product needed
• Geographic location
• Facility fees
• Surgeon expertise and demand

Costs can range from around $300 to around $800.

American Society of Plastic Surgeons, www.plasticsurgery.org/

University of Michigan, surgery.med.umich.edu

National Women’s Health Resource Center, Inc., www.healthywomen.org