Injectable wrinkle fillers can improve your appearance and give a more youthful look without undergoing major surgery. These fillers can replace volume loss and act as volumizers (cheeks, temples, hands, lips), or can be used more superficially to fill bothersome wrinkles or creases. A consultation with your dermatologist will help determine what location should be treated for maximal improvement, and what type of filler will be used.

Hyaluronic acid fillers (HA):
◦ Most popular type of filler.
◦ HA is naturally occurring in our skin, cartilage and joints.
◦ Used most commonly for nasolabial folds (between the nose and mouth), marionette lines, small chin lines, perioral rhytides (‘smoking’ or ‘kissing’ lines), undereyes, cheeks.
◦ Examples of HA fillers:
◦ Belotero balance.
◦ Juvederm Ultra, Juvederm Ultra Plus, Juvederm Voluma.
◦ Restylane, Restylane Silk, Restylane Lyft.
◦ Acts like a cushion to support the facial structures that have lost volume due to normal aging.

Calcium Hydroxylapatite:
◦ Naturally found in human bones and contains minerals.
◦ Used commonly to replace deep volume in the cheeks.
◦ Lifts the face upwards and outwards.
◦ Used in the hands to replenish volume loss and give more youthful appearance.
◦ Example of a calcium hydroxylapatite filler: Radiesse.

How to prepare for your filler appointment:
◦ If possible, avoid taking blood thinners one week prior to your appointment; these can cause increased bleeding or bruising (Aspirin, Motrin, Advil, Aleve, Ibuprofen, Gingko biloba, vitamin E, fish oil).
◦ DO NOT stop any medications that are medically necessary or prescribed by a physician without that physician’s approval.
◦ It is okay to take Tylenol.
◦ Eating leafy greens can reduce the risk of bruising and swelling.
◦ Arnica supplements (topically or orally) can reduce bruising and swelling; the oral supplements can be started the day prior to the procedure and continued until the bruising is resolved.

What to expect at your filler appointment:
◦ A topical numbing cream may be applied to the area upon arrival if you arrive 15-20 minutes early.
◦ The doctor will evaluate your skin, go over the treatment plan again and will take pre-treatment photos.
◦ Your doctor may recommend icing the area before and after the treatment to reduce bruising and swelling.
◦ You may see immediate improvement in the treated area, but the effect will ‘settle’ over the following 3-7 days.

After care:
◦ Apply cool packs to the area to reduce bruising and swelling a few times in the hours after the procedure.
◦ Sleep with your head elevated on a few pillows for 1-2 nights to prevent any swelling from moving into the eye area.
◦ Apply topical arnica gel/cream to any bruises, or take arnica supplements until the bruising resolves.

Possible complications of fillers:
◦ Bruising (can last up to 1-2 weeks).
◦ Swelling (most common for 2-3 days).
◦ Tenderness.
◦ Allergic reaction to the product (very rare).
◦ Tiny bumps under the skin.
◦ Bluish appearance under the skin called the Tyndall effect (HA fillers); it can last months or the material can be removed.
◦ Granuloma formation (Poly-L Lactic Acid fillers).

 cosmetic fillers berofe1  cosmetic fillers after1
 cosmetic fillers berofe2  cosmetic fillers after2