Dermal and Wrinkle Fillers, NYC
Restylane®, Radiesse® Juvederm™, and Perlane...
After the age of 50 we lose 1% of our dermal collagen, elastins and hyaluronans per year. As a result we experience facial changes such as:
- A thinning dermis
- Hollowing of the cheeks and mouth areas
- Deepening lines in nasolabial folds
- Descending fat pads due to gravity
- Greater bony landmarks
- Thinning of the lips
- Flattening of the upper ridges from the nose to the mouth
- Dropping of the mouth corners causing loss of support for the lip and leading to "marionette" lines
- Drooping of the nasal tip
- Decreasing support of lower third portion of the face
Today we can replace the hollowing of the skin and the volume lost to aging with a number of filler materials available. Dermal fillers (or wrinkle fillers) are also used to augment the size and shape of the lips (lip augmentation).
There are a number of dermal fillers available, each with specific uses and distinct advantages. These include Restylane, Juvederm, Perlane, Radiesse, Sculptra and more.
Dr. Vafa performs an individual facial analysis for each patient and determines the type and amount of filler needed for the most natural looking results. Dermal fillers and wrinkle fillers are priced per syringe and prices vary among different fillers. Dr. Vafa will discuss the type of dermal filler and the number of syringes needed for each individual procedure during a consultation with the patient.
Please call (212) 219-1990 to schedule a free consultation with Dr. Ali Vafa at LaserTouch Aesthetics.
Radiesse® dermal filler is made of calcium-based microspheres suspended in a water-based gel, and is injected into the skin through a simple and minimally invasive procedure. Radiesse dermal filler is the ideal choice for total facial contouring. It can restore a healthy, youthful appearance, enhance your existing features, help you defy age and gravity, and increase your confidence – all without invasive surgery or scarring.
What areas of the face are treated with Radiesse?
Typical Radiesse injections include:
- smoothing and contouring smile lines or nasolabial folds,
- wrinkles at the corner of the mouth,
- vertical lip lines,
- acne scars,
- facial defects or recessions,
- frown lines,
- restoring volume in and around the cheeks,
- modest enhancement or correcting asymmetrical features
It is also has been used for non-surgical nose reshaping, chin augmentation, and liquid face lift. Popular for its long-lasting results, Radiesse benefits should be evident for 12 – 24 months depending on area treated.
Please click here to reach the official Radiesse site for information or click below for Before & After photos and FAQ.
Restylane® and Perlane®
Restylane® and Perlane® are safe and natural cosmetic dermal fillers that restore volume and fullness to the skin to correct facial wrinkles and folds, such as nasolabial folds.
Restylane and Perlane are made of hyaluronic acid, a natural substance that already exists in the human body. The hyaluronic acid in Restylane is a crystal-clear gel called NASHA™ or Non-Animal Stabilized Hyaluronic Acid. NASHA is completely biocompatible with human hyaluronic acid.
Restylane maintains its shape using the body's own moisture. The hyaluronic acid in Restylane is hydrophilic or "water loving." As hyaluronic acid gradually degrades, each molecule binds to more water and over time, the same volume can be maintained with less hyaluronic acid. This ability of hyaluronic acid to bind to water is what helps provide lasting results.
Perlane has larger gel particles and is intended to be injected deeper within the skin.
Unlike rooster-derived hyaluronic acids and bovine collagen products, Restylane is free from animal proteins. This limits any risk of animal-based disease transmissions or development of allergic reactions to animal proteins.
After your treatment, you might have some redness or swelling. This will normally last less than seven days. Sunbathing and cold outdoor activities should be avoided until any redness or swelling disappears.
Doctor Vafa uses several different dermal fillers such as Restylane, Juvederm and Radiesse. He will suggest which filler is best for your particular situation during your initial evaluation.
Frequently asked questions
Where can Restylane be used?
Restylane® has been used in more than 3 million treatments in over 70 countries to correct a variety of wrinkles and to enhance the appearance of the lip border. It is currently approved in the U.S. for the treatment of facial wrinkles and folds, such as nasolabial folds, which are the lines from the nose to the corners of the mouth.
How long does Restylane last?
Restylane® is proven to deliver long-lasting results. Studies have shown that Restylane effects generally last for about six months. The unique NASHA™ technology helps maintain the cosmetic effect until the injected material is nearly gone.
