Soft tissue augmentation with injectable fillers such as collagen, fat, Juvederm, Restylane, and Sculptra injections can help restore youthfulness in one’s appearance without the incisions and the downtime of surgery. These injections result in an improvement of skin wrinkles and a more youthful appearance. This procedure is especially helpful in adding fullness to the lips and cheeks. When injected, the filler plumps up the creased and sunken areas of the face.
There is always a possibility of complications occurring with these procedures. With collagen, the risk involved is a small possibility of an allergic reaction. A skin test is performed to help reduce this risk. Collagen has been available for many years and thus, more is known about its potential risks and long-term outcomes. Collagen comes in different preparations for use for different areas of the face and can last up to four months.
The newer fillers on the market are reported to have been designed to be longer lasting than collagen, but there are reports of hypersensitivity reactions in some patients. Therefore these injectable fillers are very selectively prescribed.
Fat injections are another alternative and are not susceptible to allergic reaction since the fat is harvested from your own body. Filler fat injections can help reduce the appearance of laugh lines, crow’s feet, facial creases and can also be used to enhance the appearance of your lips.
What Is JUVÉDERM™ Injectable Gel?
As we age, our skin changes. Over time, the natural volume of youthful skin begins to diminish as wrinkles and folds form. But, with Juvéderm™ injectable gel, you don't have to just sit back and let it happen! Recently approved by the FDA, Juvéderm™ injectable gel is a “next-generation” dermal filler. The smooth consistency gel helps to instantly restore your skin's volume and smooth away facial wrinkles and folds, like your "smile lines" or “parentheses” (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth).
Juvéderm™ is a smooth consistency gel made of hyaluronic acid—a naturally occurring substance in your skin that helps to add volume and hydration. Your healthcare professional eases Juvéderm™ injectable gel under the skin to provide a smooth, natural look and feel—so everyone will notice (but no one will know)! In fact, studies show superior results of Juvéderm™ compared to a collagen-based dermal filler.* And, almost 90% of all study volunteers who were treated with both Juvéderm™ injectable gel and another dermal filler* preferred Juvéderm™! In addition, Juvéderm™ injectable gel is the first FDA-approved hyaluronic acid dermal filler that is proven to be safe and effective for persons of color.
With Juvéderm™ the injection process takes only about 15 minutes and results are immediate. Plus, there's minimal recovery or downtime. So you can step into your doctor's office for treatment and step right back into your life.
Juvéderm™ Ultra and Juvéderm™ Ultra Plus are indicated for injection into the mid to deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds). Side effects were usually mild to moderate lasting 7 days or less and included temporary injection site reactions like redness, pain, firmness, swelling and bumps
Benefits of JUVÉDERM™ Injectable Gel
Hyaluronic acid dermal fillers like Juvéderm™ injectable gel offer a safe and effective nonsurgical option for smoothing facial wrinkles and folds. In fact, they are the fastest growing nonsurgical aesthetic procedure in the United States according to the American Society of Aesthetic Plastic Surgery. But all dermal fillers are not the same!
If you're interested in being treated with this nonsurgical physician-administered treatment option, you should know the advantages of choosing Juvéderm™ injectable gel:
- A "next-generation" filler: JUVÉDERM™ is a “next-generation” non-animal dermal filler that is made from hyaluronic acid—a naturally occurring substance that plays a vital role in hydrating your skin and replenishing its natural volume. No allergy skin tests are needed prior to receiving treatment.
- Advanced technology for long-lasting results: JUVÉDERM™ injectable gel employs its unique manufacturing process to provide the highest concentration of cross-linked hyaluronic acid of any currently available hyaluronic acid dermal filler for long-lasting results. This advanced manufacturing process also creates a smooth consistency gel that flows consistently and easily into the skin and provides a smooth, natural look and feel. Juvéderm™ is the only filler available with this smooth consistency gel formulation—other existing hyaluronic acid fillers are made of granular consistency gels.*
- Proven safety and effectiveness: Juvéderm™ is the first FDA-approved hyaluronic acid dermal filler that has demonstrated its safety and effectiveness in persons of color.
- Quick and easy procedure: Juvéderm™ injectable gel is a nonsurgical physician-administered treatment that requires no allergy skin test and minimal recovery or downtime.
- Personalized treatment: Juvéderm™ injectable gel is available in two formulations— Juvéderm™ Ultra for versatility in contouring and volumizing facial wrinkles and folds, and Juvéderm™ Ultra Plus, a more robust formulation for volumizing and correcting deeper folds and wrinkles. This allows your healthcare professional to tailor treatment to meet your unique needs.
