All AboutĀ DermalĀ Fillers

aesthetics collagen loss cosmetic procedure dermal fillers juvederm radiesse restylane sculptra skin aging volume loss Jan 23, 2023

You've probably heard about them, and perhaps even know someone who's had them. But do you really know what dermal fillers are, and what they can do? This week I'm taking a deep dive into the world of dermal fillers and how and when we use them.

As we age, our bodies lose collagen. This happens as early as our (gulp) 20s! When we lose collagen, our skin is no longer as full and our skin can begin to crepe and show fine lines and wrinkles. I describe it like a balloon. When we are young our face, or balloon for this analogy, is full and taut. But with time, the balloon loses air and the balloon is no longer as full and can even wrinkle. When we add air back into the balloon, we inflate it and it becomes full again. We can do something similar with our skin by using dermal fillers. We re-inflate the volume loss which then makes us look more youthful, rested and removes some lines and hollows. What dermal fillers don't do is remove excess skin. This requires surgery so it's important to know what is and isn't possible with dermal fillers

Often times when I talk about dermal fillers to patients, many will worry that they will get a fake and overdone look, think First Wives Club or Real Housewives style! I can say very confidently that with just a syringe or 2 of filler, that will not happen! That overfilled look is a 'look' that some people are going for intentionally, but this won't happen with carefully placed filler and in moderation!

There are many different types of dermal fillers out there in the market and they all work in slightly different ways. 

Perhaps the most common are our hyaluronic fillers (Restylane and Juvederm type products).

These are easy to inject especially into discrete areas of volume loss, readily available and provide immediate results. They can also be removed or dissolved if one does not like the look. One of the disadvantages is that they are not as pro-collagen stimulating as other fillers.

Other fillers that are very pro-collagen stimulating include poly-l-lactic acid (Sculptra), and calcium hydroxylapatite (Radiesse). These are great for areas that need a lot of volume filled or someone with generalized volume loss. They tend to work best over time as they stimulate your own collagen formation. 

And of course the most 'natural' of all dermal fillers is using your own fat to replace volume loss with something known as fat grafting. With fat grafting, a patient's own fat is harvested from an area like the hips or buttocks and then re-injected into the area that needs volume. In my office, we call this reuse-recycle-renew! It's a bit more involved having to harvest the fat and reinject, but the results are immediate and it's a great option for large areas of volume loss.

While dermal fillers are common and everyone seems to be injecting and offering them, complications can arise, especially in the hands of inexperienced injectors with a poor understanding of facial anatomy. Lumps and bumps in the skin can occur with all dermal fillers and rarely these can become infected. Skin necrosis (aka tissue death) can also occur when the filler is placed mistakenly into an artery, and blindness has even occurred when placed in and around the eyes and nose. Fortunately these complications are rare, but they can occur. Seeing a board-certified dermatologist or plastic surgeon for your filler injections can help minimize the risks of these occurrences,

If you have an area of concern or want to learn more about dermal fillers, check out my podcast, All About Dermal Fillers.

New podcasts are released every Tuesday.


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