Injectables and Dermal Fillers
Injectables and dermal fillers refers to popular nonsurgical facial cosmetic procedures which reduce wrinkles and fine lines, treat visible signs of aging, and restore youthful appearance. These skin rejuvenation treatments are especially beneficial for:
- Adding volume to skin
- Filling in folds, wrinkles, or scars
- Plumping sunken cheeks
- Restoring vitality to skin
Dr. Ann Ranelle is highly skilled and experienced at performing injectable dermal filler procedures, Botox® Cosmetic, and Kybella® treatments and is committed to helping her patients achieve the youthful appearance they desire.
Neuromodulator injectables, such as Botox®, and dermal fillers both treat signs of aging, however they are made from different types of ingredients. Neuromodulator injectables are a derivative of botulinum toxin type A, which relaxes the facial muscles by blocking nerve signals. Dermal fillers are comprised primarily of hyaluronic acid (HA), a substance naturally present in the body, which is injected under the skin to provide volume and fullness.
Botox® Cosmetic is the most widely used neuromodulator injectable in the world. Originally used by ophthalmologists to treat optic muscle disorders, Botox® is now proven to be successful in treating:
- Moderate to severe glabellar lines (lines between the eyebrows)
- Crow’s feet
- Forehead lines
Botox® works by blocking the release of acetylcholine, a chemical within the body which triggers muscle contractions that, over time, create wrinkles. By preventing the muscle contractions, and therefore any creases which would be formed, Botox® smooths, softens, and diminishes facial lines and wrinkles.
The Botox® Cosmetic Procedure
Before the Botox® procedure, the targeted area will be treated with a numbing cream or local anesthesia, and injection points where the muscles contract will be marked. During the procedure, Botox® is injected at these precise locations into the muscles. Typically, very little, if any, discomfort is experienced due to the thinness of the needles utilized. The entire Botox® procedure generally takes less than 20 minutes.
Botox® should be administered by a medical professional with sterile instruments. You should be wary of any other circumstances in which Botox® injections are being offered, such as Botox® home parties. Having your procedure performed by an experienced licensed professional who understands how muscles contract and where they are located is key to a successful outcome.
After the Botox® Procedure
After the Botox® procedure, most patients can immediately continue everyday activities. You may be advised to avoid prolonged sun exposure. Some redness or swelling may present around the injection sites, but should resolve within the first day.
Results usually appear within a few days and continue to improve and become more evident over the first week after treatment. Botox® results usually last approximately 4 months and can be maintained with periodic follow-up treatments.
Possible Botox® Complications
Complications with the cosmetic use of Botox® are extremely rare. Most reported cases of side effects from Botox® involved patients receiving injections for non-cosmetic reasons, such as migraine treatment, strabismus, or blepharospasm.
In rare instances, side effects can include:
- Allergic reaction
- Swelling/pain at injection site
- Flu-like symptoms
- Muscle weakness (usually resolves within a few days)
Kybella® (Deoxycholic Acid)
Kybella®, or deoxycholic acid, is an FDA approved injectable prescription medication used to destroy the fat cells under the chin in order to reduce the appearance of a double chin and improve the patient’s profile. Deoxycholic acid (which is identical to Kybella®) is naturally produced in the body to aid in fat absorption. When injected into the submental fat tissue (below the chin), Kybella® destroys the cell membrane and sculpts the jaw line These fat cells are permanently disabled from storing and accumulating fat.
A single Kybella® treatment may include multiple injections, and up to 6 treatments at least one month apart may be necessary. Temporary swelling after a Kybella® treatment is normal and can be alleviated with non-steroidal anti-inflammatory drugs, such as ibuprofen.
Patients with mild to moderate submental fat and whose skin has good elasticity are considered good candidates for Kybella® treatment. Skin without sufficient elasticity will result in loose hanging skin beneath the chin.
Superficial fat under the chin often occurs with aging and is not always accompanied with being overweight, so exercise and dieting may have no effect on a double chin. With Kybella®, your neck can be rejuvenated safely and non-surgically during an in-office procedure, resulting in a younger-looking, firmer profile. After completion of a personalized Kybella® treatment plan, most patients do not need additional treatment.
Kybella® Side Effects
Mild, temporary side effects at the injection sites can include:
If injected improperly, nerve or tissue damage could occur, therefore Kybella® should be administered by a licensed medical professional and only in the submental area. If you are interested in reducing submental fat without liposuction or other invasive treatments, Kybella® may be the right solution for you.
Juvéderm® is an FDA approved family of injectable dermal fillers comprised primarily of hyaluronic acid (HA), which is a natural substance within the skin that helps retain volume, moisture, and softness while delivering nutrients. When injected under the skin, Juvéderm® boosts the skin’s elasticity by supplementing the body’s naturally produced hyaluronic acid, which keeps the skin healthy and hydrated.
Juvéderm® is highly successful in restoring facial smoothness and volume, with few allergic side effects due to its natural qualities.
