Dermal Fillers

Do you feel that your face looks sunken and tired? Do you want to restore the soft, smooth appearance of your eyes and face? We can help!

One of the main signs of aging is the loss of volume in areas of the face and around the eyes as the fat, muscle, bone, and skin of the face starts to shrink or thin. The eyes in particular can be affected significantly by this loss of volume as the eyelids lose their fullness. This can create a hollow, sunken appearance with loose upper eyelid skin or dark circles under the eyes. Loss of volume in the cheeks and the area around the nose, mouth, lips, and chin – and the folds, fine lines, and wrinkles that result – can exacerbate the situation and create an overall tired, aged look.

Dermal fillers can be used to restore this lost volume and rejuvenate the face.

What Are Dermal Fillers?

Facial dermal fillers are materials injected under the skin to plump up areas of the face that have lost normal underlying tissue structure. Different than BOTOX®, which reduces wrinkles by weakening the facial muscles that create them, dermal fillers fill in lines or hollowed-out areas to create a smooth appearance. Areas of the face that are commonly treated with dermal fillers include the circles under the eyes, the cheeks, the lines between the lips and cheeks (also known as the nasolabial folds or parentheses lines), and the temples.

The most commonly used fillers are made with hyaluronic acid (HA). Hyaluronic acid is a naturally occurring substance found throughout the body. Its highest concentrations are in the skin, eyes, and joints although the levels decrease with age. In the skin, HA attracts water and enables the skin to become more hydrated. It is this hydrating action that enables injectable HA to add volume and fill in lines and smooth wrinkles. The effects of HA-based dermal fillers are seen immediately and are fully reversible using an injectable enzyme that breaks down the product. Additional dermal filler options include calcium hydroxyapatite (Radiesse®), a long-acting filler that helps stimulate the body to create new collagen for long term improvement.

JUVÉDERM®, Restylane®, and Radiesse® at the Dean McGee Eye Institute

There are a number of facial dermal fillers available, each with different properties. The oculoplastic surgeons at the Dean McGee Eye Institute (DMEI) take full advantage of these different products to provide you with an individualized plan for facial enhancement.

Dermal fillers available at DMEI include:

• JUVÉDERM ® Ultra XC – A colorless, HA gel injected into facial tissue to smooth moderate to severe wrinkles, especially around the nose and mouth. It can also be injected directly into and around the lips for lip enhancement. It contains a small amount of lidocaine to improve the comfort of the injection. Most patients only need one treatment to achieve optimal results, with results lasting nine months to one year.
• JUVÉDERM ® Ultra Plus XC – A thicker HA gel with lidocaine, it has the ability to lift those more deeply embedded folds and wrinkles of the face, especially around the nose and mouth. Optimal results are usually obtained with one treatment and last about one year.
• JUVÉDERM VOLLURE™ XC – An HA gel with lidocaine injected with an ultrafine needle into the tissue where folds and wrinkles occur, such as the parentheses lines between the nose and mouth. Manufactured using VYCROSS® technology to create a specialized smooth gel filler, it provides a softer, more subtle, long-lasting result for up to 18 months.
• JUVÉDERM VOLUMA® XC – The first FDA-approved injectable HA gel for the correction of age-related volume loss in the cheek area for adults over the age of 21. It is injected into the cheek area to lift the skin and create a smoother contour. The product contains lidocaine to make the injection more comfortable. Manufactured using VYCROSS® technology, the specialized gel provides long-lasting results for up to two years for most patients.
• JUVÉDERM VOLBELLA® XC – A crystal-clear HA gel with lidocaine that is used to temporarily improve lip fullness and to smooth the appearance of lines around the mouth. The gel is injected using an ultrafine needle and contains lidocaine to improve injection comfort. Results typically last one year.
• Restylane® – A clear gel formulation of HA that visibly corrects facial lines and wrinkles, including parentheses lines from your nose to your mouth and marionette lines from the corner of your mouth toward your chin. It is also FDA-approved to give lips fullness and definition in patients over the age of 21. Effects usually last six months but retreatments at 4 ½ or 9 months after your first treatment can extend results for up to 18 months.
• Restylane® Lyft – A firm HA gel designed for more pronounced facial folds and volume restoration in the cheek and midface area. Results last for six to nine months.
• Restylane® Refyne – A next-generation HA dermal filler designed with XpresHAn Technology™ to help smooth out laugh lines around the mouth (parentheses and marionette lines) and restore a soft, natural look. Effects are shown to last up to one year.
• Restylane® Defyne – A next-generation HA dermal filler crafted with XpresHAn Technology™ that uses innovative cross-linking technology to help smooth out deep laugh lines around the mouth (parentheses and marionette lines) and create a look that is soft and natural. Results last for up to one year.
• RADIESSE® – a facial dermal filler comprised of microspheres of calcium hydroxyapatite suspended in an aqueous gel carrier. It stimulates the body to produce collagen, the main structural protein in your skin responsible for its firmness and youthful appearance. Designed to smooth moderate to severe facial wrinkles and folds, it provides immediate volume upon injection but achieves long-lasting effects by stimulating the production of your own natural collagen. Results for most patients last up to one year.

The oculoplastic surgeons at the Dean McGee Eye Institute can provide a thorough evaluation of your facial cosmetic needs and discuss which dermal fillers are best for you. In addition, if beneficial, dermal fillers can be used in conjunction with other cosmetic procedures such as:

• BOTOX®
• Laser Skin Resurfacing
• BBL Skin Therapy
• Eyelid Surgery
• Brow Lifts
• Revisional/Corrective Surgery

Dermal Filler Treatment Process

Facial dermal filler injections are administered in clinic and take just a few minutes. Depending on the patient and the product being used, a topical numbing cream may be applied to the injection area. Gentle massage may be applied to the area after injection to ensure even distribution of the product and reduce discomfort. Results are visible immediately after the injection.

What Are the Side Effects of Dermal Fillers?

Recovery after dermal filler treatment is usually painless, although there may be some swelling or bruising of the injection area that generally fades within a few days. However, it is important that you have a qualified medical professional give you your filler injections because they can have serious long-term side effects. The oculoplastic surgeons at DMEI understand the risks and have the specialized knowledge and skill to address them appropriately. Your physician can discuss the risks with you.

However, you should know that if there is a problem or you do not like the results, HA dermal fillers can be instantly reversed with an injection of hyaluronidase, which dissolves the filler.