Injectable Fillers Washington DC

As we age, our faces begin to show the effects of gravity, sun exposure and years of facial muscle movement, such as smiling, chewing and squinting. The underlying tissues that keep our skin looking youthful and plumped up begin to break down, often leaving laugh lines, smile lines, crow's feet or facial creases over the areas where this muscle movement occurs. Soft-tissue fillers, most commonly injectable collagen, hyaluronic acid, or fat, can help fill in these lines and creases, temporarily restoring a smoother, more youthful-looking appearance.

If You're Considering Injectables...

When injected beneath the skin, these fillers plump up creased and sunken areas of the face. They can also add fullness to the lips and cheeks. Injectable fillers may be used alone or in conjunction with a resurfacing procedure, such as a laser treatment, or a recontouring procedure, such as a facelift.

What are the different types of fillers?

Hyaluronic Acid (Juvederm, Restylane) is a natural substance found in our bodies. It is well suited to plump thin lips and fill facial creases such as nasolabial folds. It may also be appropriate for some surface wrinkles and concave scars. The results may last 6 months or longer.

Hydroxylapatite (Radiesse) is a mineral-like compound found naturally in human bones, suspended in a gel-like formulation. It is the heaviest of facial fillers and is recommended to fill deeper creases such as nasolabial folds, marionette lines and frown lines, as well as to enhance fullness of the cheeks and other facial contours.

Polylactic Acid (Sculptra Aesthetic) is a material that is a longer lasting filler-it typically lasts about two years and is excellent structural filler. Sculptra Aesthetic is made from a synthetic material called poly-L-lactic acid, which is gradually and naturally absorbed by the body as it works to replace lost collagen. Poly-L-lactic acid has been used safely for decades in dissolvable stitches and as a facial injectable since 1999. It works by replacing lost collagen and is usually injected as a series of three treatments spread out over several months. It is very good for nasolabial folds, marionette lines and flat cheeks. It is a useful adjunct in facial rejuvenation surgery in the petite face.

Human Fat, harvested from your own body, can be re-injected to enhance facial fullness, fill deep creases and to build up shallow contours. Fat injection requires a more extensive procedure than other injectable fillers because it uses minimally invasive liposuction techniques to extract the fat prior to injection. The advantage of fat grafting is that because it is your own tissue, it is biocompatible, has a natural consistency, and is permanent. However, the big disadvantage to fat grafting is that much of the grafted fat may reabsorb. Fat grafting typically requires several treatments to achieve the desired result. In the right patient this may be the best filler. Dr. Baker uses fat grafting frequently in facial cosmetic and reconstructive surgery. In fact, this is an area of expertise for Dr. Baker. He has research grants, patent applications, and ongoing sponsored trials in the subject of fat grafting.

PMMA (polymethylmethacrylate) fillers contain 20% tiny PMMA microspheres suspended in 80% purified collagen gel. An FDA-approved PMMA filler is recommended for the correction of facial wrinkles known as smile lines.

What to Expect from Treatment

The most important fact to remember about injectable fillers is that the results are not permanent. Injected material is eventually metabolized by the body. You should not expect the same long-lasting results that may be gained from cosmetic surgery.

In some individuals, the results may last only a few weeks; in others, the results may be maintained indefinitely. Researchers believe that age, genetic background, skin quality and lifestyle as well as the injected body site may all play a role in the injected material's "staying power." However, the precise reason for the variation of results among patients has yet to be identified.

If you have had short-lived results from fat injections, you should not necessarily assume that other filler injections will work better for you. Conversely, if you have had disappointing results from fillers, do not assume that injected fat is the answer. Although it's true that some individuals' bodies are more receptive to one substance than the other, others may find that neither substance produces long-lasting results. Sometimes one substance may work better than the other for a specific problem.

Risks Related to Injectables

When injectables are administered by a qualified plastic surgeon, complications are infrequent and usually minor in nature. Still, individuals vary greatly in their anatomy, their physical reactions and their healing abilities. The outcome of treatment with injectables is never completely predictable.

Fillers (Hyaluronic Acid, Hydroxyapatite, Polylactic acid): side effects are typically mild or moderate in nature and last for less than 7 days.  Adverse events include redness, pain, firmness, swelling, lumps/bumps, bruising, itching, and discoloration.

Fat: Allergic reaction is not a factor for fat because it's harvested from a patient's own body. However, there is still a small risk of infection and other infrequent complications.

