South Florida Plastic Surgery Associates - Don R. Revis, MD











Injectable Fillers

Hyaluronic Acid and Collagen Fillers for Facial Wrinkles and Lip Enhancement

Injectable soft tissue fillers may be used to enhance the lips or to fill in lines and creases that may develop as we age and the effects of gravity, smiling, chewing, and squinting take their toll. There are several options to treat these conditions, including fat transfer, collagen, hyaluronic acid-based fillers such as Restylane®, Juvederm® and Perlane®, and other products. During your consultation, Dr. Revis will help you make the right choice for your individual situation.

These techniques may also be used to enhance the results of another procedure, such as chemical peels, dermabrasion, microdermabrasion, facelifting, or brow lifting. Dr. Revis is a specialist in these state of the art techniques and can help guide your selection of the most appropriate treatment or combination of treatments to help you achieve the appearance you desire.

Soft tissue fillers have their differences, and it is important to understand these differences prior to selecting a particular treatment. Individual results with soft tissue fillers vary a great deal, and this phenomenon is not completely understood. Some patients do maintain the injected volume for years, but in other patients the results may fade after only a few months. Longevity of a treatment may also be related to the muscle activity in the area. Areas with intense, repetitive muscle activity seem to metabolize the fillers more rapidly than areas with less muscle activity. Because of this, soft tissue filler injections are sometimes combined with Botox® injections to paralyze the regional muscles and prolong the effects of the injectable filler.

Hyaluronic Acid (Restylane®, Juvederm®, Perlane®)

A naturally occurring protein found in human skin, hyaluronic acid has now replaced collagen as the current state of the art in soft tissue fillers. More than 1.5 million injections were performed in 2007, making hyaluronic acid soft tissue filler injections the second most popular nonsurgical procedure in the United States, following Botox injections. There is no risk of allergic reaction, and hyaluronic acid products typically last much longer than collagen before they are reabsorbed by the body.

Collagen (Zyderm®, Zyplast®, Cosmoderm®, Cosmoplast®)

A naturally occurring protein found in numerous structural components of the body, such as skin, muscle, and bone. Collagen was the first injectable soft tissue filler to be developed, but today has been replaced by the hyaluronic acid fillers primarily because they last much longer than collagen. In 2007, when 1.5 million hyaluronic acid injections were performed in the United States, only 63,000 collagen injections were performed.

Zyderm and Zyplast, two types of collagen, are derived from purified bovine collagen. The primary risk of collagen derived from bovine collagen is an allergic reaction. To avoid an allergic reaction, a skin test is required. This test dose is a minute amount injected under the skin of the forearm. This site is then watched for four weeks. Any signs of swelling, itching, or redness should be reported to Dr. Revis immediately and will indicate that you are not a candidate for collagen injections. If you do not have any reaction to the test dose after four weeks, you may proceed with a full treatment.

Cosmoderm and Cosmoplast are collagen fillers comprised of human collagen. There is no risk of allergic reaction, and therefore a full treatment may be performed without any prior skin test.

ArteFill®

A new category of nonabsorbable soft tissue filler made of PMMA (polymethylmethacrylate) microspheres. ArteFill is the first and currently only nonabsorbable soft tissue filler approved by the FDA for use in the United States.

The formulation of ArteFill does include some bovine collagen, therefore there is a risk of allergic reaction. To avoid an allergic reaction, a skin test is required just like in the case of Zyderm and Zyplastcollagen injections. This test dose is a minute amount injected under the skin of the forearm. This site is then watched for four weeks. Any signs of swelling, itching, or redness should be reported to Dr. Revis immediately and will indicate that you are not a candidate for ArteFill injections. If you do not have any reaction to the test dose after four weeks, you may proceed with a full treatment.

In treating patients with this new soft tissue filler, Dr. Revis recommends that patients who have never had an injectable soft tissue filler try one of the less permanent, absorbable fillers (i.e. Restylane) first. In the event that they do not like their results, the filler will be absorbed, and they will know that ArteFill is not the best choice to achieve their goals. This is because once injected, ArteFill is permanent and may only be removed surgically.

After the Procedure

No bandages are necessary following treatment with injectable fillers, and you are able to apply makeup, a moisturizer, or sunscreen immediately following injection.

The Results You Can Expect

You will notice an improvement in the contour of your face immediately. A very mild swelling usually takes several days to subside. You should be able to resume your normal daily activities the day after your procedure, and you should be able to resume all of your physical activities within several days of your procedure.

 

Please call (954) 630-2009 for further information or email Dr. Revis.

Email: DrDonRevis@hotmail.com

 

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