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.
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
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.
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 Lines - Lines/wrinkles visible at rest.
(usually treated by dermal fillers)
Dynamic Lines - Lines visible with forceful movement of muscles. (usually treated by Botox)
for more information about Botox injection in areas marked as
|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 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.
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.
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.
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.
Can Prevelle also be used to enhance lip volume?
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.
Does weight loss after the procedure impact the results of Artefill as a filler for facial scarring.
Yes it does. However, if only minute amounts of filler are used for small scars, weight loss does not adversely affect the cosmetic outcome. If a larger scar is treated and weight loss follows, the filler placement may become obvious. Filler placement is best performed with a stable weight. If weight loss is anticipated, a non-permanent filler should be favored.
have you used filler such as alloderm or radiesse to enhance nipple projection on post mastectomy patients?
I have not used fillers for this purpose. Please consult with your breast surgeon. There are a number of plastic surgeons who offer this procedure.