Injectable Fillers (Juvéderm, Voluma) - San Diego, CA

The visible signs of facial aging occur over time as a result of sun exposure, heredity and life style. One of the earliest signs of aging is a loss of facial fullness and the development of wrinkles. Softening of these facial lines and the restoration of volume and fullness in the face often can be achieved non-surgically with injectable fillers. At Manish C. Champaneria, MD, FACS, Dr. Champaneria uses Juvéderm® XC and Juvéderm Voluma® XC. Both Juvéderm and Voluma (made by the same company as BOTOX) use hyaluronic acid as the active ingredient, which is a natural substance found in our bodies to restore facial contours and reduce the appearance of lines and creases for his patients in San Diego, CA. Non-surgical rejuvenation treatments such as injectable fillers cannot achieve the same results as a surgical facelift, but may help delay the time at which a facelift becomes appropriate. The initial treatment will include a complete consultation before a treatment plan is created and performed. Subsequent follow-up procedures may take only a few minutes, as the full process of consultation is not necessary to repeat, although consent is required at each visit.

Technological advances have made it possible to manufacture a variety of fillers. Most fillers are derived from natural substances (such as collagen) while others are artificially produced. The patient’s skin condition and aesthetic goals will decide which type of filler will be best to use.

Fat transfer is the harvesting of excess fat from a donor site on the patient’s body. The fat is extracted using liposuction. These fat tissues are then purified and reinjected gradually into an area of skin with layering precision. The doctor will massage the skin and ensure that the intended contour is achieved. The body naturally absorbs fat and the results often last up to 6 months.

Collagen is a naturally occurring protein in human and animals. Skin, bone, cartilage and teeth are rich in collagen. These are harvested and converted into a sterilized liquid form and used as a derma filler. It is a popular filler for lip augmentation procedures. Some collage is derived from animals. Patients using a derma filler of this nature will require allergy testing ahead of the procedure to ensure that they will not have any complications. 

Usually found in the bones and teeth of humans, calcium hydroxyapatite is also harvested and processed to use as a liquid filler. It is considered as one of the heavier substances and ideal in adding volume to deep creases. This particular filler product usually lasts longer than some of the others on the market.

Hyaluronic acid is another substance that is sourced from humans. Rich deposits of this substance are commonly found in ligaments and connective tissues. As with other natural substances, when used as a derma filler, the results are natural and effective, but they are not long lasting as the body reabsorbs the solution over time.

Polylactic acid is an artificial substance. When injected, it doesn’t just add volume underneath the skin, but it also triggers the production of collagen, which helps in skin renewal. The contours will be visible immediately and the skin quality will be evident after several months. This filler can last up to a year or longer for most patients.

This is a popular derma filler as it lasts longer compared to fillers that are made only from natural substances. PMMA is a hybrid of microspheres mixed with a collagen solution. The result is a more solid, heavy filler that works well for deep creases and for reconstructive purposes when a good amount of tissue is absent. This filler is considered semi-permanent, meaning it has the potential to last for several years or longer.

Injectable fillers are performed in the doctor’s office with the use of local anesthetic creams if necessary. Almost pain-free, the patient will only feel a prick from the injection. The substance will be injected gradually in even layers to make sure a natural looking result and contour is achieved. Sometimes, it may take more than one full syringe depending on how much volume is needed. There may be slight swelling, bruising and redness on the treated area but this usually subsides after a few days. Patients will be able to return to a normal routine a few hours after treatment.

All derma fillers are FDA approved, meaning they have passed comprehensive testing to prove that the product is safe and effective to use. The majority of fillers are made with a natural substance so if the result is not as the patient desired, the good advantage is that the filler, at some point, will be reabsorbed by the body, and the results are temporary.

Most likely. Natural fillers are absorbed by the body in an average of 6 months to 12 months. When this happens, there will be a loss of volume similar to the condition prior to treatment. Reinjection is recommended to maintain the desired results. Some patients find this high maintenance but feel its worth the natural feel of their cosmetic treatment.

The benefit between a BOTOX injection and a derma filler is weighed with the patient’s skin condition. BOTOX is a muscle relaxant that temporarily paralyzes muscles underneath the skin preventing them from contracting, which causes wrinkles. This results in smoother skin and significant decrease with wrinkles. However, if the patient also has loose skin and/or hollow contours, volume may also be an issue and this is when a derma fillers works best. Today, a large majority of patients intermix the use of BOTOX with an injectable filler. Some include other treatments such as chemical peels and laser treatments, which essentially provides the patient with a “liquid facelift.”