Dermal Fillers

 

dermal fillers for cheeks

Before and after fillers for nasolabial folds (from nose to corner of mouth) and labiomental folds (from corner of mouth down to chin)*

permanent dermal fillers

 

dermal fillers lip

Before and after filler in upper and lower lips*

dermal fillers for lips

 

dermal fillers under eyes

Before and After fillers for under her eyes (tear troughs)*

dermal fillers for eyes

 

best dermal fillers

Before and immediately after filler in pout lines*

facial dermal fillers

 

dermal fillers for hands

Radiesse used to fill the back of the hands*

best dermal filler for hands

 

best dermal filler for lips

Before and immediately After dermal fillers for upper and lower lips and labiomental lines (from corner of mouth to chin)*

dermal fillers lips

 

lip dermal fillers

Her primary concern was her upper lip lines ("smokers lines"), but she also wanted a slight augmentation*

dermal fillers for lips before and after

 

dermal fillers for frown lines

Before and After dermal fillers for nasolabial and labiomental lines*

dermal fillers for smile lines

 

dermal fillers forehead

This is a combination of fillers and Botox (she is not frowning in either photo)*

dermal fillers for forehead

 

*Results may vary.

Questions and Answers

 

What are dermal fillers?

Dermal fillers are substances that are injected to "fill" any area of skin that needs it. They are used to fill wrinkles, lines, folds, and scars (eg. acne scars). They are also commonly used to give a fuller appearance to the lips.

One of the main features of the aging face is volume loss. We lose fat, muscle, and even bone as we age. This shows as folds and grooves. Filling these folds is a huge step toward restoring a youthful appearance.*

*Results may vary.

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What kinds of fillers are used?

Today, there are many different fillers to chose from. We offer three kinds: hyaluronic acid (Juvederm), calcium-based (Radiesse), and Sculptra (Sculptra is so different that it deserves its own page). For facial filling, we most commonly use Juvederm. Radiesse is used most commonly to fill the backs of hands.

Hyaluronic acid (Juvederm, Restylane, Teosyal, Revanesse and others): The most common fillers used today are made of synthetic hyaluronic acid. Hyaluronic acid occurs naturally in the human body. In fact, it is the most ubiquitous substance in nature, being present in almost every multicellular organism on the planet.You may see the term NASHA, which stands for Non-Animal Stabilized Hyaluronic Acid. Early hyaluronic acid products were extracted from rooster combs. The hyaluronic acid products we use today are genetic copies of human hyaluronic acid produced synthetically. The only difference between this manufactured hyaluronic acid and your own is its stability. Human hyaluronic acid is very unstable. In unmodified form, it wouldn't last anywhere near long enough to be used as a filler. So synthetic hyaluronic acid undergoes a process known as cross-linking to thicken and stabilize it. Generally, the more links, the thicker it gets and the longer it lasts.

After trying several hyaluronic acid products over the years, we have settled on the Juvederm family. We offer threel products from the Juvederm line: Volbella, Volift, and Voluma. Voluma is the thickest of all these hyaluronic acid products. It gives the longest duration of effect, averaging about 18 months.* Volbella is specifically designed for lip augmentation. 

*Results may vary.

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What areas can be treated?

Any skin can be treated, but the most common areas treated are nasolabial folds (from the nose to the corners of the mouth), labiomental folds (from the corners of the mouth down to the chin), upper cheeks (cheek apples), prejowl sulcus (the indentation that forms in front of jowls), upper lip (smoker's) lines, the glabellum (between the eyebrows), and crowsfeet.

It is also used for lip augmentation and to fill depressed scars.

The backs of hands are injected to disguise prominent veins and tendons.

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Who is a good candidate for dermal fillers?

Almost everyone from 20 (lip augmentation) to 80 (volume loss) could benefit from dermal fillers. Most patients are in their 40s, 50s, and 60s. 

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How are treatments done?

Two techiques are used.

For deeper volumizing treatments a cannula is often used. Cannulas look like needles, but they have blunt tips. A cannula is inserted through a single needle poke on each side, most commonly placed beside the mouth. The cannula can then be moved under the skin to fill most of the face (cheeks, nasolabial folds*, labiomental folds*, prejowl sulcus*). Cannulas offer huge advantages over standard needles because only a few needle holes need to be created to treat the entire face. This means less discomfort. As cannulas are advanced they push tissue aside rather than cutting as needles do. This significantly reduces the chances of bruising and damage to blood vessels and nerves.

The other technique is to use standard needles. They are most commonly used to fill lines where injections need to be placed very superficially with great precision.

The amount used depends on the area being treated. In most cases, this is 0.5 to 2.0ml. Up to 8ml can be used in one session, but this is less common.

* Nasolabial folds go from the nose down to the corner of the mouth. Labiomental folds go from the corner of the mouth down to the chin. The prejowl sulcus is the indentation that forms in front of jowls. 

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Do dermal filler treatments hurt?

There is no simple answer to this question, because pain response and tolerance is different from person to person. The degree of discomfort also varies from area to area and the depth of treatment.

When cannulas are used (see previous question), pain is minimal. 

When needles are used, we recommend the use of topical anesthetic creams.

Dental blocks (injections of local anesthetic) can be done when we do lip augmentation. This freezes the nerves that feed the entire area and eliminates pain. But the discomfort of administering the dental block is usually not worth it. 

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How long do treatments take?

Most procedures take about half an hour.

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When are the results seen, and how long do dermal fillers last?

Beneficial effects of dermal fillers can be seen immediately following the first treatment.

Dermal fillers do not provide permanent improvement. The duration of benefit depends on the substance used, the area injected, and the person injected. Results vary from person to person and even treatment to treatment in the same person.

Typically results of hyaluronic acid fillers last from 9 to 18 months.

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What are the side effects of dermal fillers?

There are very few side effects to dermal fillers.

Bruising can occur.

Mild swelling and redness often occur. It usually resolves in a few hours, but it can persist for up to two weeks.

On rare occasions redness, tenderness, and swelling develops a few weeks after treatment.

Granulomas can form. These are inflammatory lumps under the skin that can last for months. They are rare.

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What are the alternatives to dermal fillers?

There are several treatment options that can improve your skin, depending on the nature of the problem, including peels of varying strengths, laser skin resurfacing, and surgical facelifts. You should also stop smoking, start using cosmeceuticals regularly, and wear sunscreen!

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How much do fillers cost?

It's only natural to want to know about price. But before you ask this question, you should ask about the expertise of the injector. You aren't buying a bag of flour. You are purchasing a service. If you only want to know price so you can compare it to other clinics, you're asking the wrong question. You should be asking about the experience of the injector. At York Vein and Laser Clinic, all fillers are done by Dr. Kritzinger. He has been injecting fillers since 2002, and he is the #1 provider of Juvederm in the area.

Now back to price. There is no easy answer to this. It depends on the type of filler used and the number of syringes per session. There are 3 products in the Juvederm line ranging from $450 to over $700 per syringe. In each session, each syringe is a different price. The first syringe is full price. The second syringe is discounted 20%, third 30%, fourth 40%, and fifth and subsequent syringes 50%. This is a very fair and competitive pricing system.

The only way to give you a good estimate of cost is to see you in consultation so the type of product and number of syringes can be estimated. 

What is your cancellation policy?

We require 48 hours notice for cancellation of your consultation or treatment, in order to fill the appointment time. If sufficient notice is not given, the full value of the treatment to be done may be charged with the minimum amount being $100.

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