fillers - Patients ask, Dr. Ringpfeil answers
Please feel free to use the blog below to share information about fillers or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery
Dermal Fillers
As part of the aging process, our skin stretches and loses some of its elasticity and the face loses some of its subcutaneous fat. As a result, the skin looks loose, and we lose the plump skin we had in our youth.
Dermal fillers replace the fat we lose and help to restore the full appearance of our face. In addition, fillers serve as a buffer between our facial muscles and our skin. This buffer reduces the impact of the constant muscle movement of the face and fills indentations and lines left in the skin
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What until recently could only be corrected by an invasive and expensive surgery can now be corrected by Juvederm and Restylane, the two derma filler brands that revolutionized cosmetic surgery since they were introduced to the market at the beginning of the millennium.
Juvederm & Restylane: Time to results: 1-10 days. Lasts: 6-9 months.
The most common dermal fillers in the US are manufactured and distributed by a handful of pharmaceutical vendors. The Juvederm line and Kybella are produced and distributed by Allergan and Restylane by Galderma. Other products are Radiesse, Belotero, Prevelle, Artefill, and Sculptra.
Most of these products address the same facial areas such as the Nassolabian lines, vertical upper and lower lip lines, and cheeks. Cost, lasting results, and personal preference are the most common differences between the various products. Also, an experienced injector may prefer one product over another in specific situations. For example...
Static vs. Dynamic Lines
Static Lines - Lines/wrinkles visible at rest.
(usually treated by dermal fillers)
Dynamic Lines - Lines visible with forceful movement of muscles. (usually treated by Botox)
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restores cheek volume
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reduces creases and wrinkles
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enhances lips
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rejuvenates hands
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corrects scars
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Marionette lines - Radiesse / Juvederm / Restylane / Prevelle- 1-2 syringes will fill in the longer grooves that extend to the jawline.
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for more information about Botox injection in areas marked as
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Price List
| price / syringe | lasts (months) | # treatments | |
|---|---|---|---|
| Artefill | $900 (0.8 ml) | Permanent | 1-2 |
| Sculptra | $750 (1.0 vial) | 24+ | 2-3 |
| Radiesse | $750 (1.5 ml) | 12-18 | 1 |
| Juvederm | $680 (0.8 ml) | 6-12 | 1 |
| Restylane | $600 (1.0 ml) | 6-9 | 1 |
| Prevelle | $250 (1.0 ml) | 3 | 1 |
| Voluma | $880 (1.0 ml) | 24 | 1 |
The purchase of a full syringe is required. When only a partial syringe is needed, the remainder can be injected into another area.
Restylane
Restylane, Restylane Silk, and Restylane Lyft (Used to be called Perlane) are members of Galderma's family of dermal fillers.
We use Resytlane and Restylane Lyft to restore volume and correct deep lines, folds, and wrinkles.
Restylane Silk is an excellent filler to enhance lips and correct lip lines.
Restylane is made of a hyaluronic acid gel which is a substance produced by our body. It has FDA approval to be used for facial wrinkles and nasolabial folds but it is also used for tear troughs and lip enhancements.
Juvederm
Juvederm Voluma
Radiesse
Hands rejuvenation with Radiesse
Hands rejuvenation with fillers before and after
What are the risks with filler on face ?Also , what happens if you stop getting filler on the face?
Most individuals will have no side effects when they leave the office. We instruct our clients to not take blood thinners for 7 days prior to the appointment and the day of and to avoid vaccinations for 14 days before and after treatment. After filler placement they will be asked to avoid exercise for 24 hours and sleep elevated on 2 pillows during the night after filler.
Occasionally, mild redness for up to one hour, swelling for 0-4days (pending the type of hyaluronic acid filler that is used), pressure over a bnoy area for 1.5 days, and sometimes bruising for several days may occur.
Rare side effects are transient nodules that can be resolved. The rarest of all side effects are lasting nodules when filler is placed off-label near powerful facial muscles, firm “moving” nodules on the face related to vaccines, or inadvertent placement in an artery which causes loss of perfusion of the tissue that is supplied by this artery and can result in skin necrosis or blindness. Safeguard against these very rare but serious events is sound knowledge of anatomy, use of blunt microcannulas, and slow injection technique, adherence to vaccination schedule.
hello. i only want to get my top lip filled with filler for symmetric lips and don’t believe i’ll need a full syringe. do you save syringes for a later appt?
