Natural and New Technology

What is dermal filler therapy?

Dermal filler therapy has been widely accepted by patients in North America, much more so than cosmetic dentistry. You don’t need to believe me — just ask any esthetic patient if they have heard of dermal fillers injections. Ask patients if they have ever had Botox or dermal fillers and you will quickly find that these are immensely popular esthetic therapies.

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What does a dermal filler do?

Simply put, a dermal filler injection is a material injected underneath the skin in the nasolabial folds, marionette lines, cheeks, and oral commissures, which plump up these areas and smooth out the wrinkles. Lip augmentation is also done with dermal fillers. Traditionally, plastic surgeon and dermatologist offices provide these services. Today these services can be provided by MDs, dentists, nurses and medical estheticians who work in a medical / dental office or medspa.

Generally, when you look at the world of esthetic injectable treatment, botulinum toxin (Botox Cosmetic) is generally for the top half of the face, and dermal fillers are for the bottom half. The main areas where dermal fillers are used in the lips, cheeks, nasolabial folds, the oral commissures, and marionette lines. These are the areas that frame the teeth and mouth, and are certainly within the realm of dentistry and dental treatment. Dermal fillers are gently placed in these areas through an extraoral injection right under these folds and creases to plump them up. By the way, these are exactly the same areas that you routinely inject. The only difference is that you typically inject these areas intraorally when you deliver local anesthesia.

What was really interesting to me during my dermal filler training courses is that the nurses and MDs that I trained with had absolutely no problem giving the extraoral injections for face fillers, but were a bit squeamish about delivering local dental anesthesia and giving intraoral injections. The dentists that I trained with were exactly opposite and were very comfortable with the intraoral injections, but were initially a little unsure of themselves on the extraoral injections. For more information, or to see if we could help you, please contact us at (919) 578-8593.

How long do dermal fillers last?

Depending on the dermal filler used, the effects can last anywhere from six months until forever. There are temporary dermal fillers and permanent dermal fillers. Typically, most health-care professionals shy away from permanent face fillers because if the filler is placed in an improper position, its permanence becomes a huge issue and liability. Most dermal fillers placed are temporary and dissolve in six to 18 months.

There are a few types of dermal fillers on the market. Bovine and human collagen have been used in the past but require pre-testing by the patient and are not very popular anymore. Hyaluronic acid like Juvederm, Restylane, and Revanesse cosmetic fillers are today’s most popular and widely considered best dermal fillers. Hyaluronic acid is a naturally occurring substance in the body that is lost with aging. Hyaluronic acid dermal fillers add volume to the facial structures, are very hydrophilic, and look very natural. Hyaluronic acid fillers typically last six to 12 months and can also be used for lip augmentation, which is a big advantage.

Calcium hydroxylapatite is a naturally occurring substance in the body that is used in a popular dermal filler called Radiesse. Radiesse is a thick, viscous material that typically lasts longer than hyaluronic acid fillers because it takes longer for the calcium hydroxylapatite material to break down. In addition, as the calcium hydroxylapatite breaks down, the body naturally replaces it with collagen, which keeps the area free of wrinkles longer.

The choice of dermal filler material is very important depending on the areas that are being injected and corrected.

Fillers can do more than enhance lips and downplay wrinkles.

They can elevate sunken scars; reinflate hands; brighten cavernous under-eyes; and sharpen jawlines that have gone soft. The doctors we spoke to universally use brawny structural fillers (Radiesse, Juvéderm Ultra, Restylane Lyft) in the hands and jawline. For the transparent under-eye area, injecting a fine layer of a more fluid HA — one that doesn't swell or cast a bluish glow (something known as the Tyndall effect) — can lift the skin up and away from underlying vessels, obscuring discoloration and hollows

For acne scars, there’s currently only one filler technically FDA-approved for the job: Bellafill. Because it’s acrylic based, it has more lifting power for correcting depressed scars.

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