Layer Your Fillers for Better Results March 11, 2016 Cole Dermal fillers have become a popular way to smooth out facial imperfections and reverse signs of aging without surgery. The rise in their use has also led to more and more formulations designed for a wide range of purposes. With more treatments to choose from than ever before, techniques for administering the injections have also been perfected to give the longest-lasting, most natural results possible. At Cole Aesthetic Center, we offer different injectable treatments to help you achieve your desired results, including layering fillers to make the most of these formulations. The Purpose of Dermal Fillers Dermal fillers can be used for a multitude of purposes today, including: Smooth away fine lines and facial wrinkles Restore youthful volume to areas like the midface and jawline Create balance in areas that are slightly asymmetrical Reverse mild skin laxity due to aging Fill out shallow scarring for a smoother look Rejuvenate the area under the eyes to produce a refreshed, awake appearance To achieve this wide range of aesthetic goals, there are many different types of dermal fillers on the market today. Each formulation boasts its own specific benefits that allow us to customize injectable treatments to the very unique and precise needs of each patient. Types of Dermal Fillers With a wide variety of dermal fillers to choose from today, it is important to understand how each one works so you know which type of formulation will meet your needs best: Hyaluronic Acid Fillers These dermal fillers use hyaluronic acid as their base, a substance normally found in the human body that helps the skin to lock in hydration and remain soft and supple. As we age, our bodies produce less hyaluronic acid, which leads to skin laxity and the formation of some types of facial wrinkles. Fillers restore hyaluronic acid to the underlying skin structure, reversing signs of aging and restoring a smooth, supple appearance. Common hyaluronic acid fillers include: Juvaderm Restylane Restylane Lyft Restylane Silk Voluma Belotero These injectable treatments can be used to smooth away lines around the nose, mouth and jawline. The smooth formulation of Restylane Silk is also appropriate for creating lip fullness and volume and for treating the delicate areas around the eyes. Calcium Hydroxylapatite Calcium hydroxylapatite is a substance also found naturally in the body in the teeth and bones. When used in a dermal filler known as Radiesse, calcium hydroxylapatite is an effective volumizing treatment that can be used on larger areas of the face like the cheeks or jawline. Radiesse offers natural, immediate and long-lasting results. Some patients enjoy their results for 18-24 months before needing a touch-up treatment, versus 4-8 months with most other dermal fillers. Poly-L-lactic Acid Facial collagen is a key factor in the facial again process. Collagen acts as a support structure for your skin. Starting at about age 30 collagen loss begins to occur resulting in decreases in elasticity and moisture. PLLA is the main component of the injectable Sculptra. When injected, PLLA, the main component of Sculptra causes a capsule to form around each microsphere, resulting in increased collagen growth. It is the only volumizer designed to stimulate natural collagen production. This injectable provides the foundation for volume correction with the added benefit of glowing skin as a result of collagen production. Full correction is achieved with 2-4 treatments spaced about a month apart. Fat Transfer While technically not a dermal filler, autologous fat transfer is another way to reverse signs of aging and restore youthful volume to the face with simple injections. This procedure is a two-step process that begins with the removal of deposits of fat from an area like the midsection or thighs. The fat cells are then harvested and prepared for injection in a similar fashion to a dermal filler. The difference is that the patient’s own cells are used to produce the most natural result and the results are permanent for most patients. The Layering Approach While any of these injectable treatments will offer positive results on their own, the results of combining the procedures can be even more dramatic. A plastic surgeon experienced in these injectable fillers will be adept at combining them to get the best possible results. Some of the possibilities include: Layering the same formulation at different depths. This approach can be particularly effective on deeper facial creases like those that form between the nose and corners of the mouth, known as nasolabial folds. This layering approach also works well in areas requiring additional volume, such as the cheeks and under the eyes. By layering the depth of dermal filler injections, we are able to address collagen loss at different levels of the skin structure to produce results that are more dramatic and last a bit longer for some patients. Using more than one filler in a single location. Each filler solution is slightly different in terms of the size of the particles and the smoothness of the formulation, which lends well to the art of using more than one filler in a single treatment area. Using the smoother texture of Restylane to plump the lips and erase fine lipstick lines, while using Perlane to address deeper nasolabial folds, is the perfect example of combining dermal fillers to achieve the best possible results. Using multiple fillers in multiple locations Also known as a “liquid facelift,” this procedure allows us to address multiple concerns in a single treatment session. Common areas addressed in a liquid facelift include the forehead and eye area, cheeks and temples, lower facial creases and the jawline. While smoothing away wrinkles, dermal fillers are also used in this case to restore volume and address mild skin laxity that often forms around the midface and jawline, creating cheek hollows and jowling. In addition to the use of dermal fillers, Dr. Cole often includes injections of a neuromodulator like Botox to smooth away facial lines on the upper face. Because dermal fillers work best on static wrinkles and neuromodulators are most effective on dynamic wrinkles, a combination of injections is often the way to address all of the signs of aging in a single area of the face. Botox is typically injected into facial muscles, while dermal fillers are generally placed directly into the facial crease, further enabling the surgeon to offer both injections in the same treatment area. Injectable treatments are an effective way to accomplish many aesthetic goals, but it is important to remember that the results are temporary. In order to maintain your new look, you will need to come in for touch-up treatments on a regular basis. Since every injectable treatment tends to have a slightly different duration, you may find some of your injections need to be repeated more frequently than others. If you would like to learn more about how injectable treatments can turn back the clock and rejuvenate your look, contact Cole Aesthetic Center, plastic surgery in Seattle, at 360.613.2600.