Patients in Ohio Can Smooth Lines & Wrinkles, Augment Cheeks & Lips, and Rejuvenate the Face
Loss of facial volume and the appearance of wrinkles are common aesthetic concerns among both women and men as we age. One popular treatment of facial volume loss with no downtime is non-surgical rejuvenation with dermal fillers. Ohio-based, double board-certified facial plastic surgeon Dr. David Hartman is an ExpertInjector™, a qualification earned by just 3% of the injecting physicians in the United States approved to administer the most frequently used cosmetic injectable treatments.
How Do Dermal Fillers Work?
Using a tiny needle or a microcannula, dermal fillers are placed in hollowing or thinning areas of the face to restore lost facial volume. Using special topical numbing creams, dermal filler treatments can be administered comfortably. Dermal fillers naturally and subtly enhance your facial appearance, turning back the clock so you still look like you, only years younger.
What are Dermal Fillers?
Most of the dermal fillers popular today are made by crosslinking a naturally occurring molecule, hyaluronic acid (HA). HA is already found in and around all human cells – particularly cells of the skin and joints. Its role is to retain moisture that keeps these structures supple and healthy. HA can be crosslinked in a laboratory to make it more sturdy or stable so that it can be used as an outstanding filler to return a youthful healthy look to areas of our face that are thinning or hollowing out as our face ages.
Starting in our 20s, the production of essential building blocks such as hyaluronic acid, collagen, and elastin reduces significantly, leading to the development of creases, folds, and hollows. Dermal fillers can help restore lost volume and improve facial appearance from the inside out.
What Do Dermal Fillers Treat?
Dermal fillers add back lost volume – particularly to the apples of the upper, outer cheeks, hollows around the eyes, and thinning lips. Fillers can also be used to improve some static wrinkles and folds. “Static” refers to wrinkles that are noticeable even when the facial muscles are at rest. For dynamic wrinkles (which become most noticeable during expression or muscle contraction), combining neuromodulators (such as BOTOX® or Dysport®) with filler treatments can be particularly effective.
Static wrinkles that can be addressed include:
Smile lines or nasolabial folds
Vertical lip lines
Lack of volume in certain areas may seem less obvious but is often what contributes to a less youthful or vital appearance. Dermal fillers can quite literally “fill” in such areas to correct issues such as deflated cheeks, weak chins, hollows under the eyes or at the temples, or even some external nasal imperfections. Lip injections are particularly popular with both young and more mature patients, to augment either naturally thin lips or thinning lips due to aging.
Which Filler is Right for Me?
The type of filler appropriate for a given treatment largely depends on which areas you would like to correct. Although HA is used in the production of all the fillers we use, the thickness and pliability of each filler vary according to its intended purpose. While thicker, stiffer fillers will stay in place better and last longer, they do not allow for subtle shaping and are not appropriate for smaller or more delicate areas.
For example, Dr. Hartman might use a stiffer filler for the apples of the upper/outer cheeks, and a thinner, more pliable filler, such as Restylane® Silk for the lips. Recognizing these needs, manufacturers formulate variations under their umbrella brands. At our practice, we use Juvederm Voluma® and Restylane® Silk, Refyne, Defyne, and Lyft.
Filler to restore youthfulness to the cheeks will generally require one to two cartridges to achieve the desired beautifying effect. However, a single cartridge is generally more than sufficient to restore and beautify the lips – in fact, for many women, only half (or even less) of a filler cartridge to the lips is the perfect amount.
Depending on the brand of dermal fillers, prices typically start at $550 to $650 per cartridge (note that these are subject to change with manufacturers’ prices).
Is Filler Treatment Painful?
Dr. Hartman uses very thin microcannulas to administer filler and we routinely use an excellent topical numbing cream, called NumbMaster, to keep the treatment comfortable. We may employ additional steps such as cool air streams or vibrating tools for additional comfort if desired.
Our fillers also all come with lidocaine, a numbing agent, to further reduce discomfort during and after treatment. For patients concerned about an allergic reaction to lidocaine: true lidocaine allergy is so exceedingly rare as to be considered non-existent. Many experts, in fact, believe true lidocaine allergies do not exist at all.
Any reactions experienced with lidocaine are very likely related to the epinephrine medication which is frequently mixed with lidocaine. Epinephrine may cause racing heart rate, shivering, or other nervousness-like symptoms. Note that the lidocaine in our fillers does not contain epinephrine.
Are There Any Side Effects?
As with all injectable treatments, dermal filler treatments may result in slight and temporary bruising, swelling, redness, or itching at injection sites. These uncommon side effects typically subside in a matter of days (in most cases, just 1 day), with most patients returning to normal activities immediately. Results may vary, and multiple treatment sessions may be required to achieve your desired rejuvenation.
The most serious concern with fillers is inadvertent placement into a facial artery, which could lead to dire consequences. For this reason, fillers placed along the side of the nose or under the eyes should be placed only by a well-trained and experienced board-certified injector. Also, it is critical that both the client and the injector understand what fillers can and cannot reasonably accomplish. Misuse or overuse of fillers can lead to disappointing results. Therefore, at Fine Arts Skin & Laser, only Dr. Hartman performs filler and neuromodulator injections.
The biggest concern the consumer should have when getting filler is to be sure that the injector you choose is board-certified in facial plastic surgery, plastic surgery, or cosmetic dermatology. Fillers can certainly restore a youthful, beautiful look, but they must be used wisely and carefully. The facial anatomy must be exquisitely known and understood.
– Dr. Hartman
Alternative & Complementary Treatments
As mentioned earlier, neuromodulators (such as BOTOX®) may be used instead of, or in conjunction with, dermal fillers for aesthetic concerns due to muscle contraction.
Trying to erase lines with fillers from very loose skin, particularly in the midface, often leads to results that do not look natural. To properly address moderate to severe skin laxity, a facelift or neck lift may be more appropriate.
Fat transfer is also gaining popularity as a permanent, all-natural facial volume restoration treatment. In a fat transfer procedure, the patient’s very own living fat is harvested via liposuction from the extra subcutaneous fat deposits of the tummy, love handles, or outer/inner thighs. Fat transfer can be performed as a “stand-alone” procedure or can be combined with surgical rejuvenation procedures such as facelifts, eyelid rejuvenation, or breast lifts.