Published: May 4, 2009
Updated: Jan. 31, 2012
Restylane
Perlane
Juvéderm
Xeomin
Radiesse
Sculptra
Autologous Fat
Preparing for Your Procedure
The Duke Difference
Volume loss in the face is one of the primary causes of facial aging. Replacement of facial volume loss in an artistic manner with injectable fillers -- also known as a liquid or non-surgical face lift -- creates a more youthful appearance with very little downtime. A short office procedure can take years off of your appearance in just a few minutes.
A variety of fillers including Restylane, Perlane, Juvéderm, Radiesse, and Sculptra are most often used.
Restylane was FDA approved in 2003 for the treatment of depressed wrinkles of the face that remain apparent when the face is perfectly still. It is a volume-filler that allows immediate results that can last up to 18 months. Restylane can be applied under the eyes and around the eyes to reduce the appearance of wrinkles.
Restylane is a gel made of hyaluronic acid, a naturally occurring substance in the body that contributes significantly to cell growth and movement. The full term for the substance is NASHS (non-animal stabilized hyaluronic acid).
Restylane is extremely safe. The FDA does not require skin testing for this product, so you can achieve results on your initial visit.
A small amount of bruising and swelling are possible and may take a few days to resolve. One of the best things about Restylane is that any noticeable lumps or bumps can be immediately dissolved one to two weeks after the original procedure should the patient desire.
Just like Restylane, Perlane adds volume and fullness to the skin to correct moderate to severe facial wrinkles and folds, such as the lines from your nose to the corners of your mouth (nasolabial folds).
Like Restylane, Perlane is a clear gel formulation of hyaluronic acid that is specifically formulated to add volume like your body's own hyaluronic acid.
What makes Perlane different is the average size of the particles and the depth of injection. On average, the gel particles in Perlane are larger than those in Restylane, which makes Perlane a good choice for wrinkles that benefit from a deeper injection into the skin.
Juvéderm was introduced as another hyaluronic acid filler in 2006. Juvéderm is a smooth consistency gel made of hyaluronic acid -- a naturally occurring substance in your skin that helps to add volume and hydration.
Many patients enjoy the smooth, natural feel of Juvéderm and like that it comes in two different consistencies -- Juvéderm Ultra is thinner and Juvéderm Ultra Plus is thicker. Your physician will help you decide which is best for your needs.
The results from a Juvéderm treatment are immediate.
A small amount of bruising and swelling are possible and may take a few days to resolve. An excellent quality of Juvéderm is that any noticeable lumps or bumps can be dissolved one to two weeks after the original procedure, should the patient desire.
Radiesse is a dermal-filler made of calcium-based microspheres suspended in a water-based gel that is best for deep facial contouring of the nasolabial folds and cheeks. The makers state that Radiesse stimulates your body to produce your own collagen surrounding the injected area, thus promoting a longer lasting effect.
A small amount of bruising and swelling is possible and may take a few days to resolve.
Sculptra is made of poly-L-lactic acid. It is currently approved for filling deep hollow areas of the cheeks for patients infected with HIV. It does not require a skin pre-test, so you can achieve results on your initial visit. It is used for facial fat loss for many patients with cosmetic concerns that do not have HIV.
Autologous fat injections were mainly used in the past for patients that were allergic to collagen. Now it is used only in cases where patients want large areas of volume replacement.
This is a larger surgical procedure and can be done if you and your physician decide that you are an ideal candidate. Fat injections are not good for fine lines around the mouth because the fat is too thick.
This procedure is done with a sterile surgical field in an operating room, not in an office environment like other injectables.
Before your treatment, we recommend you stop taking aspirin, vitamin E, fish oil, and ginko for one week prior to the procedure with the permission of your physician.
A typical treatment involves a discussion with your doctor about your areas of concern, what you are hoping to achieve through the procedure, and what to expect during the surgery.
Topical and injectable anesthetics may be used to decrease discomfort during the procedure and may take 15-20 minutes to take effect. The injection treatment may take another 15-20 minutes.
Post-procedural care includes the following:
At Duke, there are no nurse injectors. All injections are performed by highly experienced physicians who will leave you with an improved and natural look.
For more information about injectable facial fillers (liquid or non-surgical face lift) at a Duke Eye Center location near you in Raleigh, Durham, or Cary, North Carolina, contact us at 919-681-8555 or info@dukeeye.org.
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