Posted on November 18, 2011 in Dermal Fillers, Juvederm, Perlane, Restylane
Facial dermal fillers, such as Restylane, Perlane, Juvederm and Artefill, are some of the most popular cosmetic office-based treatments I perform on a daily basis. These minimally invasive injection procedures involve careful placement of a gel-like filler substance to correct unwanted facial lines and creases. The results in most cases can be a significant improvement and enhancement of the facial appearance with essentially no downtime, which is why these fillers as so attractive to so many patients. A good number of you out there have likely already dabbled in this arena with filler injections of the smile lines (or nasolabial folds), cheeks and lips – some of the more common areas for filler enhancement. Every so often we see someone in the office for possible filler injection who says something to the effect that they had the treatment in the past, but it didn’t work. In most of these instances, I try and educate the patient as to what probably really occurred – a point that I would like to emphasize here today.
Filler Failure? Not Likely
The reality is that there is rarely a ‘filler failure’ in most plastic surgery offices. Meaning it is highly unlikely that the filler material simply did not do what it was designed to do. What it usually boils down to is the fact that not enough filler was used to treat the area(s) of concern. For example, when someone consults with us for treatment of deep smile lines, also known as the parenthesis deformity, they usually require 1-2 syringes of the chosen filler – whether it be Restylane, Perlane, Juvederm or Artefill. In some patients who are less aged, perhaps one syringe may work to soften or fill both smile lines. In others, their parenthesis deformity is more pronounced with deeper creases that might necessitate using one or more syringes of a filler on each side – so a total of two to four syringes. If the latter patient is only interested in purchasing one syringe (but really needs two or more), they are not going to have as nice of a result as the former patient (who really only needed one syringe). In this instance, the patient who got the one syringe, but really needed more than that, may see their injectable filler result as a failure. In reality though, they simply didn’t get enough filler injected for their particular problem. So why did this happen you might ask? The answer is largely economical. Many patients who get injectable fillers are on some kind of budget. Each syringe of injectable filler can range in price from $425 up to $900. If that particular patient was recommended to have two or more syringes of filler, yet only budgeted for one, they are unlikely to attain an ideal result. This is not a filler failure. It is simply an issue that not enough filler was injected for that specific patient.
Multiple Site Injections
A similar scenario arises in cases where injectable filler patients are looking to have multiple sites treated, but only want to purchase one syringe. For example, I had a recent patient in the office who wanted to treat her smile lines, lips and pre jowl area on both sides of the face. However, she was only willing to purchase one syringe of Restylane on that particular day. As I discussed with her in detail, one syringe of Restylane (or Perlane, Juvederm, etc.) was just not sufficient to treat these multiple areas. You can certainly try and use one syringe of a filler and distribute it across all of these injection sites. But the end result will be just slight improvement in each area. This is in contrast to significant enhancement of one particular area if the entire syringe is used to target just one of these regions. To help better understand this concept, you can use the analogy of traveling around the world on a set budget for one week. Think of having a fixed amount of money (filler) and wanting to see certain tourist sites (facial lines and creases). You have to decide if you want to spend in-depth, quality time in just one tourist destination or visit multiple sites each for a short period of time. If you had an unlimited budget, you may choose to spend quality time in a multitude of sites living life to the fullest. But the reality is that most people, and patients, do not have this luxury.
Injectable Filler Consult San Diego, CA
I hope this explanation sheds some light on the reality of having injectable fillers for undesirable facial lines and creases. This doesn’t mean you have to necessarily pay more money just to achieve an enhanced facial appearance with Restylane, Perlane, Juvederm or Artefill. It just means that you have to be realistic in what areas you want treated with a certain amount of filler. If you are considering an injectable dermal filler treatment and want more detailed information, contact our San Diego facial plastic surgery office today to consult with Dr. John Hilinski – one of the area’s foremost experts in facial enhancement with fillers.
Posted on October 9, 2011 in Dermal Fillers, Facial Plastic Surgery
Many patients inquire about non-absorbable options for treating unwanted hollowing and volume deficiency of the face. These are patients that have tried temporary injectable fillers, such as Juvederm, Restylane, Perlane and Radiesse, but are unhappy with having to get repeated treatments every year. One alternative is to use liquid silicone injections to achieve a more long-lasting cosmetic enhancement. Silicone injections are considered off-label when used for this type of purpose. They are FDA approved for injection elsewhere in the face, but like Botox and hyaluronic acid fillers, silicone is used off-label (meaning off the FDA label) in other areas for cosmetic treatment of unwanted soft tissue depressions and hollowing. This includes undesirable shadowing around the lower eyelid-cheek junction and loss of facial volume in the mid-cheek region. The patient example below highlights the typical candidate for silicone injection.