How JUVÉDERM™ Works
Juvéderm™ injectable gel is a nonsurgical, physician-administered treatment. Your healthcare professional eases Juvéderm™ under the skin using a fine needle to augment, or fill, the soft tissue of the dermis—the dense inner layer of skin beneath the epidermis—to add volume and diminish wrinkles and folds. Juvéderm™ injectable gel is used most effectively for those wrinkles and folds in the lower third of your face, like your "laugh lines," "smile lines" or "parentheses" (nasolabial folds), or "marionette lines" (oral commissures).
Juvéderm™ is a "next-generation" filler. It is made from hyaluronic acid—a naturally occurring substance in your skin that helps to hydrate and add volume. Hyaluronic acid may diminish with age, contributing to the formation of wrinkles and folds. Juvéderm™ injectable gel works to correct this by restoring hyaluronic acid in your skin, helping to smooth wrinkles and folds.
A unique manufacturing process.
Juvéderm™ employs its unique manufacturing process to provide the highest concentration of cross-linked hyaluronic acid of any currently available hyaluronic acid dermal filler for long-lasting results. This advanced manufacturing process also works to create a smooth consistency gel that flows easily into the skin during the injection process and provides a smooth, natural look and feel—so everyone will notice (but no one will know!) Juvéderm™ injectable gel is the only filler available with this smooth consistency gel—other existing hyaluronic acid dermal fillers are made of granular consistency gels.
What to Expect During Treatment
Because Juvéderm™ injectable gel is a simple, nonsurgical treatment, there is minimal recovery or downtime. So you can make an appointment to stop by your healthcare professional's office for treatment on the way home from work or the gym, or even while the kids are at soccer practice—and get right back to your life. Here's what to expect when you visit your healthcare professional's office for treatment. (Please note that although this experience is typical, the routine at your healthcare professional's office may be different).
Before you go: Some doctors recommend that you avoid any medications that can prolong bleeding, such as aspirin and non-steroidal anti-inflammatories (NSAIDS), for at least a week prior to treatment in order to reduce the risk of bruising and bleeding at the injection site. Ask your healthcare professional what he or she recommends.
When you arrive: If this is your first visit, your healthcare professional will ask about your medical history, including any allergies you may have or medications you may take, and will tell you more about wrinkle treatment with Juvéderm™. Juvéderm™ injectable gel does not require an allergy test.
Determining your treatment needs: Your healthcare professional will examine the soft tissue of your face to assess the depth of wrinkles and folds to determine your treatment. Juvéderm™ injectable gel is available in two formulations—Juvéderm™ Ultra for versatility in contouring and volumizing facial wrinkles and folds, and Juvéderm™ Ultra Plus, a robust formulation for volumizing and correcting deeper folds and wrinkles. This allows your healthcare professional to better tailor treatment to your unique needs. Your healthcare professional may even take pretreatment photographs so you can see the difference after treatment!
Before the procedure: Although anesthesia is not required, your healthcare professional may use topical or injectable anesthesia to numb the treatment area first.
The procedure: Your healthcare professional will ease the Juvéderm™ injectable gel under your skin to augment, or fill, wrinkles and folds. Following the injection, your healthcare professional may gently massage the treated areas. The procedure is quick and easy. The injection itself usually takes only about 15 minutes.
After the procedure: With Juvéderm™, there is minimal recovery or downtime.
For the first 24 hours following treatment, you should avoid strenuous exercise, excessive sun or heat exposure, and consumption of alcoholic beverages in order to help minimize the risks of temporary redness, swelling, and/or itching at the treatment sites. After the treatment, some temporary injection-related reactions may occur, including redness, pain, firmness, swelling, and bumps. Studies have shown that these are usually mild to moderate in nature and clear up on their own in 7 days or less. If you experience swelling at the injection site, you can apply an ice pack for a brief period. Your healthcare professional will tell you when makeup may be applied after your treatment.
Seeing results: You should see an immediate improvement in the treatment areas. Most patients need one treatment to achieve optimal wrinkle smoothing, and the results last up to 6 months or more. However, results may vary and correction is temporary. Supplemental “touch up” treatments may be required to achieve and maintain optimal results.
What is Restylane?
Restylane® is a safe and natural cosmetic dermal filler that restores volume and fullness to the skin to correct facial wrinkles and folds, such as nasolabial folds.
Restylane is a cosmetic dermal filler made of hyaluronic acid, a natural substance that already exists in the human body. The hyaluronic acid in Restylane is a crystal-clear gel called NASHA™ or Non-Animal Stabilized Hyaluronic Acid. NASHA is completely biocompatible with human hyaluronic acid.