Limitations of Fillers: Fillers are a wonderful method to soften creases and folds in the face. Patients in their thirties to forties are typically excellent candidates for fillers. In these patients, fillers are very effective at alleviating the creases and folds beginning to appear in the face. However, as one ages fillers lose their ability to reduce the facial folds without creating a puffy overfilled look. At this point, treatments consist of removing redundant skin and repositioning deeper facial fat and muscle. As a patient matures to his/her late forties and fifties, it is important to be informed of all the options, not just fillers. As an expert in facial surgery, Dr. Baker will be able to discuss all your options: fillers, minimally invasive surgical procedures, and traditional surgical facial rejuvenation.

Planning for Treatment

Facial rejuvenation is very individualized. That's why it's important to discuss your hopes and expectations with a board-certified plastic surgeon who has experience with many different types of surgical and non-surgical facial procedures.

In your initial consultation, Dr. Baker will evaluate your face - the skin, the muscles and the underlying bone - and discuss your goals for the surgery. Dr. Baker will help you select a treatment option based on your goals and concerns, your anatomy and your lifestyle.

Dr. Baker will ask you about your medical history, drug allergies, and check for conditions that could cause problems, such as active skin infections or non-healed sores from injuries.

Where Your Treatment Will Be Performed

Injectables are usually administered in Dr. Baker 's office-based facility. If, however, you are being hospitalized for a facelift, neck lift, brow lift, or any other procedure, your injections may be administered in the hospital as well.

Types of Anesthesia

Filler: Because the anesthetic agent lidocaine is mixed in with hyaluronic acid, additional anesthetic is usually not used. However, if you are especially sensitive to pain, Dr. Baker may use a topical cream anesthetic or nerve blocks to numb the injected area.

Fat: Both the donor and recipient sites are numbed with local anesthesia. Sedation can be used as well. If you elect to use sedation, be sure to arrange for a ride home after your treatment.

Fillers (Resylane, Juvaderm, Radiesse, Sculptra Aesthetic): Fillers are used primarily to fill wrinkles, lines and scars on the face and sometimes the neck, back and chest. Local anesthesia can be used to control discomfort as the injections are administered. You may be asked to hold a hand mirror during the procedure to help your doctor decide when you've had enough.

After treatment, you may notice some minor discomfort, stinging or throbbing in the injected area. Occasionally some bruising or swelling will occur, but it is usually minor. Redness that appears in the injected site usually disappears within 24 hours. Tiny scabs may also form over the needle-stick areas; these generally heal quickly.

No bandaging is needed and you are free to eat, drink, and wear makeup with SPF protection shortly thereafter. There may be some temporary swelling and redness in the treated area which should dissipate within a few days. If these symptoms persist, contact Dr. Baker.

The duration of your results will vary. In general, the injected material is likely to disappear faster in areas that are more affected by muscle movement. Dr. Baker can help you determine how long you can go between treatments to best maintain your results.

Fat Injection: Fat-injection procedure is also known as autologous fat transplantation or micro-lipoinjection. Fat cells are extracted from the patient's abdomen, thighs, buttocks or elsewhere and re-injected beneath the facial skin. Fat can fill in sunken cheeks or lines between the nose and mouth, correct skin depressions, minimize forehead wrinkles or enhance the lips.

After cleansing and treatment with local anesthesia, fat is withdrawn using a syringe with a large-bore needle or a liposuction cannula. The fat is then prepared and injected into the recipient site with a needle. Sometimes an adhesive bandage is applied over the injection site. Slight overfilling may be necessary to allow for fat re-absorption that occurs. When fat is used to augment the cheeks, this overcorrection may cause the face to appear abnormally full.

While some treatments require a brief recovery period, many patients resume normal activity right away. Expect some swelling, bruising or redness in both the donor and recipient sites. The severity of these symptoms depends upon the size and location of the treated area. Stay out of the sun until redness and bruising subsides - usually about 48 hours. In the meantime, you may use makeup with SPF protection to help conceal your condition. In some cases, swelling and puffiness in the recipient site lasts several weeks, especially if a large area was filled.

Dr. Baker will advise you on how to maintain your results with repeat treatments.

Your New Look

If you're like most patients, you'll be very satisfied with the results of your injectable treatments. You may be surprised at the pleasing results that can be gained from this procedure.