Cosmetic Dermal Fillers

Injectable cosmetic fillers are among the most popular and fastest growing areas in the cosmetic industry. Patients are thrilled with the dramatic improvements which can be gained following a 20-30 minute office procedure. These treatments result in a more youthful and refreshed appearance.

Injectable cosmetic fillers are beneficial in two main ways. First, they can lift up areas in the skin which form lines, folds, wrinkles, or scars. Some of these wrinkles are formed due to atrophy and degeneration of the skin with age. Other folds may simply be an anatomical feature of one's face. Either way, these fillers elevate the skin into a smoother contour.

Common areas that fillers may improve appearance include the nasolabial folds (between the nose and mouth), parentheses lines around the mouth, hollows under the eyes, and marionette lines.

The other way cosmetic fillers work is by adding volume to larger areas of the face to restore the youthful fullness that has been lost due to the aging process. Loss of fullness in the face is a characteristic sign of aging. This is because aging causes deflation as well as sagging of the face.

Sagging can be improved by a face lift and neck lift , but loss of fullness cannot. Injectable fillers are a non-surgical way to bring a more youthful appearing fullness to your face. Full cheek bones, smoothness under eyes, full lips – these are all features of a youthful face that deflate over time and aging.
 

Safest and Most Effective Cosmetic Fillers

Dr. Kim offers a selection of what he believes are the most effective and safest of the currently available cosmetic fillers at his San Francisco office. All the fillers offered eventually become absorbed by the body, which means their effect is temporary. Although this may seem less than ideal for those wishing a permanent result, this characteristic actually has clear advantages.

First, the face continues to age and to change even after administration of the filler. The location and amount needed to improve an area will therefore change over time, requiring progressive modification of the technique of filler placement for each person in each location. A permanent cosmetic filler, therefore, might start to look unnatural and out of place over time as the tissue around it changes.

The other important point is that there are multiple reports of complications related to permanent fillers. Chronic infection, skin granulomas, scarring, etc have been reported with the use of these products at a rate much higher than the absorbable fillers. Dr. Kim believes that permanent fillers can lead to permanent problems, and for this reason does not offer them in his practice.

With so many cosmetic filler products in the market, you may be confused about which is the best choice for your needs. Dr. Kim and his staff can help you select the best choice for your anatomy and your goals.
 

Restylane™, Perlane, Juvederm

Restylane, Perlane, and Juvederm are safe and effective cosmetic fillers with immediate and long-lasting results. These fillers are used for enhancing lips, facial wrinkles, folds, and replacing lost facial volume. The hyaluronic acid (HA) in these fillers is almost identical to that naturally found in the body. The result is instantaneous and produces a long-lasting, natural enhancement that is gentle and safe for your skin.

Treatments take approximately 30 minutes. Recovery time is minimal and most patients return to normal activities immediately. Duration of these HA fillers usually lasts six to twelve months.

The characteristics of the HA fillers differ from brand to brand. Restylane is the currently the most prevalent cosmetic filler in the world and represents a standard by which most other fillers are compared. In Dr. David W. Kim’s practice in San Francisco, Restylane is used for superficial to medium depth lines and folds.

Juvederm is a similar product, with a slightly smoother quality. This allows Juvederm to disperse more within the tissue, a feature that gives it advantages in some areas.

Perlane is a larger particle version of Restylane which is designed for application into deeper areas. Dr. Kim uses Perlane for deeper folds or regional volume enhancement.

Areas that can be improved with HA fillers:

• lines between the eyebrows
• worry lines
• pebbly chin
• lines around the mouth
• lip sculpting and enhancement
• receding lips
• lip lines / smoker’s lines
• sagging cheek bones
• tear trough
• dark circles under eyes
• smile creases
• marionette lines (jowls)
• thinning backs of hands

Restylane before & after
 

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Radiesse®

Radiesse is a safe, FDA-approved dermal filler that restores a natural, youthful look and lasts about 1 year. Radiesse is composed of calcium-based microspheres that form a “scaffold” to support tissue and stimulate the growth of one’s own collagen.

Like the HA fillers, Radiesse is valuable both in the treatment of localized folds and wrinkles as well as restoring a youthful volumized appearance to larger regions of the face. Like Perlane, Dr. Kim uses Radiesse in his San Francisco practice for deeper folds and larger areas of volume enhancement. Slightly more expensive than HA fillers, Radiesse lasts a few months longer on average.

Areas that can be treated with Radiesse:

• mid-face rejuvenation
• worry lines, pebbly chin
• lines around the mouth
• sagging cheek bones
• smile cheek creases
• marionette lines (jowls)

Sculptra®

Sculptra is an enduring treatment approved by the FDA for restoration and/or correction of the signs of facial fat loss, or lipoatrophy. It is the first FDA-approved product of its kind for this condition.

Facial fat loss, or lipoatrophy, is the loss of fat beneath the skin, which can result in sunken cheeks, indentations, and hollow eyes. Made from poly-L-lactic acid, the same material used in absorbable stitches, Sculptra is a safe, synthetic, and bio-compatible material that is injected below the surface of the skin in the area of fat loss. It provides a gradual and significant increase in skin thickness, improving the appearance of folds and sunken areas.

Unlike other fillers, Sculptra acts primarily through stimulation of your own body’s collagen rather than as just a filling agent. No skin testing is required.
Sculptra generally requires 2-3 treatments and lasts up to 2 years.

Dr. Kim’s Approach To Injectable Cosmetic Fillers

More is not always better – Over-treatment will lead to a flat appearance (Botox) or unnatural puffiness (fillers). A gradual approach is more likely to result in favorable results. Dr. Kim strongly believes in the concept that more treatments can always be done, but excessive treatment is not easily undone.

Addition of volume – Aging leads not only to sagging tissue but also deflation and volume loss. That is why adding volume is important in order to achieve full rejuvenation. Surgical lifting procedures are therefore much more likely to result in excellent outcomes if enhanced with replacement of lost volume.

Avoid permanent fillers – Although there are a number of permanent injectable fillers available on the market, Dr. Kim believes these materials lead to a higher risk of complications, such as skin injury, inflammation, or permanent lumpiness.

The cosmetic fillers he uses at his San Francisco office are long-lasting but do eventually become re-absorbed by the body. Although this means that re-treatments are necessary in order to maintain improvements, Dr. Kim views this as a positive. Specifically, he believes that since the face changes over time, the ideal location and amount of injection of filler material to attain a favorable result changes as well.

Customizing injections to match a changing face is only possible with non-permanent fillers.