Restylane maintains its shape using the body's own moisture. The hyaluronic acid in Restylane is hydrophilic or "water loving." As hyaluronic acid gradually degrades, each molecule binds to more water and over time, the same volume can be maintained with less hyaluronic acid. This ability of hyaluronic acid to bind to water is what helps provide lasting results.
Unlike rooster-derived hyaluronic acids and bovine collagen products, Restylane is free from animal proteins. This limits any risk of animal-based disease transmissions or development of allergic reactions to animal proteins.
Results May Vary
Where can Restylane be used?
Restylane® has been used in more than 4 million treatments in over 70 countries and is now approved in the U.S. for the treatment of facial wrinkles and folds.
The answer to lasting wrinkle correction is Restylane.
If you're considering a wrinkle correction treatment, we invite you to learn important facts about Restylane. In this section, you'll learn more about Restylane and see examples of how it can help you realize your goal of a younger and healthier appearance. It's quick and easy. The recovery time is minimal and the results are immediate and lasting.
After your treatment, you might have some redness or swelling. This will normally last less than seven days. Sunbathing and cold outdoor activities should be avoided until any redness or swelling disappear. If you are pregnant, breastfeeding, or under 18, you shouldn't use Restylane.
How Long Does Restaylne last?
Restylane® is proven to deliver long-lasting results. Studies have shown that Restylane effects generally last for about six months. The unique NASHA™ technology helps maintain the cosmetic effect until the injected material is nearly gone.
Follow-up treatments are typically scheduled at six-month intervals. (Individual results may vary.)
What can I expect?
You should take a few precautions before being treated with Restylane®. One week prior to treatment with Restylane, avoid taking St. John's Wort, high doses of Vitamin E supplements, aspirin, and other non-steroidal anti-inflammatory medications, such as ibuprofen. These agents may increase bruising and bleeding at the injection site. Also, if you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another recurrence.
Restylane is injected directly into the skin in tiny amounts by an ultrafine needle, resulting in minimal discomfort. The procedure is simple and convenient and results are practically instantaneous. To optimize your comfort during the short procedure, your physician may decide to numb the treatment area.
What are the advantages of Restalyne?
Restylane® is different from Botox®.
Restylane is a natural, cosmetic filler. Botox is a drug that blocks nerve transmission and relaxes the underlying muscles. Many patients have been very pleased after receiving treatment with both products.
Restylane is different than other hyaluronic acid-based products and bovine collagen.
Unlike rooster-derived hyaluronic acids and bovine collagen products, Restylane is free from animal proteins. This limits any risk of animal-based disease transmissions or development of allergic reactions to animal proteins.* Bovine collagen is derived from cowhide and requires an allergy test. Restylane can be administered without pretesting, so no waiting is required.
Please observe the following after treatment with Restylane®.
- After your treatment, you might have some redness or swelling. This will normally last less than seven days. Sunbathing and cold outdoor activities should be avoided until any redness or swelling disappear. If you are pregnant, breastfeeding, or under 18, you shouldn't use Restylane.
- Avoid touching the treated area within six hours following treatment. After that, the area can be gently washed.
- Sunbathing and cold outdoor activities should be avoided until any redness or swelling disappear.
- If you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another recurrence. Speak to your physician about medications that may minimize a recurrence.
- Avoid exercise and alcohol for six hours after your treatment.
- Having a follow-up treatment before the product has fully dissipated may enhance the lasting effect. Please be sure to consult your physician about recommendations for touch-up or follow-up treatments.
- One week prior to your next treatment with Restylane, avoid taking St. John's Wort, high doses of Vitamin E supplements, aspirin, and other non-steroidal anti-inflammatory medications, such as ibuprofen. These agents may increase bruising and bleeding at the injection site.
What is collagen?
Collagen, a naturally occurring fibrous protein found in both humans and animals, provides structural support for bones, skin, tendons, ligaments, and blood vessels and is the most abundant protein in the body.
What is Collagen Replacement Therapy®?
Zyderm and Zyplast collagen implants, also known as Collagen Replacement Therapy, are safe, non-surgical treatments in which highly purified bovine collagen is injected into the skin to replenish the skin's natural collagen.
Where does bovine collagen come from?
Zyderm and Zyplast collagen implants are composed of highly purified bovine dermal tissue. This material is obtained from the hides of steers within a closed herd.
What is a closed herd?
