- Breast Augmentation
- Breast Lift (mastopexy)
- Breast Reduction
- Breast Reconstruction
- Implant Removal and Revision
- Male Breast Reduction (gynecomastia)
- Liposuction
- Large-volume Liposuction
- Tummy Tuck (abdominoplasty)
- Lower (circumferential) Body Lift
- Arm Lift (brachioplasty)
- Thigh Lift
- Buttock Lift
- Labioplasty (labial reduction)
- Fat Transfer Contouring
- Massive Weight Loss
- Facelift
- Liquid Facelift
- Brow Lift (forehead lift)
- Eyelid Lift (blepharoplasty)
- Facial Implants
- Fat Transfer
- Neck Rejuvenation
- Ear Correction
- Lip Augmentation
- ThreadLift
- Skin Resurfacing
St. Louis Tissue Filler Injection Specialists
Areas of the face that benefit from tissue filler injections include smile lines around the mouth and eyes, the nasolabial fold between the nose and corners of the mouth, marionette lines that run downward from the corners of the mouth, frown lines between the brows, and some recessed scars from acne or other causes. In addition, it can be used to fill out the orbitomalar septum, nasojugal groove, and lateral malar hollows. The injection process usually takes 15 to 30 minutes and the results are immediate.
Tissue fillers are also used for lip augmentation in patients who either want fuller lips than they were born with or want to restore the fullness they had when younger. Small vertical lines above the upper lip also can be filled.
The volume of collagen-containing supportive tissue beneath the skin naturally shrinks with age and this shrinkage is especially visible in the face. As this tissue volume decreases, wrinkles and creases become apparent and make people look older. An effective way to reduce the appearance of wrinkles is injection of a tissue filler, which is one of the most popular in-office procedures at BodyAesthetic Plastic Surgery.
Types of Tissue Fillers
Some injectable fillers are made from natural substances found in the human body, some are synthetic forms of these substances, and others may contain synthetic, biocompatible materials.
Perhaps the most effective and long-lasting filler is a patient's own fat transferred from another part of the body to fill lines or sunken areas in the face. Some patients undergoing liposuction or another type of body contouring choose to have some of the fat transferred to facial areas.
Current tissue filler favorites available at BodyAesthetic include:
Juvederm Ultra, which is composed of hyaluronic acid, a polysaccharide found naturally in the skin, eyes, joints, and muscles. Injectable fillers made from hyaluronic acids produce longer-lasting results than collagen, but they are not permanent. Juvederm Ultra is indicated for injection into the mid to deep dermis of the skin for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds). It is frequently used in other areas, such as, frown lines, nasolabial folds, marionette lines, lips, acne scars, filling out the cheeks and filling in deep hollows around the eyes. Juvederm has 24 mg/ml of hyaluronic acid and approximately 90% of the hyaluronic acid is cross linked. The greater the amount of cross linked hyaluronic acid, the longer the product will last once it is injected. Another characteristic that determines how long a hyaluronic acid lasts is the degree of cross linking. The greater the degree of cross linking, the greater the longevity of the hyaluronic acid. Juvederm Ultra's degree of cross linking is 6%. Juvederm Ultra persists for at least 9 months. Interestingly, it has been shown that hyaluronic acids do cause some collagen formation with repetitive injections, which means that there is some permanent correction caused by the Juvederm.
Juvederm Ultra Plus, which is composed of hyaluronic acid, a polysaccharide found naturally in the skin, eyes, joints, and muscles. Injectable fillers made from hyaluronic acids produce longer-lasting results than collagen, but they are not permanent. Juvederm Ultra Plus is indicated for injection into the mid to deep dermis of the skin for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds). Juvederm Ultra Plus is thicker than Juvederm Ultra, so it is injected deeper than the Juvederm Ultra and is used for deeper folds. Juvederm Ultra Plus has 24 mg/ml of hyaluronic acid and approximately 90% of the hyaluronic acid is cross linked. The greater the amount of cross linked hyaluronic acid, the longer the product will last once it is injected. Another characteristic that determines how long a hyaluronic acid lasts is the degree of cross linking. The greater the degree of cross linking, the greater the longevity of the hyaluronic acid. Juvederm Ultra Plus's degree of cross linking is 8%. Juvederm Ultra Plus persists for at least 12 months. Interestingly, it has been shown that hyaluronic acids do cause some collagen formation with repetitive injections, which means that there is some permanent correction caused by the Juvederm.
