Fillers (Juvederm Ultra XC, Radiesse)

As we get older, the two important substances found in our skin that keep it smooth and supple, collagen and hyaluronic acid, start to diminish which cause the skin to lose structure and volume.  As a result, unwelcome lines and wrinkles appear.

In order to fix those unwanted wrinkles, we offer a variety of FDA approved fillers for the correction of facial folds, lines, and wrinkles.  They include Juvederm Ultra XC, and Radiesse.

Juvederm Ultra XC


What You Should Know Prior To Treatment


What are fillers, and how do they work?

The way your skin looks is directly related to the way your skin is supported. As we age, the natural support layers in the skin diminish resulting in the formation of wrinkles. Two important substances, collagen and hyaluronic acid, form the foundation of your skin. Collagen is a protein that provides your skin with structural support. Hyaluronic acid is a natural sugar found in all living cells that attracts and binds water, hydrating your skin and giving it volume.

collagen_fill_1With time, sunlight, and other factors, collagen and hyaluronic acid in your skin diminish, the skin loses structure and volume, and unwelcome lines and wrinkles appear. An emerging trend is to temporarily replace this loss by using collagen, hyaluronic acid, and a variety of other fillers either alone or in combination to smooth away unwanted lines and wrinkles.

What are my options?

There are several products used either independently, or in conjunction with each other to give you the most effective treatment. Hyaluronic acid treatments, such as  Juvederm, add volume to your skin by mimicking the hydrating effects of your skin’s natural hyaluronic acid. These fillers are injected just below the surface of the skin temporarily adding volume, thereby filling lines, wrinkles and folds from the inside out. Radiesse is a new filler which gives long lasting results by using a  material consisting of calcium hydroxylapatite to give deeper, nonsurgical correction.  Juvederm is an injectable filler made of hyaluronic acid, a naturally occurring substance in your skin that helps to add volume and hydration.  Juvederm is injected under the skin to instantly restore your skin’s volume and smooth away facial wrinkles and folds.

Will the injections hurt?

collagen_fill_2In general, injections may cause some discomfort. The products are injected directly into the skin using a fine needle to reduce injection discomfort. Anesthetic creams or other techniques may be used to diminish discomfort.  These will be discussed prior to treatment.

How safe are the injected fillers?

The injection process and injected fillers are very safe. The fillers have undergone extensive testing including scientific clinical trials to establish safety and effectiveness.  However, as with any cosmetic procedure, there are risks.  Please be sure to discuss these with your provider prior to treatment.

What should I expect immediately after treatment, and how should I care for the treated area?

juvaderm_lip_enhancementImmediately after the treatment most people feel comfortable in resuming their normal activities. Temporary puffiness of the treated areas should be expected. There may be temporary redness, slight bruising, and tenderness around treatment sites. A complete discussion of what to expect after fillers are injected as well as care of the area will occur prior to treatment.

Does the correction last forever, and if not, how often will I require treatment?

Correction is temporary and repeat injections are usually needed to maintain optimal benefit. The duration of correction is different for everyone, but on average, wrinkles will return about 12-20 weeks for collagen products.  The results usually last 12-32 weeks for hyaluronic acid products, depending on the area injected and the product used.  Radiesse typically lasts about 14 months.


Radiesse Facial Contouring


Radiesse is an injectable product approved by the FDA for the purpose of filling facial folds and lines. The advantage of this product is the potential for a long lasting effect. Radiesse consists of calcium hydroxylapatite suspended in gel (carboxymethylcellulose). Because calcium hydroxylapatite is a normal constituent of bone, it should not elicit a chronic inflammatory or immune response. Additionally, the gel carrier doesn’t require allergy testing such as required with collagen. Calcium hydroxylapatite has been used in humans for a long time in prosthetic implants in dental, facial, and orthopedic surgery. Studies have shown that the product remains soft when injected into the skin. The longest term studies come from Italy and suggest that Radiesse shows promise as a new agent for facial contouring with no serious side effects and reasonable effectiveness and durability.

Frequently Asked Questions


How long will the Radiesse treatment last?

Most patients treated with Radiesse can expect a correction which lasts approximately one to two years, although some patients’ treatment results can last longer. The average duration of effect is 14 months.

What areas of the face are normally treated with Radiesse?

Typical Radiesse treatments include: smoothing and contouring smile lines or nasolabial folds, wrinkles at the corner of the mouth, facial/nasal defects or recessions, frown lines, restoring volume in and around the cheeks and chin, and modest enhancement or correcting asymmetrical features (facial contouring). More applications are being developed.

Will the Radiesse become hard, calcified or noticeable to touch?

To the contrary…Radiesse will remain soft and take on the characteristics of the surrounding tissue. New soft tissue will gradually replace the Radiesse over time with most replacement occurring within three months.

Does the treatment hurt?

A mild localized anesthetic is normally used to minimize or usually eliminate the pain associated with this type of treatment. The numbing effects will wear off in as little as fifteen minutes to as long as a couple of hours depending on the anesthetic used by your physician. There may be some mild discomfort for several hours or even a day or two after treatment.

Are there any lingering effects of the treatment and when can I return to my normal activities?

There is minor inflammation or swelling from the treatment as a result of the expansion of facial tissue. This normally resolves within 24 hours but has been reported to last as long as 48 hours for some patients. Bruising may also occur and may last for 3-7 days. Most patients resume normal activities only a few hours after receiving treatment. Application of ice intermittently for a short period after the treatment will help reduce any swelling.

Are there any activity restrictions after I receive the treatment?

You should avoid activities that will strain your facial features for 48 hours following treatment as much as possible (“facial rest”). For example, avoid activities such as smoking, strenuous laughing, using a straw, singing, shouting, etc., especially if injected around the lips. Otherwise normal activities are fine.