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INJECTABLE FILLERS

There is a variety of injectable fillers to choose from, including fat injections, Artefill, and Sculptra® Aesthetic. Dallas plastic surgeon Dr. Steve Byrd is a renowned facial plastic surgeon with the expertise to help you get the most from your facial rejuvenation. Facial fillers give patients a way of fine-tuning their plastic surgery results or a non-surgical alternative for improving their appearance and confidence if they’re not quite ready for plastic surgery.

If you’re interested in facial fillers in Dallas/Fort Worth but you’re not sure which option is best for you, give us a call at (214) 821-9662. We’ll be happy to give you a full evaluation and recommendation in our office on North Central Expressway. You’ll be looking and feeling better before you know it.

DR. BYRD’S APPROACH

An office consultation where you’ll discuss your desired changes and the appropriate products is the first step. Lisa, our nurse in Dallas for the past 20 years, assists in the evaluation and treatment of patients interested in injectables. She is compassionate and gentle in the injection technique, and she is fluent in all the latest products, their indications, and their limitations. Topical anesthetics and blocks can be used to make the procedures as comfortable as possible. It takes a clinically trained, artistic eye to decide what filler or combination of fillers would best help a patient realize his or her goals.

The wide array of wrinkle treatments and facial rejuvenation options in Dallas and Fort Worth today can seem overwhelming. Schedule a consultation today, and Dr. Byrd and Lisa will help you sort through your choices and select the products best suited to your needs.

EXPECTATIONS/RESULTS

Products Chemical Name Expected Results Additional Information
Fat Autologous adipose tissue Lifetime 50% of injections “take”/survive the transfer
Artefill Polymethylmethacrylate Lifetime* Skin test required prior to initial injection
Sculptra Poly-lactic Acid 18 – 24 months Requires 2 – 3 injections 6 – 8 weeks apart
Restylane Hyaluronic Acid 6 – 9 months Requires maintenance 1-4 times a year depending on the area injected
Juvederm Hyaluronic Acid 6 – 9 months Requires maintenance 1-4 times a year depending on the area injected
Juvederm Ultra Hyaluronic Acid 6 – 9 months Requires maintenance 1-4 times a year depending on the area injected
Voluma XC Hyaluronic Acid 18 – 24 months Consistent users may be able to wait 3 months between treatments

*FDA studies went beyond 7 years and presence of fill is still apparent.

Injectable filler ARE YOU A CANDIDATE:

If sun damage, injury, or natural aging have created frown lines, crow’s-feet, marionette lines, or vertical lip lines on your face, you may derive great benefit from one of the injectable product therapies available. The fillers supplement your body’s natural collagen, while BOTOX Cosmetic keeps your own deep muscle tone from creating permanent facial creases. You can also discuss your candidacy for facelift, endoscopic brow/midface lift, and other facial surgery and which would be best for you.

Injectable filler PROCEDURE: What to Expect

A topical anesthetic is applied about 30 minutes prior to the injection of fillers used in the nasolabial folds, cheeks, eyelids, and chin area. If lips are to be injected, a dental block is utilized to minimize any discomfort. After the products are injected, pressure, massage, and ice therapy are begun immediately to achieve the desired effect while minimizing swelling and any possible bruising. (Please advise the scheduler and arrive 45 minutes prior to your appointment to allow the anesthetic time to work properly.) BOTOX Cosmetic does not require any topical numbing, but it can be administered upon request. We advise stopping all medications that contain aspirin 10 to 14 days prior to receiving any of these injections to limit bruising.

Injectable filler RECOVERY: What to Expect

Day 1 – 2
  • Use cold compresses intermittently to reduce swelling.
  • Massage as directed depending on the filler used.
Day 3 – 14
  • Bruising and swelling should subside by now (on lips).

FAT INJECTIONS

Fat injections are my overall favorite filler. Lab results indicate a 40% to 50% cell survival rate, which translates into permanent, stable, and long-term outcomes. Fat has the advantage of staying exactly where it is injected, rather than migrating to other parts of the body.

