The technology of dermal fillers has advanced tremendously over the past several years. The current set of fillers provide predictable results, are longer-lasting, and in many cases, can be dissolved. When performed carefully and conservatively, modern fillers provide excellent alternatives or complements to surgery in changing the appearance of your face in very natural ways.
All fillers utilized by Dr. Mehta and Shannon, our Aesthetic Nurse, are comfortably injected in the office. We will begin by applying topical numbing cream and ice. For most areas, this combination allows for the filler to be injected very comfortably. In addition, all of our fillers also contain lidocaine, which provides numbness of the area while the filler is being injected.
Hyaluronic Acid (HA) Fillers
At Mehta Plastic Surgery, we commonly inject hyaluronic acid fillers, such as Restylane, Restylane Lyft, Restylane Refyne, Restylane Defyne, Juvederm Ultra, Juvederm Ultra Plus, Vollure, and Voluma. Each different filler is best suited for specific areas of the face, so Dr. Mehta and Shannon can let you know which is most appropriate for your unique face as well as your desired treatment area. These fillers have the appearance of a clear gel, allowing the placement of the thinner hyaluronic acid (HA) fillers to be placed in areas with thin skin, such as under the eyes (tear troughs). The other advantage of these products is that they are easily dissolvable with the injection of hyaluronidase. Many of these HA fillers are also wonderful options for nonsurgical rhinoplasty, also known as a liquid rhinoplasty. Dr. Mehta is very talented and experienced at using these fillers to reshape the nose.
Each filler is best suited for specific areas of the face. Listed below are the areas where each specific type of HA filler is most commonly injected.
Restylane: Tear troughs, nasolabial folds, corners of the mouth, acne scars, nose (nonsurgical rhinoplasty)
Restylane Lyft: Cheeks, jawline, nose (nonsurgical rhinoplasty), chin, pre-jowls, hands, nasolabial folds
Restylane Refyne: Lips, around mouth, nasolabial folds
Restylane Defyne: Deeper wrinkles of the face, cheeks, nasolabial folds
Juverderm Vollure: Lips, nasolabial folds, marionettes
Juvederm Voluma: Cheeks, chin, jawline, temples, nose (nonsurgical rhinoplasty)
Juvederm Ultra: Lips, cheeks, nasolabial folds, lines around mouth, earlobes
Juvederm Ultra Plus: Cheeks, temples
In general, a thicker filler like Radiesse is used to fill deeper lines and provide volume to various areas of the face. Radiesse also may be more economical for large volume augmentation, such as the cheeks, temples, and jawline, as it comes in a 1.5 mL syringe. Radiesse is comprised of calcium hydroxylapatite, so it is a different class than the HA fillers. We find it most useful for the temples, cheeks, nasolabial folds, pre-jowls, chin, and the hands.
Sculptra is unique among the fillers we offer at MPS, as it is a semi-permanent filler. Comprised of Poly-L-lactic Acid, Sculptra works by stimulating your body to create natural collagen. This product arrives at our office as a white powder, which we mix with sterile water and lidocaine a few days in advance of your treatment. It then has the consistency and appearance of skim milk, remaining refrigerated until injection. Because of the collagen stimulation, there results develop slowly over a few weeks to a few months. Once apparent, we expect the results to last 3-5 years or more! Some patient return in 1-2 years for a touchup/maintenance vial, depending on their volume preferences. A general rule of thumb is that patients require one vial per decade of life for the initial package (i.e. a patient in her 40’s likely needs four vials to provide complete correction. This, of course, varies, depending on a patient’s unique anatomy. In a single session, one or two vials are typically injected.
The commonly corrected areas include the temples, upper and lower cheeks, nasolabial folds, chin, jawline, marionette lines, and pre-jowls. Sculptra can also be injected into acne scars and the decolletage. Additionally, Sculptra is FDA-approved for the treatment of HIV-associated lipodystrophy (lipoatrophy), as it is an excellent option for treating the loss of upper and lower cheek volume related to this condition.
The injection of Sculptra begins with the application of numbing cream and ice. Dr. Mehta then marks the treatment areas with a white pencil, cleans the skin with a surgical prep, and injects small drops of local anesthetic at the planned entry points. The anesthetic reduces bleeding and bruising while also making the treatment more comfortable. The Sculptra is then injected into the desired treatment areas, slowly and carefully, ensuring placement at the correct depth and locations. The injections generally take around 10 minutes for the full face. Afterward, Dr. Mehta or Shannon will massage the treatment areas to make sure that the product is smooth, without any bumps or lumps. Ice is again placed on the face, to reduce the chance of bruising. The face should be massaged for five minutes, five times a day, for five days, again to make sure the results are smooth. We generally see you back in four to seven weeks for the next treatment session, if needed.
The decision of which dermal fillers to use is a complex one, which Dr. Mehta will make with you, after a thorough discussion of your areas of concern and desired effects. As a careful and gentle injector with a trained aesthetic eye, Dr. Mehta has thousands of satisfied patients who have loved their results. Because he is both a skilled injector as well as a surgeon, Dr. Mehta can advise you regarding the benefits and limitations of injectable products while also considering surgical alternatives or complementary procedures.
After a consultation and treatment, individuals can typically see results immediately. There may be some swelling but most people are considered socially presentable immediately following fillers. Occasionally a bruise may occur, which is easily covered with makeup. We advise that you refrain from exercise the remainder of the day following filler injections to help minimize swelling. Reduction of salt and avoidance of alcohol are also advisable on the day of treatment.
If you have any additional questions or would like to schedule a consultation, please feel free to get in touch with us.