Since their introduction over 20 years ago, injectable fillers have changed the way we think about facial rejuvenation. By adding volume to specific areas of the face in a calculated, artistic way, our team can help your face to look dramatically younger while maintaining a natural appearance.
Fillers are performed in the office setting without the need for anesthesia. Downtime is typically minimal and usually involves minimal swelling and little to no bruising, although this varies between patients and with each injection. Patients can usually go back to work the same day and resume exercise the next day.
Fillers add volume. They can be used to smooth deep wrinkles, to augment regions of the face that have become flat or hollow with age; they can outline the jaw or smooth the nose. Fillers offer a powerful alternative to surgery in well selected patients, but they accomplish different aesthetic goals than surgery; they are not equivalent to procedures like a facelift.
Fillers are often used in combination with surgery, to enhance and maintain the results of facelifts, blepharoplasties, or related procedures. Fillers add volume, while surgery can lift, tighten, and reposition tissues that have drooped with age. In some patients, surgery and injectables used together will yield a more dramatic and natural result than either technique by itself.
Fillers are substances that we will add volume to the face or body when injected under the skin or into deep tissues. The most commonly used fillers are made of hyaluronic acid, a chemical found in the skin and joints that attracts water. Hyaluronic acid is a clear gel purified from bacteria in the laboratory setting. Different consistencies of gel can be manufactured. This affects the thickness and other properties of the gel, which in turn affects how it can be used. The choice of which brand and type of filler varies based on its intended use and also on the preferences of the doctor.
Other types of fillers include calcium hydroxyapatite (Radiesse™), which is a thicker filler that can be used to contour the jawline or cheeks. It may also be used to stimulate collagen and other proteins in the skin, which is referred to as biostimulation. Poly-L-lactic acid (Sculptra™) is another biostimulatory filler that is most commonly used to contour regions or subunits of the face.
Platelet rich plasma (PRP) and platelet rich fibrin (PRF) can also be injected. They behave differently than traditional fillers, not directly adding as much volume, but they likely have a greater biostimulatory effect. These biofiller treatments use your own blood, which is spun in a centrifuge.
Various components can then be reinjected for their stimulatory effect and potentially for some filler effect. We have found that PRF is particularly useful for the lower eyelids and lid cheek junction. Most patients experience improvement in skin texture and consistency. The terms biofiller and biofiller gel are sometimes used to refer to PRP or PRF when injected. Terminology can be confusing for patients, because it is used differently by different providers.
Fillers work by adding volume and support to specific areas of the face to soften and fill wrinkles, add volume to facial hollows, or enhance facial contours (like emphasizing the cheeks or straightening the jaw-line). Fillers are typically made from substances that mimic the body's natural components, such as hyaluronic acid (found in skin and joints) and calcium hydroxylapatite (a building block of bone). When artfully placed into targeted areas, fillers can reverse some signs of aging, creating a dramatic but natural looking rejuvenation.
Most of the fillers have a direct volume augmentation effect, meaning the fillers themselves plump up the tissues into which they are injected. Some of the fillers also have a biostimulatory effect, in which the production of collagen, elastin, and other compounds within the skin may be stimulated by the injected material. This can have a volumizing effect and can also improve skin texture and smoothness.
Some fillers, like Sculptra™ and Radiesse™, can also have a bio-stimulatory effect, meaning they stimulate the body to produce collagen or other substances that add volume or improve skin quality. Biofiller, as noted above, has significant stimulatory effects.
Dr. Goldman offers a diverse range of dermal fillers, each designed to address different aspects of facial rejuvenation and enhancement. Here’s an overview of the types of fillers available:
Each filler is selected based on your specific needs and goals for a personalized approach to facial rejuvenation. Dr. Goldman’s unparalleled expertise in using these advanced fillers allows for tailored treatments that achieve natural-looking and satisfying results.
Dr. Goldman and his team believe in a comprehensive, holistic approach to facial rejuvenation. We therefore encourage healthy lifestyle changes, like cessation of smoking and tanning, reduction of alcohol consumption, as well as optimization of weight with diet and exercise–all of which have been shown to improve skin quality. We then tailor a multi-pronged approach for your facial rejuvenation journey, utilizing options including medical grade skin care, cosmetic injectables, fractional CO2 and other lasers, and surgical techniques like the deep plane facelift, temporal brow lift, and facial fat injection.
Skin care and fillers are often the starting point for treating early signs of facial aging. The choice of treatments depends not just on your physical characteristics but also on your goals, which may change over time. We believe in establishing long-term relationships with our patients to maintain the results of any therapies and keep you looking young and healthy
We know that, especially if this is your first experience with facial fillers, you likely have many questions about what the treatment will be like. We begin with a detailed consultation to determine the best treatment plan for your needs - and we take the time to answer all of your questions.
Explore our gallery to see the transformative results our patients have experienced. Discover the impact of our personalized approach to facial rejuvenation with natural and refined improvements achieved through our diverse range of filler options.
The longevity of filler results depends on the type and amount of filler used, the areas treated, and individual factors like age, skin quality, and body weight. Typically, results can last about 6 months, but there is significant variability patient to patient.
Fillers are often combined with other cosmetic treatments such as botulinum toxin injection, laser resurfacing, or skincare to achieve a comprehensive facial rejuvenation. During your consultation, you’ll work with our team to create a tailored treatment plan based on your aesthetic goals.
Some patients may require surgical procedures, like Dr. Goldman's deep plane facelift, to achieve results consistent with their goals. Facial rejuvenation surgery is usually combined in some fashion with cosmetic injections and skin care to obtain optimal results.
Common side effects include temporary redness, swelling, bruising, and tenderness at the injection site. These effects usually resolve within a few days. Any patient undergoing cosmetic filler or facial fat injection should be aware that there have been rare cases of blindness and skin necrosis (when a patch of skin is deprived of blood flow and dies, leaving a scar) caused by injections. Filler or fat can be injected into a tiny artery, blocking blood flow to the retina or an area of the skin, causing blindness or skin necrosis. Fortunately, this is very rare, but any filler patient should be aware of this risk.
Results are often visible immediately or within a few days after the treatment. Some swelling may occur initially, but this usually subsides within a few days, revealing the final results. Most fillers will produce immediate results as they augment volume, although some swelling can occur, and the skin is usually somewhat tight initially, so the end result generally takes about 2 weeks to become visible. The biostimulatory fillers will gradually stimulate collagen production and other changes to the skin which take a few weeks to fully appear.
Proper filler choice depends on multiple factors, including the desired effect, the areas being treated, the characteristics of the filler required, and patient and doctor preferences. This is a complex discussion that we love having with our patients at your consultation.
Injectable fillers offer a versatile, powerful solution for patients desiring a more youthful look. Even though filler injection is a relatively quick office procedure, it is important to plan it thoughtfully and artistically, to perform injection with technical precision, to have appropriate followup, and possibly to combine fillers with other treatments to achieve ideal results. So be sure to consult with a well-trained, highly experienced, and compassionate team, like ours at Beachwood Plastic Surgery, Westlake Plastic Surgery, The Surgeon's Spa - Beachwood, and The Surgeon's Spa - Westlake.
Don’t hesitate to call, email, or come in and see us if you have questions.