Follow-up treatments are typically scheduled at six-month intervals. (Individual results may vary.)
What are pre-treatment precautions?
Before being treated with Restylane® or Perlane® you should take a few precautions. Prior to treatment, avoid using aspirin, nonsteroidal anti-inflammatory medications, St. John’s wort, or high doses of vitamin E supplements. These agents may increase bruising and bleeding at the injection site. Also, if you have previously suffered from facial cold sores, discuss this with Dr. Vafa, who may prescribe a medication to minimize recurrence.
Is Restylane safe?
Since 1996, over 3 million Restylane® treatments have been safely administered by dermatologists and plastic surgeons in more than 70 countries. This innovative treatment is now approved in the U.S. for the treatment of facial wrinkles and folds.
Restylane has a highly favorable safety profile. It's composed of Non-Animal Stabilized hyaluronic acid. Hyaluronic acid is a substance found naturally in the human body. Restylane is fully biocompatible. There is limited risk of animal-based disease transmission or development of allergic reactions to animal proteins. No allergy testing is required before use.
Based on clinical studies, Restylane treatments produce a low occurrence of adverse events. The most commonly reported side effects were temporary redness and swelling at the injection site. These effects typically resolve in less than seven days.
How much does Restylane cost?
Restylane® is injected in a customized procedure based on your specific needs, so the cost will vary from patient to patient. In general, the cost of Restylane treatment is comparable to the cost of similar procedures. In our office the price may range from $500 and up depending on area of injection and amount of medication used. However, Restylane's lasting properties often prove to be very economical over the long term. Please consult Dr. Vafa to determine the best recommendation for your particular needs.
What are the advantages of Restylane?
Restylane® is different from Botox®.
Restylane is natural, cosmetic filler. Botox is a drug that blocks nerve transmission and relaxes the underlying muscles. Many patients have been very pleased after receiving treatment with both products.
Restylane is different than other hyaluronic acid-based products and bovine collagen. Unlike rooster-derived hyaluronic acids and bovine collagen products, Restylane is free from animal proteins. This limits any risk of animal-based disease transmissions or development of allergic reactions to animal proteins. Bovine collagen is derived from cowhide and requires an allergy test. Restylane can be administered without pretesting, so no waiting is required.
What are my Restylane post-treatment instructions?
Cold compresses (a cloth dipped in cold water, wrung out, and applied to the injected area) may be used immediately after treatment to reduce swelling.
Avoid touching the treated area during the 6 hours following treatment, so you do not accidentally injure your skin while the area is numb. After that, the area can be gently washed with soap and water.
Until any redness or swelling goes away, avoid exposure of the treated area to intense heat (sun lamp or sunbathing).
If you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another recurrence. Speak to Dr. Vafa about medications that may minimize an outbreak.
Avoid taking aspirin, nonsteroidal anti-inflammatory medications, St. John’s wort, or high doses of vitamin E supplements for one week after treatment. These agents may increase bruising and bleeding at the injection site.
Please be sure to consult your healthcare professional if you experience side effects beyond 14 days. Also, ask your healthcare professional about recommendations for a follow-up appointment.
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Recently approved by the FDA, Juvederm™ injectable gel is a “next-generation” dermal filler. The smooth consistency gel helps to instantly restore your skin's volume and smooth away facial wrinkles and folds, like your "smile lines" (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth).
Juvederm™ dermal filler lasts long because it's the only dermal filler currently available with the highest concentration of hyaluronic acid and a special formulation process. This process creates a smooth gel that flows easily into the skin, creating smooth, natural looks.
All other currently approved hyaluronic acid dermal fillers use a gel particle suspension formulation. These gel particles may be visibly seen as opposed to the smoother formulation used in Juvederm™. The smooth consistency of Juvederm™ dermal filler also may help to minimize the discomfort that can sometimes occur during the injection procedure. In addition, Juvederm™ injectable gel is the first FDA-approved hyaluronic acid dermal filler that is proven to be safe and effective for persons of color.
Call our office to schedule a complimentary consultation with Dr. Vafa to discuss if Juvederm™ is right for you.
