The term “soft tissue fillers” refers to a group of injectable materials designed to safely add volume to areas of soft tissue deficiency. Some of the many applications for “soft tissue fillers” include adding fullness to the lips, treating the vertical lines present in the skin adjacent to the lips and reducing the depth of several common facial wrinkles.
At Horizons Plastic Surgery, three distinct materials are utilized to increase facial volume. These include the popular hyaluronic acid (HA) fillers, poly-L-lactic acid and autologous fat.
“Soft tissue fillers”, approved by the FDA include the Galderma family of (Restylane) products and the Allergan family of Juvederm and Voluma products. These materials all contain hyaluronic acid, a naturally occurring component of healthy skin. When injected, they bind to water and provide volume to fill in the lips and larger folds of skin around the mouth and cheeks. A patient notices an immediate plumping of the tissue in the treated areas. These materials are an excellent choice for the enlargement of the lips and management of the naso-labial fold, cheekbones and lower eyelids.
Approved by the FDA in 2009, micro-particles of poly-L-lactic acid (Sculptra) are injected into facial tissue to correct contour deformities, deep and shallow smile lines and other facial wrinkles. Sculptra works by stimulating the growth of the patient’s own collagen and can be used to correct areas of soft tissue deficiency. This technique requires four to six sessions, four weeks apart and the effects usually last twelve to twenty-four months. Sculptra may also be combined with ‘micro-needling’ to improve the collagen content on facial skin.
During the complimentary consultation at Horizons Plastic Surgery, an individualized approach can be developed to address each patient’s unique goals. Although these filler materials are not a substitute for a surgical facelift, they can often provide temporary relief in the management of the aging process.
Before and After Examples
Dysport and Botox
The injection of Dysport® and Botox® is a safe, nonsurgical technique for reducing the appearance of selected facial wrinkles. The most popular facial sites treated with Dysport or Botox include the transverse wrinkles of the forehead, the crow’s feet adjacent to the eyes and the “eleven line” located between the eyebrows. Dysport® or Botox® can also be used to treat platysmal bands in the neck, the “gummy” smile, excessive wrinkles on the chin and lips and hyperhidrosis, a condition of excessive sweating in the armpit.
Dysport and Botox work by interfering with the contraction of the “mimetic muscles”. These muscles contribute to the formation of facial expression by exerting tension on the skin. Excessive actions of these muscles form wrinkles that can make us look angry or tired. Selective weakening of these muscles by Dysport® or Botox® contributes to the improvement in facial appearance.
At Horizons Plastic Surgery, the patient’s experience begins with a thorough evaluation of their facial anatomy and the development of a precise treatment plan. The injection of Dysport or Botox takes just a few minutes and the patient may return to work immediately. Relaxation of the muscles is usually apparent in three or four days. The muscle regains its normal capacity to contract in three or four months and the wrinkle returns to its original state. Complications associated with the use of Dysport® and Botox® are infrequent. These may include mild swelling or bruising at the injection site, asymmetry, difficulty swallowing, a droopy eyelid, partial correction of the wrinkle, infection and possible headache.
Using Dysport or Botox to successfully improve facial appearance is dependent upon the precise placement of the drug into the muscle that is causing the problem. A comprehensive knowledge of facial anatomy is essential to obtaining the optimal outcome.
A patient wishing to use his or her own fat to reduce the appearance of facial wrinkles may be a candidate for autologous fat grafting. During this procedure, fat is harvested from either the patient’s abdomen or thigh, processed, and then injected into the soft-tissue of the face to reduce the wrinkle.
Autologous fat may also be advantageous in breast reconstruction. It is a particularly valuable technique when applied to the breast tissue that has been treated with radiation. Irradiated breast tissue may often develop fibrotic changes in the collagen and capillaries of the skin resulting in a harsh, tawny appearance of the skin and a lack of softness to the touch. By transplanting the patient’s own healthy fat cells, softness and flexibility of the tissue is frequently improved and the skin may take on a healthier appearance.
