"What are dermal fillers and why do we need them?"

Dermal fillers are materials that we use to replace and augment skin tissue.  The majority of our skin is made up of collagen bundles and a hydrating material between those.  These create the shape and fullness that we see.  But skin tissue can be lost or atrophied because of heredity, sun exposure, muscle action, pressure, sleep positions, smoking, weight loss and just with age.  As this tissue is lost and there is less natural filler underneath, the skin becomes less taut. This can leave wrinkles, folds, depressions, grooves and sagging skin.  Refilling these areas restores normal contours and rejuvenates the area and the face.

Several kinds of dermal fillers have been developed to replace that tissue and different ones are best for different people and areas.  Thomas Steinberg, M.D., Dermatologist and Director of the Advanced Dermatology Center will discuss those with you and then carefully select the best fillers for your needs. We prefer dermal fillers that are natural, long-lasting, and stimulate your own collagen.  And of course we also require that they be very safe. 

The following are real, unretouched photos of some of our patients, showing the improvements achieved by using dermal fillers in various areas...

SMILE LINES
Before	After

UNDEREYE CIRCLES
Before	After

UNDEREYE-CHEEKS
Before	After

LIPS
Before	After

CHEEKS, NASOLABIAL FOLDS, CORNERS OF MOUTH
Before	After (This photo was taken minutes after treatment to illustrate the immediate improvements. Therefore there is still slight redness, which disappears in a few hours)

MARIONETTE LINES
Before	After

HAND TREATED WITH RADIESSE
Before	After

HAND TREATED WITH RADIESSE
Before	After

What areas do you treat with dermal fillers?

These dermal fillers are very versatile when used properly, so we use them to improve and rejuvenate many areas.  Some of the most common are:

• Lips – to plump and define the lips, restore lip borders and keep lipstick from bleeding over
• Cheeks and cheekbones – to round and raise the cheeks, and restore the look of youthful contour and high cheekbones.
• Smile lines (Nasolabial Folds)
• Corners of the mouth – when turned down you can look sad and the right filler corrects that
• Marionette lines - the “parentheses” around the mouth
• Undereye circles which make people look tired
• Depressed scars from acne, trauma, etc. are smoothed
• Hollowing of the cheeks and temples
• Hands - which can otherwise look old.
• Other areas including earlobes, chin, remodeling the nose, etc.

Who are the best candidates for soft tissue enhancement/replacement with dermal fillers?

We treat men and women of all ages and all skin types.  In general people with milder problems need less material to restore and enhance them.  So we recommend that you maintain your skin health with a reasonable regimen and treat early while depressions are less deep.

How is the treatment done?

We inject these dermalfillers just under the skin through a tiny needle to raise those areas that have been depleted and we often use anesthetics to make the procedure more comfortable.  The results are dependant on the technique of the injector so we inject slowly and carefully and that’s why patients come to us.

What should I expect after treatment with dermal fillers?

After we place the dermal filler our patients can see immediate improvement!  That’s why this is such a satisfying procedure both for our patients and for the ADC staff. Generally there will be a little swelling and redness which is usually gone in a few hours and sometimes there can be some bruising (so it’s better to avoid aspirin or anticoagulants before the injections if you are medically able to). If you need to look good immediately for an affair that night we have fillers that rarely cause any swelling or bruising.

Which dermal fillers do you prefer?

We often prefer Radiesse and Restylane.  These are FDA-Approved for cosmetic use and are very safe.  Each is used in particular areas.  We also have other dermal fillers available for particular purposes.  You can find out more about each of these in their separate descriptions.

What results will I get with dermal fillers?

Dermal fillers are a wonderful tool and we now have excellent products, but the results are very dependant on the skill of the injector.  Dr. Steinberg has a vast experience with these treatments.  He knows these treatments are important to you and therefore Dr. Steinberg specifically does all the injections himself.  In our office these are not done by a nurse, physician’s assistant or anyone other than Dr. Steinberg himself.

How long do the results last with dermal fillers?

That varies with the treatment, the filler, the site and the person, and some dermal fillers may last up to one to two years.  Most patients love the results and find them very cost effective and choose to have subsequent treatments after that.  Subsequent treatments generally require less material because of persistence of the original material and because these fillers can actually stimulate you to form more of your own new collagen. 

Dermal fillers alone can make a tremendous difference in the appearance of folds and wrinkles, but in addition we often combine these with other procedures and treatments.  And we suggest that you follow our Aesthetic Improvement & Maintenance System to help maintain your result and improvement.

Information about specific Dermal Fillers we prefer:

Restylane® and Perlane

Restylane and Perlane are treatments we use to smooth wrinkles, enhance lips and shape facial contours.  These are clear, synthetic gels made of hyaluronic acid (HA). HA is a molecule that occurs naturally throughout the body and is the substance that holds moisture in your skin. HA is the natural component of your skin that gives it fullness and body. 

Radiesse

(Click here to download the Radiesse product brochure in Adobe PDF format.)

This is a long-lasting dermal filler made of calcium hydoxylapatite which is found naturally in your body.  It has been approved by the FDA for use as a cosmetic filler but was used for many years before that for non-cosmetic uses. It is commonly used for the nasolabial folds, marionette lines, chin, and mental crease.  We also use it to enhance the cheekbones and do all these to give you a more youthful appearance.  This provides an immediate and very long-lasting correction in these areas and stimulates your body to form new collagen.  We have been very pleased with the dramatic results and our patients have been very happy with their improvement.