Fat cells are harvested from the patient’s abdomen or thighs using a small cannula and syringe, not a liposuction machine. A numbing solution mixed with fluids is injected at the harvest site to reduce pain and bleeding. We remove several times as much fat as will be injected in the selected site. After the cells have been purified, the fat is placed in syringes and made ready to inject.

The procedure requires IV sedation and a short office recovery prior to returning home. The injection area may be swollen for about 3 weeks, but as you heal, the injected area becomes soft and smooth, taking on the body’s normal feeling and texture. Microfat injections are my favorite overall lip filler, and they also can be used successfully for the nasolabial folds, hollows or depressions near the eyelid/cheek area, cheeks, and even in body-contour deformities.

Because about 50% of the fat is expected to “take,” or remain permanent, we slightly overfill during injection to compensate somewhat for that expected and normal loss. We are reluctant to double the desired fill volume, though, for fear of getting an undesired lump or overcorrection. You can always add more fat, but you can’t remove it.

VOLUMA XC

VOLUMA XC is indicated for deep (subcutaneous and/or supraperiosteal) injection for cheek augmentation to correct age-related volume deficit in the mid-face in adults over the age of 21. We have been using this product since March 2014. It creates an immediate, natural lifting/filling response in the tissues. It is said to last 18-24 months. We will have patients return for a checkup appointment approximately 3 months post injection to evaluate possible need for additional fill. We are excited about this product however we are using the product conservatively and monitoring the outcomes/patient satisfaction in other centers for injectable excellence.

Restylane, Juvaderm Ultra or Juvaderm Ultra Plus (all are cross-linked hyaluronic acid)

Hyaluronic acid is contained in most every cell/part of the body. The FDA does not require any skin testing prior to use of this product in patients for this reason. We use the XC versions of these products as they contain lidocaine alongside the product and provides for some local pain relief during the injection session.
Hyaluronic acid products are best used for short term fill (6-9 and, sometimes, 12 months) in the lips, around the mouth in the nasolabial folds/marionette. These products can be used elsewhere, however, we do not use it outside these noted areas. It is ideal in young patients and those who want to “try on the look” of fillers before moving to something more long lasting. Caution is used in placement of this product around the eyes or in the lips as it is very hydrophilic and this drawing of fluid to the product can yield some unwanted fullness that does not go away until the last bit of the product has been resorbed by the body. It can, if necessary, be removed using the enzymatic properties of injectable Hyaluronidase.
Both Restylane and Juvederm products are smooth and easy to use by an expert injector. The Juvaderm contains more hyaluronic acid per syringe volume. We believe this causes more fluid retention and volumizing in some areas. For this reason we use Restylane in the lips.
Restylane is provided in .4 cc and 1.0 cc syringe sizes and Juvaderm comes only in 1.0 cc syringes.

ARTEFILL

In 2006, after a number of years of use in Europe (and labeled with another name), the FDA approved the use of ArteFill in the United States for the treatment of nasolabial folds. The filler that is used in this treatment is composed of synthetic microspheres called polymethylmethacrylate, or PMMA, cow collagen and lidocaine. The PMMA does not reabsorb into the body; instead, it stimulates the body to produce its own collagen supply.

POLYLACTIC ACID – SCULPTRA AESTHETIC

Sculptra is an injectable approved by the FDA for use in HIV patients with “facial atrophy,” or the loss of fat between the skin and muscle of the face that creates a gaunt look. Sculptra has been used safely outside the United States for years for cosmetic treatment of deep volume loss or atrophy in the face. It has now become a favorite long-term filler for Dallas and Fort Worth patients seeking correction of deep lines and hollows. Applications for use include gaunt cheeks, tear troughs, nasolabial folds, and sublabial hollows. Correction of the sublabial depression helps minimize the appearance of jowls either before or after a face lift. Two to three injections are scheduled 6 to 8 weeks apart to establish the desired fill and contour. Following the last injection, the result should last 18 to 24 months.

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