Fillers

As described the last newsletter, facial wrinkles are caused by sun (UV) exposure, repetitive contraction of facial expression muscles, and loss of skin collagen and volume.  As skin become less elastic, the muscles pull and force the skin above to form a wrinkle, which become etched in the skin.  There are two types of wrinkles.  Dynamic wrinkles form when the muscle is contracted.  Static wrinkles are present even when the muscle is relaxed.  Dynamic wrinkles progress to static wrinkles.

The appearance of facial aging is also due to drooping and deflation.  Drooping occurs from the effects of gravity over a lifetime, drawing the facial features such as skin, subcutaneous tissue, and fat inferiorly.  Deflation occurs from volume loss as collagen is decreased, fat becomes atrophied, and fluid turgor is decreased.  Drooping and deflation leads to signs of facial aging such as prominent nasolabial folds (folds from the side of the nose to the corner of the mouth), marionette lines (vertical lines below the mouth corners to the chin), nasojugal grooves (groove from the inner corner of the eye to the cheek), among others.

Fillers are injectable gels that are injected into the facial tissue to smooth deeper, static wrinkles, folds, and grooves.  Fillers add volume back to the deflated face which give the face a smoother look and restore youthful contours to the skin.  There are many fillers on the market, but we prefer Juvederm and Restylane. Juvederm and Restylane are made of hyaluronic acid (HA), which occurs naturally in the human body particularly in skin and cartilage.  Natural HA provides volume and fullness to the skin, acts as a cushioning agent, and delivers nutrients.  HA is safe, and it is routinely injected inside the eye during cataract surgery to preserve the shape of the eye while the surgeon is working through the surgical incision in the eye.

Juvederm and Restylane work well on the nasolabial fold, marionette line, and nasojugal groove.  We also use these fillers to augment thin lips.  These fillers also work well on deep, static wrinkles that Botox alone may not fully soften. Remember from last newsletter that Botox smoothes the dynamic component of a wrinkle.

The procedure takes 15 minutes.  We numb the area with anesthetic cream or injection of anesthesia.  A tiny needle is used (27g).  Risks include swelling and bruising.  The effects of Juvederm or Restylane last for about 6 to 9 months as the body breaks up the HA just as it breaks up the body’s natural HA.

If you or any of your patients are interested in trying fillers such as Juvederm or Restylane, please call any of our 4 offices to make an appointment.

Eyesthetica is the largest private group in the greater Los Angeles area, whose practice is dedicated solely to oculofacial plastic surgery specializing in cosmetic surgery, eyelid reconstruction, lacrimal and orbital surgery.  We have opened a new office in Torrance to better serve you and your patients.

Eyesthetica                                                                                     Ophthalmic Plastic & Reconstructive Surgery

Oculofacial and Cosmetic Surgery Associates                                                                Orbital and Lacrimal Surgery

Steven C. Dresner, M.D., Michael A. Burnstine, M.D., Melanie Ho Erb, M.D.                               Cosmetic Surgery

Santa Monica          Pasadena               Torrance               Downtown Los Angeles                                                                  www.DrDresner.com

310-453-1763         626-564-0004       310-530-9482       213-482-3467                                                                               www.DrBurnstine.com