The most commonly used lip filler, Volbella, is available as a half syringe (0.55 ml) and as a full syringe of 1 ml. The smaller syringe is the best option for your goal.
Looking for permanently treatment for puffy under eyes
Permanent treatment of puffy under eyes can be achieved with surgery. Results of a lower lid blepharplasty often last 7-10 years until genetic changes catch up. Fillers are suitable i individuals with a mild to moderate degree of puffy under eyes and provide temporary camouflage for up to one year.
I am very interested in getting fillers for my marionette lines, tear troughs and double chin. I am concerned however about recovery time of bruises and swelling. I am an African American female. Will I be able to hide most of the bruising with makeup? What is the average recovery time for these procedures.
Filler is safe in all skin colors. Bruising and swelling can both occur after filler placement. It can take up to 3 weeks to resolve although the majority will have no visible swelling after 3 days and bruisng can be covered with make up in all skin colors. It is important to avoid acetyl salicylcic acid (aspirin), ibuprofen, fish oil, ginkgo, St Johns wort and vitamin E supplements 7 days before the filler procedure unless your need for these medicines outweighs the side effect of potential bruising.
Hi Doc,
Do you have any pics for before/after use of Radiesse for upper lids?
Are there any risks of altering shape of the area? How does the filler work in this case.
Thanks.
M.
Our office offers lid fill with fat transfer which looks very natural. It is usually part of fat transfer to several areas on the face. We perform reshaping of the brows and temples with fillers. As filler development progresses, I am certain that a suitable synthetic filler might soon be available.
The tip of my nose has become slightly lower and I want to know if there is anything a filler can do to raise it slightly and fill in uneven areas along the sides.
Correction with filler is possible. Please seek the help of an ear nose and throat specialist who performs these injections routinely. Not all ENT specialist who inject fillers will offer this service.
Hello,
Can Prevelle also be used to enhance lip volume?
Thanks!
Prevelle can be used to enhance lip volume. It lasts at most three months in areas of muscular movement such as the lips and has therefore fallen out of favor of most people desiring fillers. Therefore, we no longer offer it.
With hand rejuvenation can the more permanent filler Arte Fill be used? On the average how many vials would be used? Thank you.
Hand rejuvenation with fillers takes under consideration that our hands age dynamically. Therefore, permanent fillers are not typically used because most people consider what hands might look like 20-30 years down the road. It is easy to hide breast implants under clothing when they no longer fit the rest of the body. Hands are not usually hidden and a permanent filler, that does not get periodically augmented when aging progresses, might look unnatural.
I have ice pick scars on my nose, some big others look like enlarged pores. These scars cause me to be self concious. I hate to see my reflection and look at the awful scars, most were caused by blackheads . I was wondering what could be done , can the tretments make my skin smooth again? Also what would be the cost? And lastly does insurance cover any of these costs? Please let me know thanks, Jay
Enlarged pores and scars are generally difficult to treat. The degree of improvement with any type of treatment is dependent on the severity of pore enlargement or scar formation and is tough to judge by description. Please understand that a blog cannot replace an in-person consultation and therefore specific treatment recommendations and their associated fees cannot be provided. Insurance covers neither treatment for enlarged pores no scars. Please schedule a consultation.
dI am very disappointed with my first treatment with juvederm today. A MD Dr injected one syringe of juvederm around my mouth for all the deep vertical lines. It did not fill them in. The only result was swelling and bruising. Any suggestions?
When I perform this procedure I explain to my patients that vertical upper lip lines are not easy to treat when they have started to show permanently. The treatment choices include hyaluronic acid fillers (Juvederm, Restylane, Belotero and others), botulinum toxin and laser resurfacing or any combination thereof.
Filler treatment for vertical upper lip lines does not instantaneously remove the lines that had time to form over many years. Hyaluronic acid fillers are injected with the intend to enforce the thinned skin of the cutaneous lip. While swelling and bruising usually resolve after one week, it can take the deep lines up to 3 weeks to significantly flatten. I often compare this to the effort it takes to remove a crease that was accidentally ironed into a pair of woolen slacks.
Fine lines in the upper lip will resolve entirely with filer placement.
Moderate lines will much improve, yet best results are typically seen with repeated treatments. Deep lines also improve with filer placement but you were probably counseled that 100% effacement of these lines is not possible.
Another technique for reduction of deep vertical upper lip lines is laser resurfacing. The results after single procedure last for years and it is often standard during a face lift. It reduces the lines by about 50%.
Filler can be injected after laser resurfacing, which yields additional improvement.