Common Juvéderm® treatment areas include:
- Nasolabial folds (also called marionette lines or parentheses): Fills in lines between the nose and corners of the mouth
- Nasogenian grooves: Volumizes folds between the nose and cheeks
- Lips: For volume enhancement
- Cheeks: Reshapes and lifts the contours of the cheeks
Juvéderm® and Hylacross Technology
Juvéderm® utilizes the science of hylacross technology to dispense the hyaluronic acid into the targeted areas. Hylacross technology blends the HA particles which allows the final product to have an extremely smooth consistency.
Benefits provided by hylacross technology include:
- High concentration of hyaluronic acid: Juvéderm® has the highest concentration of any dermal filler, which enables longer lasting results.
- Comfortable injections: The smooth consistency allows the Juvéderm® to be easily and precisely injected.
- Cross-linked hyaluronic acid: Cross-linking provides viscosity and stability, making Juvéderm® longer lasting and highly effective.
The Juvéderm® Procedure
During the Juvéderm® procedure, the transparent gel is injected with a fine needle into the facial dermis (the layer of skin that contains nerve endings, corrective tissue, oil and sweat glands, and blood vessels). Depending on the treatment area, the entire process usually takes 15-60 minutes.
Due to its gel-like consistency, Juvéderm® is able to provide a natural smoothness and volume to the targeted areas. Juvéderm® results typically last 6-12 months with one treatment. Because Juvéderm® is biocompatible, it is eventually absorbed naturally and safely into the body.
Most patients experience little to no discomfort during the dermal filler procedure and can immediately return to most normal activities the same day.
It is recommended during the first 24 hours after treatment that patients avoid:
- Prolonged sun or heat exposure
- Alcoholic beverages
- Strenuous activity
- Aspirin or anti-inflammatories that may promote bruising
- Heavy make-up
Side Effects of Juvéderm®
Because Juvéderm® utilizes the non-toxic hyaluronic acid naturally produced by the body, any side effects experienced are typically mild and temporary in nature.
Injection site side effects can include:
- Risk of infection
In most cases, placing an ice pack on the injection site will alleviate any discomfort.
Juvéderm® Ultra Plus
Juvéderm® Ultra Plus is a thicker version of the Juvéderm® dermal filler. Both products utilize the hylacross technology of administering hyaluronic acid to smooth and fill facial lines and wrinkles, and are similarly injected into the skin. Juvéderm® Ultra Plus has a higher degree of cross-linking (8% vs. 6%), which enhances its filling ability and makes it more effective on deep facial folds. Juvéderm® Ultra Plus is injected deeper into the skin allowing it to fill out facial features with more dramatic results.
Juvéderm® Ultra Plus is recommended for:
- Deep wrinkles: Such as severe nasolabial folds
- Lips: When significant enhancement is desired
- Shaping the face
- Creating facial volume: Such as filling out cheeks
Juvéderm® Ultra Plus results typically last about one year.
Juvéderm® Voluma is the member of the Juvéderm® family of injectable dermal fillers which is primarily used for shaping and enhancing facial features that have experienced volume loss over time. Voluma, like other Juvéderm® products, is long-lasting and lifts the treated facial areas through the use of cross-linked hyaluronic acid. Voluma is injected deeply into the skin, resulting in little to no bruising.
Common uses for Voluma include:
- Volumizing the chin
- Lifting the jowls
- Shaping and filling out cheeks
Due to its thickness, Voluma is not appropriate for correcting lines around the eyes, filling nasolabial folds, or lip enhancement. Voluma results are immediate and, under optimal conditions, can last up to 2 years.
Restylane® is an FDA approved line of hyaluronic acid dermal fillers which are tailored to treat the signs of aging by enhancing and smoothing facial features.
Restylane® products include:
- Restylane®: Used for correcting moderate to severe wrinkles or folds, such as nasolabial folds (smile lines)
- Restylane® Silk: Uses smaller HA particles and is specifically designed to treat lines around the lips and provide natural-looking fullness and shape to thinning lips
- Restylane® Lyft (also called Perlane®): Corrects midface volume loss by augmenting and shaping cheeks and other areas with contour deficiencies, and can also be used to smooth and fill other moderate to severe facial lines
Restylane® is a clear gel produced biotechnologically in a sterile lab environment and does not use any animal sources. Once injected into the skin, Restylane® works to maintain facial volume by attracting and binding water molecules beneath the skin’s surface. Because it is formulated with biodegradable hyaluronic acid, it is eventually absorbed safely into the body. Restylane® results typically last approximately 6 months.
Restylane® Side Effects
Side effects of Restylane® are rare and, when present, are generally mild and temporary in nature.
Possible Restylane® side effects at injection sites include:
- Nodules or hardening
In extremely rare cases, patients may experience an allergic reaction, however, Restylane® is considered to be an extremely safe method to treat signs of facial aging.
If you are interested in having smoother, more refreshed looking skin, contact our office for a consultation with Dr. Ann Ranelle.