A closed herd is defined as one in which:
- there is no case of Bovine Spongiform Encephalopathy (BSE);
- there is no feeding of mammalian-derived (animal by-products) protein;
- there is a fully documented breeding history;
- there is a fully documented veterinary monitoring;
- each animal is monitored and traceable; and
- genetic material has been introduced only from herds with the same BSE-free status.
Why would one choose Collagen Replacement Therapy?
When a person smiles, frowns, or squints, stress is placed on the collagen in the skin, wearing it down and resulting in the formation of facial lines and wrinkles. Zyderm and Zyplast collagen injections can improve the appearance of the skin by reducing lines and wrinkles.
How long have people been using bovine-based collagen?
Zyderm and Zyplast bovine based collagen has been the preferred source for injectable collagen since 1981. Over 1.5 million patients have been treated with Zyderm and Zyplast collagen implants worldwide.
Has bovine-based collagen been approved by the FDA?
Yes. Zyderm and Zyplast collagen implants made by INAMED Aesthetics, are FDA-approved collagens for facial injection.
How do we know INAMED Aesthetics' bovine-based collagen facial injections are safe and free of contamination?
INAMED Aesthetics manufactures a highly purified form of bovine collagen, derived from a USDA-certified and carefully monitored closed herd of cattle in California.
How is collagen injected?
Bovine collagen in injected through a tiny needle just below the surface of the skin to smooth wrinkles or define the lip border.
What are the indications for treatment?
Fine to deep wrinkles, frown lines, smile lines, crow's feet, lip border, acne and other scars.
How long does a treatment last?
Treatments generally last 3-6 months.
What are the advantages to collagen treatment?
Collagen treatment requires minimal recovery and is relatively painless. Results are immediate and the product does not "migrate." Zyderm/Zyplast injectable collagen contains lidocaine for greater patient comfort.
What is Sculptra®?
Sculptra® is a synthetic injectable material known as "poly-L-lactic acid." Poly-L-lactic acid is biocompatible (a material that does not harm the body) and biodegradable (able to be broken down by the body). Poly-L-lactic acid has been widely used for many years in dissolvable stitches, soft tissue implants, and other types of implants.
How does Sculptra® work?
Sculptra® is injected below the surface of the skin in the area of fat loss. Sculptra® provides a gradual increase in skin thickness. Visible results appear within the first few treatment sessions.
Sculptra® will not correct the underlying cause of the facial fat loss, but will help improve the appearance by increasing skin thickness in the treated area.
Do I need a skin test before being treated with Sculptra®?
No skin testing is required prior to use.
Are the results from Sculptra® immediate?
No. At your first treatment visit, it may appear that Sculptra® worked immediately because of swelling from the injections and the water used to dilute Sculptra®. In a few days, when the swelling goes down and the water is absorbed by your body, you may look as you did before your treatment. Sculptra® takes time to gradually correct the depression in your skin. Your healthcare provider will see you again in a few weeks to decide if you need more Sculptra® injections.
How many treatments are required?
Your healthcare provider will decide the appropriate number of treatment sessions and the amount of Sculptra® you will need at each session. Patients with severe facial fat loss may require 3 to 6 treatment sessions.
How long do treatment results last?
Treatment results will differ for each person. In a clinical study, the treatment results lasted for up to 2 years after the first treatment session, in most patients. Touch-up treatments may be needed to maintain the desired effect.
Do injections of Sculptra® hurt?
As with any injection, injections with Sculptra® may hurt. Sculptra® is injected in small amounts using a very fine needle. Your healthcare provider may apply a topical or local anesthetic.
What is Lipoatrophy?
When the word lipoatrophy is broken down, "lipo" means "fat," and "atrophy" means "the loss of." Facial lipoatrophy is the loss of fat beneath the skin, which can result in sunken cheeks, indentations, and hollow eyes.
What can I expect to happen at a treatment session?
Make-up should be removed.
The area where the injections will be given will be cleaned with an antiseptic.
You and your healthcare provider will determine if a topical or local anesthetic is needed.
Sculptra® will be injected in small amounts into the skin using a very fine needle. Multiple injections will be needed.
An ice pack should be applied to the treatment area to help reduce swelling.
Your healthcare provider will answer all of your questions and prepare you for the treatment.
After the treatment session, the area should be thoroughly massaged to distribute the product evenly
What can I expect after treatment?
