What is a dermal filler?
Dermal filler treatments have become one of the most commonly performed cosmetic procedures in the US, second to BOTOX treatments. They are primarily indicated for the treatment of facial wrinkles and folds and facial sculpting and contouring to minimize the appearance of lines on the lower two-thirds of the face.
Dermal fillers used at Embrace are composed of hyaluronic acid (a naturally occurring sugar in the body) which adds volume and fullness to the skin. The injections are clear, colorless gels that also contain lidocaine to minimize discomfort during injection.
The role of hyaluronic acid in the skin is to deliver nutrients, hydrate the skin by holding in water, and to act as a cushioning agent.
What areas of the face are dermal fillers used for?
In the lower two thirds of the face volume loss and laxity are more evident and dermal fillers are most commonly used in this region. Treatment areas typically include:
Nasolabial folds (the creases alongside the nose)
Marionette lines (frown lines on the sides of the chin)
Lip lines (fine lines surrounding the lips)
Lip thinning (lip border and body)
What dermal fillers are offered at Embrace?
At this time the following dermal fillers are offered:
Juvederm Ultra XC (nasolabial folds, marionette lines, lip augmentation; softer tissue filling effect)
Juvederm Ultra Plus XC (lip augmentation, perioral lip lines; firmer tissue filling effect)
*Based on client needs, new products such as Juvederm Volbella XC (lips), Kybella (for neck lines) and Voluma (for cheek enhancement) may be offered in the near future.
How long do the results last?
The duration of results is dependent upon several factors including the type of product and volume used, the patient’s metabolism, degree of motion in the treatment area due to facial expressivity.
Subsequent injection in the treatment area to maintain results is recommended when the volume of dermal filler product visibly diminishes but is still felt, before the area returns to its pretreatment appearance.
Juvederm Ultra XC (6-12 months)
Juvederm Ultra Plus XC (6-12 months)
How much do the dermal fillers cost?
Juvederm Ultra XC = 1 syringe = $550
Juvederm Ultra Plus XC = 1 syringe = $550
When will I notice a result from the treatment?
The results are immediately visible. The provider may suggest taking before and after photos for you to compare the treatment effectiveness.
Which product will I need and how much of it?
This varies depending on the amount of wrinkles or lines, skin type, gender, age, previous treatments, skin laxity, volume loss, etc. Following a complimentary consultation, the nurse practitioner will provide her recommendation on how much of which product you may need to reach the desired effect.
On average, these amounts are typically required per treatment area:
Nasolabial folds (1-2 syringes)
Marionette lines (1-2 syringes)
Lip enhancement or perioral lines (1-2 syringes)
What will the consultation entail?
The nurse practitioner will sit down with you and review your past medical history, medication use, surgical history, family history, past cosmetic procedures, allergies, and perform a focused skin exam to determine the most appropriate treatment for you and if you are an eligible candidate for dermal fillers.
How long will the visit take?
The complimentary consultation will take approximately 15 minutes, and if you decide to have “same-day treatment” the procedure may add up to an additional 30 minutes to your appointment. The procedure itself generally takes 15 minutes and is referred to by some as a “lunch-time” procedure. The topical numbing cream will need to sit on the skin for about 10 minutes prior to beginning the procedure.
Does the treatment hurt?
Dermal fillers are administered with a tiny needle injected under the skin and the depth for injections can vary depending on the treatment area. All products contain a numbing agent called lidocaine to help minimize discomfort prior to treatment (products without lidocaine can be specialty ordered for those with an allergy). There are typically numerous injection sites per treatment area. The nurse practitioner may also apply a topical numbing cream pretreatment.
Will I look overdone or “plastic”, “frozen”, “fake”?
Dermal fillers will soften lines and wrinkles as opposed to erasing them. Subtle improvements in contours can be achieved but fillers do not offer surgery-like results. Facial expression will still be evident and you will have a natural look.
What are absolute contraindications to dermal filler use (who is not a candidate)?
< 21 years old
> 65 years old
Hypersensitivity or severe allergies to latex or xylocaine products (including but not limited to: xylocaine, novacaine, zylocaine, benzocaine, prilocaine, or tetrocaine)
Active inflammation or infection at treatment area (cysts, acne, pimples, rashes, hives, cellulitis)
Scarring in the treatment area
Recent chemical peel or microdermabrasion (skin not healed completely)
Psoriasis or eczema in the treatment area
Use of blood thinners such as Coumadin, Warfarin, Lovenox, Plavix
Unrealistic expectations (some patients may just need surgical correction)
Please note this is not an all-inclusive list, your provider will determine if you are an eligible candidate following a detailed complimentary consultation
What are the potential risks and complications from Dermal filler treatments?
The most common side effects include tenderness, swelling, firmness, lumps/ bumps, bruising, pain, redness, discoloration, and itching.
Most side effects are mild or moderate and last 14 days or less.
If bruising is evident, it can be concealed with makeup. Specific colors can counter bruises at different stages: peach minimizes blue and lilac minimizes yellow discoloration.
One of the risks with using this product is unintentional injection into a blood vessel, and while rare, the complications can be serious and may be permanent. These complications, which have been reported for facial injections, can include vision abnormalities, blindness, stroke, temporary scabs, or permanent scarring.
As with any injection, this procedure carries the risk of infection. The syringe is sterile and standard precautions associated with injectable materials will be taken.
Some patients may experience additional swelling and tenderness at the injection site and on rare occasions, pustules may form. These reactions might last for as long as two weeks, and in appropriate cases, may need to be treated with oral corticosteroids or other therapies.
This is not an all-inclusive list of risks, please review Important Safety Information on BOTOX and Dermal Fillers at the bottom of this page
Will I need to follow special instructions after treatment?
Some visible lumps may occur temporarily following the injection. The nurse practitioner may massage the areas of injection to conform to the contour of the surrounding tissues.
Swelling, redness, firmness, itching, and tenderness may be present for up to two weeks. Use of cool packs may be used as needed.
Sleep with your head elevated to reduce the amount of swelling.
Do not massage or put pressure on the treated area, unless instructed by the nurse practitioner.
Wait 4 hours to apply cosmetics, moisturizer or any lotions on the area
Do not perform heavy aerobic exercise, or do anything to raise your core body temperature for 24 hours
The results will be immediate, but its best effects are noted after swelling has resolved.
Tylenol may be used as directed on the bottle for any discomfort after injection.
Benadryl 25-50 mg, per directions on bottle, may be used for itching. Benadryl can make you sleepy. Do not drive or perform any activities accordingly.
The use of Arnica Montana (available at health food stores) may help with bruising. It is available topically or orally. Follow bottle directions. Lumps, bumps or irregular asymmetrical areas may be noted, especially once swelling has subsided. It is normal to feel these lumps and bumps, however they should not be visible.
Any severe swelling, itching, redness, increasing discomfort or discharge from treated area should be reported to the office.
Periodic touch-ups will help sustain the desired level of correction.
It can take up to TWO weeks for swelling and any bruising to subside. If additional filler is desired in an area of previous treatment, your provider may ask you to wait until the two weeks has passed.
Minimize exposure of the treated area to excessive sun or UV lamp exposure and extreme cold weather until any initial swelling or redness has gone away.
Please call Embrace Medical Aesthetics at 219-663-7317 with any questions or messages for the provider.
Will there be a follow up appointment?
Patients are assessed 2-3 weeks after treatment to evaluate for reduction of lines and wrinkles and correction of contours.