Injectable Fillers

Adults wishing to add volume and soften facial wrinkles (especially on the lower half of the face) may benefit from injectable cosmetic fillers. It must be emphasized that this procedure does not “erase” wrinkles, but rather smoothes out contours for a more youthful appearance.

There are a wide array of available injectable fillers. Hyaluronic acid fillers offer an improvement in safety, quality, and duration of results over previous methods which utilized fat and collagen.  Hyaluronic acid is a substance found naturally in our bodies that provides volume and fullness to the skin.   We offer Juvederm^® Ultra XC, Juvederm^® Ultra Plus XC, and Juvederm^® Voluma which are variations of hyaluronic acid.  Juvederm^® Ultra XC is intended for shallow wrinkles, and Juvederm^® Ultra Plus XC is optimal for deeper furrows.   Juvederm^® Voluma is intended for adding volume to your cheek area to correct age-related volume loss.

The results of these injections can be seen almost immediately following treatment. Sometimes despite the provider’s good faith estimation of the necessary amount of filler to achieve a given cosmetic result, injection of requested amount of filler does not result in complete correction.  In these cases the patient may decide to purchase additional filler to attempt to achieve desired results (incurring additional cost).

Patients with a strong tendency to bruise may choose to avoid injectable fillers. Patients with active cold sores should wait until these resolve before the procedure.   Additionally, patients with a known allergy to bacterial proteins are not candidates for this treatment.    Patients who are pregnant, attempting to become pregnant, or nursing should avoid these injections.

While most patients tolerate the procedure very well, there is often mild discomfort associated with the injections and sometimes bruising and/or swelling.  Bruising may take up to 2 weeks to subside.  Other less common side effects include infection of an injection site, bluish discoloration over an injection site, beading of injected material, and very rarely scarring, ulceration, embolus, or an allergic reaction.

Multiple treatments may be necessary to achieve desired results. Treatments generally last for up to 6 months or longer. Touch up treatments may be necessary to maintain desired results.  No guarantee, warranty, or assurances can be made  since clinical results will vary per patient.

• If you are taking over the counter agents than can increase bruising such as Advil (ibuprofen), Aleve (naproxen), aspirin, or vitamin E, please ask your primary care doctor about stopping these one week before the procedure if possible to minimize the risk of bruising. If these medications are medically necessary, we ask that you do not stop using them.    Please do not stop your Coumadin or Plavix.  Do not stop aspirin without consulting with your primary care doctor.
• Optional: You may purchase LMX 5% cream at the pharmacy (non-prescription) and apply to areas that will be treated 30 minutes before the procedure in order to minimize injection discomfort.
• Please do not wear make-up at the time of the appointment (or be prepared to wash it off before the procedure).

There is anesthetic mixed with the Juvederm material, so extra anesthesia is often unnecessary (see above for optional use of topical LMX 5%). The doctor will inject Juvederm with a small needle.  There will be some minor discomfort during the injection, but it is tolerable.   The entire Juvederm procedure typically takes 20-30 minutes.

If you stopped a blood thinning medicine, you may resume 24 hours after the procedure. If you feel lumps of materials in the injected areas, gently massage these.  You will likely have minor swelling of treated areas for 24-48 hours which can be managed with cold compresses.  Do not fly in an airplane or do vigorous exercise for 24 hours after procedure to avoid bruising.  Please contact the office if you develop new bumps, pain, or redness one or more days after the procedure.