Immediately following a treatment session with Sculptra®, redness, swelling, pain, bruising or all of these signs can happen in the treatment area. These signs usually go away in a few hours to a few days. Some have been known to last up to 17 days. Your healthcare provider will give you specific post-treatment care instructions. You should massage the treated area (a few times each day) for several days after the treatment session. Within the first 24 hours after treatment, an ice pack should be applied for a few minutes at a time to the treatment area to help reduce swelling. Wrap the ice in a cloth and avoid putting ice directly on your skin. Avoid excessive sun and UV lamp exposure until any initial swelling and redness has resolved.
Report any worsening or longer-lasting symptoms or signs to your healthcare provider.
How quickly can I get back to my daily activities?
Most patients feel comfortable going back to their normal activities following treatment.
When will I be able to apply make-up after treatment?
Make-up may be applied a few hours after treatment if no complications are present (for example, open wounds or bleeding).
What are the possible side effects of treatment with Sculptra®?
The most common side effects with the use of Sculptra® include injection-related side effects at the site of the injection such as bleeding, tenderness or pain, redness, bruising, or swelling. These side effects generally last, on average, 3 to 17 days.
One possible delayed side effect with Sculptra® can be small bumps under the skin in the treated area. These small bumps may not be visible, and you may notice them only when you press on the treated skin. These bumps tend to happen within the first 6 to 12 months after the first treatment. Occasionally, these bumps go away on their own. Visible bumps, sometimes with redness or color change to the treated area, have also been reported. As with all procedures that involve an injection through the skin, there is a risk of infection.
Report any side effects to your healthcare provider.
Who should not use Sculptra®?
You should not use Sculptra® if you are allergic to any ingredient of Sculptra®. Talk to your healthcare provider about your medical history when deciding on treatment options.
Sculptra® is injected into the skin for restoration and/or correction of the signs of facial fat loss (lipoatrophy) in people with human immunodeficiency virus.
IMPORTANT SAFETY INFORMATION
You should not use Sculptra® if you are allergic to any ingredient of Sculptra®. Sculptra® should not be injected while you have an active skin infection or inflammation in the treatment area.
Side effects of Sculptra® may include the delayed appearance of small bumps under the skin in the treated area. Generally these bumps are not visible and may only be noticed when pressing on the treated area. Other side effects may include injection-related events at the site of injection, such as bleeding, tenderness or discomfort, redness, bruising or swelling.
Your doctor will administer several tiny injections of BOTOX® Cosmetic directly into the muscles that cause those moderate to severe frown lines between the brows.
Your doctor will determine where to administer the injections by examining your ability to move certain muscles in your brow area. The location, size, and use of the muscles that create a furrowed brow vary markedly among individuals.
No anesthesia is required, although your doctor may choose to numb the area with a cold pack or anesthetic cream prior to injecting. Discomfort is usually minimal and brief.
You can expect to be in and out of the physician’s office without downtime. You may see a marked improvement in the moderate to severe frown lines between your brows within days. Improvement may continue for as long as a month, and could last up to 4 months.
What Is Botox®?
BOTOX® Cosmetic is a purified protein produced by the Clostridium botulinum bacterium, which reduces the activity of the muscles that cause those frown lines between the brows to form over time.
In fact, the American Society for Aesthetic Plastic Surgery (ASAPS) ranked BOTOX® Cosmetic as the most popular physician-administered aesthetic procedure in the United States for the fourth year in a row (surgical and nonsurgical combined).
Botox® for Men
BOTOX® Cosmetic is certainly not just for women. Women may talk about their looks more often, but men are concerned about their appearance as well.
In nature, some male species have all the luck when it comes to looks. Think about a peacock and a peahen. It's the male who's got that gorgeous train, not the female. And the father of the lion family is the one with the glorious mane. With humans, it doesn't always work that way, but the fact is, guys do care about their looks.
Why shouldn't they? A man who goes to the gym to work out and cares about his clothes and grooming is a man who not only cares about his appearance, but what it says about him personally, as well as in business.
Men are also doing something about their brow lines
A man who has pronounced lines between his brows may be perceived as angry or stressed—and he doesn't want to look that way. That's why it's not surprising that men are also choosing BOTOX® Cosmetic, a non-surgical, physician-administered treatment.
A BOTOX® Cosmetic treatment requires little time out of the office. So, it’s possible to have the procedure done during a lunch hour and head right back to the office.
Important Safety Information
Serious heart problems and serious allergic reactions have been reported rarely. If you think you’re having an allergic reaction or other unusual symptoms, such as difficulty swallowing, speaking or breathing, call your doctor immediately. The most common side effects following injection include temporary eyelid droop and nausea. Localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising may be associated with the injection. Patients with certain neuromuscular disorders such as ALS, myasthenia gravis, or Lambert-Eaton syndrome may be at increased risk of serious side effects.