What are soft tissue fillers?
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These are injectable materials used to fill in the wrinkles, improve the folds, and restore fullness in areas of the face that have lost volume over time. They are also used to enhance the lips.
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They fall into three categories: Collagens, Hyaluronic acids, and Synthetic injectables.
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Nearly all currently available and FDA approved soft tissue fillers are temporary in nature. They must be repeatedly injected into the tissues to maintain their effect.
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The length of time they remain in the soft tissues varies with the characteristics of the filler itself and the patient’s unique response to the filler.
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Most patients who seek treatment with soft tissue fillers often wonder why the FDA has not readily approved permanent soft tissue filler. It is important to understand that any filler used in the facial tissues may shift over time. This occurs due to the constant facial movements such as speaking, smiling, chewing, grimacing, etc.
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If a permanent injectable facial filler is used and shifts over time, it could potentially result in a significant permanent deformity.
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Although the concept of permanent correction of soft tissues may seem very attractive, it is important to remember that our specific facial features are not permanent. With the passage of time and aging, our facial features undergo significant change. As such, a soft tissue filler that may have appeared perfectly placed at one point in life may be very misplaced as the soft tissues around it shift due to the natural forces of aging.
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Extreme caution must be exercised when considering treatment with any product or procedure that is not FDA approved. Our FDA has strict guidelines to ensure the proper use of various therapeutic modalities. Improper or unapproved use may lead to significant complications. Patients must be very judicious in the treatment modalities they seek and the physicians they seek to perform them.
How are soft tissue fillers placed in the tissues?
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These are injections performed using very tiny needles in an office setting with the patient fully awake.
What can I expect after
the soft tissue filler injection?
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There is minimal recovery following these injections.
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Make-up may be worn shortly after the treatment.
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Very mild redness and swelling may occur for the first few hours after the injection.
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If patients have a tendency to bruise, ice is helpful.
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Patients undergoing any kind of injection procedures should try to abstain from products that increase bleeding since this will increase their tendency to bruise. See Products to Avoid Prior to Cosmetic Procedures.
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If there is slight bleeding at the site of the injection, simple applied pressure will alleviate this.
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Some individuals may develop “bumpy areas” where fillers have been injected. This may be a result of:
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Filler being injected too superficially
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Too much filler being placed in one area
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Migration of the filler to one region
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This is especially true of areas such as the lips and nasolabial folds
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Inflammatory reaction the patient has to the injection
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Massage is helpful to soften these areas.
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Active inflammatory skin reactions such as herpetic blisters, rashes, pimples, cysts or hives necessitate postponing the injection of fillers into the affected area until the condition has resolved.
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Patients with a strong history of herpetic blisters should undergo suppressive treatment with anti-herpetic treatment prior to undergoing filler injections in the lips or adjacent areas.
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Patients with connective tissue disorders may have increased susceptibility to hypersensitivity reactions.
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Women who are pregnant, attempting to become pregnant or nursing should avoid soft tissue fillers since its safety during these conditions has not been established.
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Collagen is a substance that naturally occurs in our skin. It is part of the supporting structure of our skin. Over time, from smiling, frowning, and talking, it breaks down thereby creating wrinkles, lines and creases. The timing of this process is influenced by age, genetics and lifestyle.
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Two major types of collagen replacement therapy are available to patients in the United States. These include bovine collagen (Zyderm I, Zyderm II, and Zyplast) and human collagen (Cosmoderm I, Cosmoderm II, and Cosmoplast).
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Treatment with these products lasts approximately 3 months.
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Hyaluronic acid is a natural complex sugar found throughout all living organisms
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It retains water—absorbing more than 1000 times its weight—and adds volume to the skin’s surface.
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It also binds with collagen and elastin and transports essential nutrients to these fibers.
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The combination of collagen, elastin, and hyaluronic acid provides structure, elasticity, and volume to the skin and contributes to its overall appearance.
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As the skin ages and is exposed to environmental pollutants and ultraviolet rays, the cells lose the ability to produce hyaluronic acid. As a result, the skin begins to lose volume, resulting in the formation of facial wrinkles and folds.
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Dermal fillers compromised of hyaluronic acid are used to temporarily replace lost hyaluronic acid and to restore skin volume and a smooth, natural appearance.
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The currently available Hyaluronic Acids include:
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Restylane
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Hylaform
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Hylaform Plus
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Captique
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Juvederm
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These are materials not normally found in our skin but have been created as an injectable product thought to enhance the tissues.
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The currently FDA approved synthetic fillers include: Radiesse, Sculptra and Artifill