Belotero Balance Dermal Filler
Belotero Balance Dermal Filler is an FDA approved injectible filler that quickly integrates into the skin. Belotero Balance is FDA-approved for injection into the mid-to-deep dermis for correction of moderate-to-severe facial wrinkles and folds, such as nasolabial folds. Once injected, it instantly smooths the lines and wrinkles in your face. While Belotero Balance is made of the same material (hyaluronic acid) as some of the other fillers, Belotero Balance has unique properties that allow it adapt within the skin for soft results. The filler may last about 6 months or more according to the manufacturer - Merz Aesthetics. As with other fillers, there is very little to no down-time associated with a Belotero Balance procedure.
Call our office to schedule a complimentary consultation with Dr. Vafa to discuss if Belotero Balance is right for you.
Dr. Vafa now performs a novel technique to inject Juvederm XC or Restylane in the dermis for optimal correction of dynamic facial lines. Mobile facial folds represent a greater challenge for correction using standard injection techniques. The new injection technique is named the Fern Pattern Technique. The purpose of the Fern Pattern Technique is to use a Hyaluronic Acid filler material in such a way that it becomes a skin stiffening agent, rather than a simple filler in order to provide optimal correction for lines that deepen with expressive facial movements. The Fern Pattern Technique also uses less material to provide a correction that is not visible at rest or during dynamic movement for lines that deepen during a smile, as well as the dynamic lower nasolabial fold.
Four basic injection patterns have been described using dermal fillers in cosmetic dermatology:
1. The linear threading technique: fill a fold with a singular "thread-like" shape after puncturing the epidermis once to provide linear volume.
2. The serial puncture technique: fill a fold with multiple injections of the epidermis placed in a row to provide linear volume.
3. The fanning technique: puncturing the epidermis once, "fanning" the needle in a fan pattern to provide volume in a triangular shape.
4. The cross-hatching technique: combines multiple injections of linear threading that crisscross at right angles to provide volume in a square shape.
These injection techniques introduce hyaluronic acid (HA) into or underneath the skin, and provide the physician 4 ways to restore volume deficits. For example, areas of the face that are relatively immobile, such as the top half of the nasolabial fold or the tear trough can be filled with relative ease using one of these basic injection techniques. A good correction can usually be achieved. However, none of these 4 injection patterns are satisfactory for correcting the problem of dynamic folds, such as the lower half of the nasolabial fold, the corners of the mouth, and the smile lines found in the lower lateral cheeks. These folds are quite mobile with expressive facial movements, and they present a greater challenge in providing optimal correction.
The Dynamic Nasolabial Fold
The dynamic nasolabial fold is often filled using a linear threading technique. Unfortunately, during animation there remains a tendency of the nasolabial fold to shift alongside the filler if the correction used was only a linear threading technique, which can then be easily recognized by an observer. In order to solve this problem, it is necessary to produce a broad plane across the nasolabial fold to prevent it from reappearing lateral to the filler during a smile. Many injectors attempt to use the cross-hatching technique to provide more support next to the dynamic fold, which frequently gives the appearance of an area that is overfilled at rest.
Among the most difficult wrinkles to adequately fill are the "smile lines," which appear on the lower lateral cheek while smiling. Linear threading is usually unsatisfactory, especially during animation, and cross-hatching often results in a "pad" of filler in patients who have thin skin. In addition, even linear threading can be visible in an individual with thin skin.
The Fern Pattern Technique
To achieve correction that is undetectable at rest and during animation of a dynamic fold, Dr. Vafa uses HA not as a filler, but rather as a skin stiffening agent to attempt to increase the stiffness of the skin on either side of the dynamic line. Patients observe increased stiffness of the skin on either side of the dynamic fold after injection and a decreased ability for movement of lines in the treated area.
Fern Pattern Technique:
1. Leaves less visible dynamic skin folds and creases - which occur during facial motion - compared to traditional pattern injections.
2. Less product is used per area, so one syringe can correct an area which needed two syringes with traditional pattern injections
3. We have found that the HA lasts significantly longer because of the placement technique and location of the HA in the dermal plane. Most patients come back for re-treatment in a year.
The technique requires multiple small injections; therefore before the procedure we apply a topical anesthetic to the treatment area for 30 minutes, which significantly minimizes any discomfort.