Juvederm XC is a new formulation of Juvederm Ultra and Juvederm Ultra Plus with lidocaine added to decrease the pain associated with injections. Otherwise, it is identical to the Juvederm Ultra and Juvederm Ultra Plus.
Restylane, which is composed of hyaluronic acid, a polysaccharide found naturally in the skin, eyes, joints, and muscles. Injectable fillers made from hyaluronic acids produce longer-lasting results than collagen, but they are not permanent. Restylane is indicated for injection into the mid to deep dermis of the skin for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds). It is frequently used in other areas, such as, frown lines, nasolabial folds, marionette lines, lips, acne scars, filling out the cheeks and filling in deep hollows around the eyes. Restylane has 20 mg/ml of hyaluronic acid and approximately 80% of the hyaluronic acid is cross linked. The greater the amount of cross linked hyaluronic acid, the longer the product will last once it is injected. Another characteristic that determines how long a hyaluronic acid lasts is the degree of cross linking. The greater the degree of cross linking, the greater the longevity of the hyaluronic acid. Restylane’s degree of cross linking is less than 2%. Restylane persists for at least 6 months. Interestingly, it has been shown that hyaluronic acids do cause some collagen formation with repetitive injections, which means that there is some permanent correction caused by the Restylane.
Sculptra is another popular product that produces impressive results. It is a synthetic material made from poly-L-lactic acid that is biodegradable and biocompatible. Sculptra is injected into tissues below the skin and is therefore more effective than the hyaluronic acid products for filling deep creases (especially those on the lower half of the face) and areas of volume loss, such as hollow cheeks. It is also effective for rejuvenating the back of the hands.
The results of Sculptra injections are not immediate (as they are with products like Restylane) and may take a few weeks before a difference is fully visible. This is because Sculptra works by stimulating new collagen formation in deeper layers of the skin so the filling effect comes from your own new collagen production rather than from an injected substance. Even though results are not immediate, they last up to 2 years, much longer than other tissue fillers. Treatments usually consist of 2 to 4 treatments every 4 to 6 weeks, and yearly touch-ups may be advised.
Radiesse™ is another product that effectively adds facial volume. It is a relatively new introduction to the tissue filler market. Radiesse provides immediate visual improvement common with Restylane and other fillers, plus the benefit of long-lasting results found with products like Sculptra. This is because Radiesse is made of very tiny, smooth calcium hydroxylapatite (CaHA) microspheres. The microspheres (particles) form a scaffold through which your body’s own collagen grows, and this produces the desired long-term effect. Radiesse is useful for adding volume to areas of the face that are not ideal for treatment with other tissue fillers.
Collagen (from cows) was the most popular tissue filler available for many years, but its use has diminished because bovine collagen requires allergy testing that takes a month before injections can begin. Newer forms of collagen (CosmoDerm and CosmoPlast) eliminate the need for allergy testing so injections can be done immediately.
What To Expect After Receiving A Tissue Filler
Tissue filler injections are done by our surgeons in the office under local anesthetic. The injections are not painful and require little or no downtime. Results are immediate with most filler products. You may experience some redness, tenderness, or itching at the injection site, but this should be gone within a few days. The most common complication of fillers is bruising at the site of injection. Some medications make you more prone to bruising, so it is beneficial to avoid these medications for a week prior to your injections. Examples of these medications include: aspirin, non-steroidal anti-inflammatory medications (ibuprofen, motrin, naproxen), vitamin E, omega 3 fatty acids, and fish oil.
At BodyAesthetic Plastic Surgery we use only those injectable fillers that we believe are safe over the long term and have been approved by the FDA for facial use. Your surgeon will explain the type of filler recommended for you and why. He will also discuss the results you can expect and how long those results should last.
New types of tissue fillers are being introduced all the time as their popularity increases, so you may want to ask about what's new or coming in the near future.
