The Fountain Rejuvenation Center
Fillers
If you're considering injectables...
As we age, our faces begin to show the effects of gravity, sun exposure and years of facial muscle movement, such as smiling, chewing and squinting. The underlying tissues that keep our skin looking youthful and plumped up begin to break down, often leaving laugh lines, smile lines, crow's feet or facial creases over the areas where this muscle movement occurs.
Soft-tissue fillers, most commonly injectable collagen or hyaluronic acid, can help fill in these lines and creases, temporarily restoring a smoother, more youthful-looking appearance. When injected beneath the skin, these fillers plump up creased and sunken areas of the face. They can also add fullness to the lips and cheeks. Injectable fillers may be used alone or in conjunction with a resurfacing procedure, or thermage.
If you're considering a facial-rejuvenation treatment with collagen or hyaluronic acid, this article will give you a basic understanding of the procedure - when injectables can help, how the procedure is performed, and what results you can expect. It may not answer all of your questions, since a lot depends on your individual circumstances.
KNOWING YOUR OPTIONS
Injected collagen and hyaluronic acid are primarily used to improve the appearance of the skin's texture. They can help fill out deep facial wrinkles, creases and furrows, "sunken" cheeks, skin depressions and some types of scars. They can also be used to add a fuller, more sensuous look to the lips. A resurfacing technique, such as chemical peel, dermabrasion or laser treatments may help as well. Rather than filling in facial lines, resurfacing methods strip away the outer layers of the skin to produce a smoother appearance. Deep folds in the face or brow caused by overactive muscles or by loose skin may be more effectively treated with thermage, injectab;es and botulinum toxin.
A WORD ABOUT OTHER TYPES OF FILLERS
Thisarticle deals with the two most commonly used types of injectable fillers, collagen and hyaluronic acid. However, to a lesser extent, a number of other filler materials are also being used for facial-rejuvenation purposes. They are numerous and each has its own risks and benefits. If you're considering any of these alternative filler treatments, ask us.
WHAT TO EXPECT FROM TREATMENT
The most important fact to remember about injectable fillers is that the results are not permanent. Injected material is eventually metabolized by the body. In some individuals, the results may last only a few weeks (lips especially); in others, the results may be maintained indefinitely. Researchers believe that age, genetic background, skin quality and lifestyle as well as the injected body site may all play a role in the injected material's "staying power."
However, the precise reason for the variation of results among patients has yet to be identified. If you've had short-lived results from fat injections, you shouldn't necessarily assume that collagen injections will work better for you. And, conversely, if you've had disappointing results from collagen, don't assume that injected hyaluronic acid is the answer. Although it's true that some individuals' bodies are more receptive to one substance than the other, others may find that neither substance produces long-lasting results. Sometimes one substance may work better than the other for a specific problem.
RISKS RELATED TO INJECTABLES
When injectables are administered by a qualified physician, complications are infrequent and usually minor in nature. Still, individuals vary greatly in their anatomy, their physical reactions and their healing abilities. The outcome of treatment with injectables is never completely predictable. Allergic reaction is the primary risk of bovine collagen (not human collagen).
Risks not necessarily related to allergies include infection, abscesses, open sores, skin peeling, scarring and lumpiness, which may persist over the treated area. Reports of these problems are very rare. Allergic reaction is not a factor for fat injections because it's harvested from a patient's own body. However, there is still a small risk of infection and other infrequent complications.
PLANNING FOR TREATMENT
Facial rejuvenation is very individualized. Your physician will ask you about your medical history, drug allergies, and check for conditions that could cause problems, such as active skin infections or non-healed sores from injuries. It is usually a good idea to bring a picture that you like from when you were 5 to 10 years younger to your consultation.
Collagen injections are generally off limits for pregnant women, individuals who are allergic to beef or bovine products, patients who suffer from autoimmune diseases, and those who are allergic to lidocaine (the anesthetic agent contained in the syringe with the collagen material).
WHERE YOUR TREATMENT WILL BE PERFORMED
Injectables are administered in a relaxed pleasant atmosphere with the patient in a seated position that is comfortable for them.
TYPES OF ANESTHESIA
Collagen: Because the anesthetic agent lidocaine is mixed in with collagen, additional anesthetic is usually not used. However, if you are especially sensitive to pain, we dr may use a topical cream anesthetic to numb the injected area. Or, you may elect to have an injected local anesthetic or sedative drugs.
Hyaluronic Acid and Facian: There is no lidocaine in this and a topical or local anesthetic or a dental block may be administered.
Fat: Both the donor and recipient sites are numbed with local anesthesia. Sedation can be used as well. If you elect to use sedation, be sure to arrange for a ride home after your treatment.
THE TREATMENTS
Collagen is a naturally occurring protein that provides support to various parts of the human body: the skin, the joints, the bones and the ligaments. Injectable collagen, patented by the Collagen Corporation under the trade names Zyderm and Zyplast, is derived from purified bovine collagen. The purification process creates a product similar to human collagen. Injectable collagen received approval from the Food and Drug Administration in 1981.
It is produced in various thicknesses to meet individual patient needs.Collagen is used primarily to fill wrinkles, lines and scars on the face and sometimes the neck, back and chest. The collagen is injected using a fine needle inserted at several points along the edge of the treatment site. If a local anesthesia has not been used, you may feel some minor stinging or burning as the injections are administered.
Since part of the substance is salt water that will be absorbed by the body within a few days, your doctor will slightly overfill the area. You may be asked to hold a hand mirror during the procedure to help your doctor decide when you've had enough. Immediately following treatment, you may notice some minor discomfort, stinging or throbbing in the injected area. Occasionally some bruising or swelling will occur, but it is usually minor. Any redness that appears in the injected site usually disappears within 24 hours.
However, in some individuals, particularly fair-skinned patients, this redness may persist for a week or more. Tiny scabs may also form over the needle-stick areas; these generally heal quickly. No bandaging is needed and you are free to eat, drink, and wear makeup with sunblock protection shortly thereafter. There may be some temporary swelling and redness in the treated area which should dissipate within a few days. If these symptoms persist, contact us. Results: As stated earlier, the duration of results from collagen injections is variable.
Collagen's longevity depends on the patient's lifestyle and physical characteristics as well as the part of the body treated. In general, the injected material is likely to disappear faster in areas that are more affected by muscle movement. Your doctor can help you determine how long you can go between treatments to best maintain your results.
Fat: In the medical world, the fat-injection procedure is known as autologous fat transplantation or microlipoinjection.
It involves extracting fat cells from the patient's abdomen, thighs, buttocks or elsewhere and reinjecting them beneath the facial skin. Fat is most often used to fill in "sunken" cheeks or laugh lines between the nose and mouth, to correct skin depressions or indentations, to minimize forehead wrinkles and to enhance the lips.
The procedure: After both the donor and recipient sites are cleansed and treated with a local anesthesia, the fat is withdrawn using a syringe with a large-bore needle or a cannula (the same instrument used in liposuction) attached to a suction device. The fat is then prepared and injected into the recipient site with a needle.
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