All posts in Fillers

New Product Promises a Better Way to Get Full Lips

New Product Promises a Better Way to Get Full Lips

Duck lips have replaced fake boobs as everyone’s favorite cosmetic-surgery joke (not to mention celebrity rumor), but that may end soon. Restylane Silk, a new, softer form of Restylane, the hyaluronic-acid wrinkle filler approved by the FDA in 2011 (and again in 2012, when lidocaine was added for pain), will be widely available throughout the U.S. next month.

Restylane Silk was approved by the FDA last June for injection in lips and perioral lines (smoker’s lines or pucker lines to you and me). This is the first product approved for these fine wrinkles. Because of changes in corporate ownership, the introduction of the filler was delayed, and only a small group of physicians in a pilot program had access to it. By February, that will all change.

The product’s softness is its defining feature. Fillers can be manufactured with different viscosities, and Restylane Silk is composed of smaller and smoother particles than its siblings, which allows practitioners to use of an ultrafine needle. The lip is perhaps the most sensitive area of the body, and the combination of the tiny needle and the inclusion of lidocaine in the formula provides a more comfortable patient experience. “It’s wonderful to have a product that is approved specifically for lips and the lines around them that gives a natural, supple look,” says Diane Berson, a Manhattan dermatologist, who has found that a little goes a long way. “In most patients, I only need one syringe.”

Because the lips are in constant motion, longevity has always been a problem for fillers in the area. Previous products often lasted only three to four months in lips versus six months in smile lines, says Berson. In the FDA trial of Restylane Silk, which involved 221 mostly female patients, 98 percent had visible improvement 14 days after injection, and 76 percent still had lip improvement at six months. Study participants were offered an optional second injection at two weeks, and some took advantage of it. Some patients may not even bother to test Restylane Silk’s longevity, says Jeanine Downie, a dermatologist in Montclair, New Jersey. “I think the majority of women getting this procedure will not wait the full six months, because they will enjoy the results so much, they will want to have it redone before their lips go back to baseline.”

If Restylane Silk lives up to its promise, comedians will need a different augmented body part to make fun of. Fortunately, the butt is coming on strong.

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New Trends in Plastic Surgery

New Trends in Plastic Surgery

The 2014 plastic-surgery statistics will be released later today by the American Society for Aesthetic Plastic Surgery (ASAPS). Thanks to an advance peek, I can report that butts are getting bigger, while breasts are getting smaller.

Buttock augmentations are up 86 percent over 2013. Michael C. Edwards, a plastic surgeon and the president of the ASAPS notes that most women don’t want giant backsides, they just want more shapely ones. The other big news is breast revisions, which are up 30.4 percent. Many attribute that rise to aging implants in need of replacement, along with many women’s desire to switch from saline to silicone-gel-filled implants, which may not have been available when they originally had surgery. What’s more, insiders say most of these women are exchanging their old implants for smaller replacements.

The other news in the numbers is a five percent drop in overall procedures: 10,663,607 in 2014, down from 11,419,610 in 2013. The decrease was mostly in minimally-invasive procedures like Botox and fillers. No explanation for this was offered by the ASAPS, but could it be what I call injection fatigue? Many women I’ve spoken to don’t want to return again and again for refills. Surgical procedures fell only 1.5 percent from 1,883,048 to 1,764,956, a drop that the number crunchers say is not statistically significant.

Fat—and getting rid of it—is still a high priority. In recent years the top surgical procedures for women have flipped back and forth between breast implants and liposuction. In 2014, liposuction held the number one spot, followed by breast augmentation (down 8.5 percent), tummy tuck, blepharoplasty (or eye lift), and in fifth place, the breast lift. Facelifts are in eighth place.

Liposuction may still be king (or is it queen?) in the surgical department, but non-surgical fat reduction with devices such as CoolSculpting and VASERshape rose a whopping 42.7 percent, from 94,922 in 2013 to 135,448 in 2014. That number could rise even more this year if ATX-101, an injection for fat reduction under the chin, gets FDA clearance, which it’s expected to receive.

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Are Fillers The Right Choice For You?

Are Fillers The Right Choice For You?

 

 Fillers are popular. To help you decide whether this treatment is right for you and to have the treatment performed safely, the AAD provides the following facts.

What happens when I get a filler?

