Skin Care Articles
To Fill Or Not To Fill...That is the Question
Joyce Black, RN, CPSN
Many of my days are spent talking to my patient’s about methods of rejuvenation that would be most beneficial for their particular needs and concerns. Whether we are discussing an acne scar, wrinkles or simply lines created as the result of facial movement, a plan must be formulated to treat the problem with long term results in mind.
Because of that “long term result” attitude, I always discuss lifestyle, including sun exposure, diet, hydration and smoking habits. I also discuss the products my patients are currently using. If they are able to improve upon their general skin appearance without the added discomfort and/or expense of facial fillers or even neurotoxins like Botox and Dysport, then we feel they are being cared for in this practice in a way that gives long term benefits.
If a decision is finally made for “enhancing” adequate skin care, it must be decided whether facial fillers are indicated.
This practice is very familiar and most comfortable with products that contain hyalyronic acid. HA is a naturally occurring sugar molecule that helps make our skin softer while providing a cushion for our joints (synovial fluid). Examples of HA injectables are:
Restylane/ Perlane: Longevity—6-18 months.
Juvederm Ultra/Juvederm Ultra Plus: Longevity—6-18months.
The differences between these two companies products is small because both give positive results with very little chance for complications. Both contain lidocaine for comfort while injecting.
Juvederm Ultra plus and Perlane are manufactured with a larger molecular structure for injection into deeper folds and wrinkles. Restylane and Juvederm Ultra are used for more superficial lines and in the upper and lower lips.
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*Radiesse: An effective dermal filler made of a substance call Calcium Hydroxyappetite. This is delivered in a solution via microsperes and is mostly considered safe and effective.
The benefit of this particular injectable is that it claims longer duration. The negative is occasional “lumpiness” issues.
Longevity—Claims of up to 2 years.
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Cosmoderm: Collagen is a naturally occurring protein in our bodies that gives strength and support to our skin. This product is a human-based, highly purified form of collagen used for injection. Cosmoderm is a great alternative for finer lines, especially around the mouth.
Longevity—3-6 months.
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Prevelle Silk: This product is a less viscous form of hyaluronic acid used for finer lines similar to using collagen. Prevelle also contains a small amount of lidocaine for comfort.
Longevity—3-6 months.
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*Sculptra: This injectable product is made of poly-l-lactic which is beneficial for moderate to deep wrinkles or scars.
3 sessions over a few months are indicated as this product claims to rebuild your own collagen over time.
Longevity—up to 2 years.
*Not carried at the Aesthetic Skin Care Center/EVMS
Indication for any of the above “fillers” are fine to deep lines on either side of the mouth called nasolabial folds, upper and lower lip lines (vermillion definition), increase volume in the upper and/or lower lips, chin depressions marionette area (corners of the mouth), tear trough area, deep scars and hands.
It should be noted that the FDA has cleared hyalouronic acid products for use in only the nasolabial fold areas but these products are almost universally used in the other areas noted as well.
Hopefully at least some of your questions have been answered about these 21st century rejuvenation supplements to cosmetic surgery. We’re always excited about the changes we can make with the use of these products and look forward to meeting you and discussed your individual needs.
Joyce Black, RN |