The procedure varies with the filler your dermatologist will use, the part of the body to be treated, and your medical history. Here are some general guidelines about what you can expect:

  • Most filler treatments take between 15 and 30 minutes and require one office visit.
  • Before getting the injections, you may need ice, an anesthetic applied to the skin, or a nerve block (an injection). This varies with the filler and area to be treated. Hands generally do not need anesthesia; lips often require a nerve block.
  • Your dermatologist will inject the filler into the area, often giving you several injections to produce the best results.
  • You may feel a stinging or burning sensation as the filler is injected.
  • A few fillers require allergy testing to make sure you do not have an allergic reaction.
  • If you need allergy testing, you must wait for the results from the allergy test before you can get the filler.
  • If your own fat will be used as a filler, the entire treatment can often be completed in one day. You will first have a procedure called tumescent liposuction, which safely removes a small amount of fat from another area of your body. The fat removed from your body is then processed so that it can be injected into the area that needs more fullness.

What must I do after getting a filler?

Most patients can return to their everyday activities after leaving the office.

To reduce any redness and swelling from the injections, your dermatologist may recommend icing the area for 15 to 20 minutes before you leave.

Before you leave the office, you should be able to apply makeup.

After leaving the office, you should:

  • Wait until the next day to exercise or do any other strenuous activity.
  • Stay out of the sun and do not use a tanning bed or other type of indoor tanning.
  • Avoid touching the treated area for three days, unless you receive instructions to massage the area.
  • One filler, poly-L-lactic acid, requires you to gently massage the treated area for about 5 minutes several times a day for 1 to 2 weeks. Your dermatologist will tell you if you need to massage the area.

Is there downtime?

This varies with the filler. Most fillers do not cause downtime. Be sure to ask your dermatologist whether you will have downtime.

When will I see results after getting a filler?

This also varies with the filler. Most fillers fill the skin, so they produce immediate — or close to immediate — results. A filler also can stimulate your body to produce collagen, but this takes time.

Most fillers offer immediate results

Filler  When see results 
Collagen Immediate
Hyaluronic acid gel Immediate
Calcium hydroxyl apatite Immediate
Poly-L-lactic acid 2 or 3 weeks
Fat taken from your body Immediate
PMMA (polymethylmethacrylate) Immediate

You may see other fillers advertised. All fillers listed above have been approved by the U.S. Food and Drug Administration (FDA), except for self-donated fat. This filler does not require FDA approval because it comes from your own body.

Will I look natural?

To get natural-looking results, the person injecting the filler must have expertise in placing the filler.

Dermatologists recommend not overdoing fillers. Your results will look more natural with a conservative approach. For example, patients who have very thin lips should not get dramatically fuller lips. Creating fuller lips in these patients could be extremely unflattering because the lips might start to resemble a duck’s bill.

How long will the results from fillers last?

Most fillers offer temporary results and require repeat treatments to maintain the results.

Temporary fillers offer one key advantage. These can be injected as needed to replace lost fullness. This is advantageous because no matter what we do, our skin continues to age.

How long fillers typically last

Filler  How long  it lasts
Collagen 2 to 3 months (often longer when treating scar)
Hyaluronic acid gel 4 to 12 months
Calcium hydroxylapatite 6 months to 1 year
Poly-L-lactic acid 1 to 3 years
Fat taken from your body 1 to 3 years (often longer when treating a scar)
PMMA (polymethylmethacrylate) permanent

You should ask your dermatologist how long the recommended filler should last in the area you want treated.

When is it safe to get another treatment?

If you get a temporary filler, you can usually have another treatment when the signs of aging reappear.

What are the possible side effects?

After receiving filler injections, some patients have minor, temporary side effects where they were injected. You may have:

  • Redness
  • Swelling
  • Tenderness
  • Bruising (occasionally)

These side effects tend to clear within 7 to 14 days — if not earlier.

Serious side effects are more likely when the person injecting the filler does not have adequate medical training and experience. To protect your health, you should never get filler injections in a non-medical setting, such as non-medical spa, salon, or someone’s home.

When fillers are injected in a non-medical setting or by an inexperienced provider, reports of more serious side effects increase dramatically. These side effects include:

  • Lumps.
  • Ridges.
  • Over-filled areas.
  • Allergic reaction.
  • Skin discoloration.
  • Infection.
  • Severe swelling.

What is the safety record for fillers?

 This is one of the safest cosmetic treatments available. For years, dermatologists have been refining the use of fillers to diminish signs of aging. Today, dermatologists safely treat people of many ages and all skin colors.
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