Micro Injection of Silicone
This male patient from San Diego felt as if his cheeks were becoming too hollowed and thinned. On examination, he definitely demonstrated evidence of soft tissue atrophy (shrinkage) particularly through the cheek to lower eyelid region. We discussed the various options available to him. Ultimately, he chose to have micro silicone injections to help him achieve a more sustained, long-term cosmetic enhancement. By ‘micro’ what is implied is that the silicone is placed with much smaller volumes of injection distributed over a wide area. This in contrast to injecting the same amount of total volume into one or two confined areas. By distributing the silicone injections over a broader region, the body has greater opportunity to surround the micro droplets of silicone with collagen tissue. Thus, there is a more dramatic, smoother collagen response that translates into an improved cosmetic result with less chance of complications. Following a series of silicone injections spaced apart 6-8 weeks each, the body’s own collagen elicits a controlled response to fill out the treated areas. As you can see in his before and after photos, there has been a notable volume enhancement through the cheek and lower eyelid region that gives him a ‘fuller’ look to his face. And what he sees in terms of a clinical response is there for the long run as silicone injections result in a more permanent outcome.
Posted on February 16, 2011 in Dermal Fillers, Dysport, Perlane, Plastic Surgery, Restylane
San Diego’s The Hilinski Clinic of Facial Plastic Surgery is pleased to announce our current specials on the Medicis line of products – Restylane, Perlane and Dysport treatments! Restylane and Perlane now contain lidocaine (novacaine) within the gel preparation, making the injection process much more comfortable for everyone. These new products, now known as Restylane-L and Perlane-L, are a significant improvement over previous injectable fillers that did not contain the numbing medication. Dysport is the only true alternative to Botox cosmetic and is used for the same purpose – to treat unwanted facial wrinkles & creases from excess muscle movement. Dysport treatment is a great alternative to give you that more rested, youthful look from a simple, office-based procedure.
Current Restylane, Perlane and Dysport Specials
The Hilinski Clinic of Facial Plastic Surgery is now offering the following specials for all San Diego patients.
Restylane-L Receive $100 back when you purchase two (2) syringes of Restylane for treatment of unwanted facial wrinkles and creases
Perlane-L Receive $60 back when you purchase one (1) syringe of Perlane for treatment of unwanted facial wrinkles and creases
Dysport Receive $50 back when you purchase Dysport for treatment of undesirable frown lines and facial wrinkles
These offers are good from now through March 31, 2011 at The Hilinski Clinic – San Diego’s dedicated facial plastic surgery clinic.
Call us today at 619-296-3223 to schedule your consultation and treatment session.
Posted on January 14, 2011 in Dermal Fillers, Injectable Filler, Juvederm, Lip Enhancement
In order to help let our potential patients know what it looks like immediately after lip enhancement with Juvederm (or Restylane), I have provided the following case example. This young female patient presented for augmentation of her lips using an injectable filler. On examination you can see that her lips were clearly asymmetric with the right upper lip being much smaller than her left upper lip. As is indicated by the white arrow, one can appreciate that her right upper lip looks much flatter and, in fact, slants downward toward the corner of her mouth more so than her left side. This happens to be more the rule than the exception when it comes to lip enhancement or lip augmentation patients. All of us are asymmetric to some degree, which can include our lips. Fortunately, injectable fillers such as Juvederm and Restylane can be used effectively to address these asymmetries while also augmenting, or volumizing, the lips. In this particular female patient from San Diego, we used Juvederm to plump out her lips. First we started out correcting the asymmetry by adding volume to her right upper lip. Once we achieved adequate symmetry of the lips, we then began augmenting the lips with the filler. I injected her lips to give her a more pouty, puffy look while trying to maintain a natural shape and look. This was done in the office examination chair and took maybe 10 minutes at most to complete. The photos below show her 2 minutes after the injectable filler treatment to enhance her lips. As you can see, she now has improved symmetry with a moderate volume enhancement of her lips. She also now has a nicely defined vermillion border of the lip with a more feminine overall appearance. Importantly, you can appreciate that she is not significantly swollen. There is certainly some degree of swelling from the injection procedure, but not as much as many patients fear when they think of Juvederm or Restylane lip enhancement. And not bad at all for 2 minutes following the injection. Over the next 24-48 hours this will settle down to the point that hardly anyone would be able to tell she even had lip injections performed. So for those of you worried about excessive swelling and puffiness immediately following lip injections, hopefully this blog entry helps you in your decision making process!
Posted on December 2, 2010 in Artefill, Dermal Fillers
Many patients ask whether or not fillers can be used in the more aged patient as an alternative to undergoing the knife. The reality is that many patients, including more elderly patients, are considered great candidates to undergo dermal filler treatment of their face. The following patient is a great example of exactly what I am referring to with dermal fillers. This female patient from San Diego is 77 years old and simply didn’t want to undergo a surgical procedure for rejuvenation of her chin and jowl region. So we discussed in detail using a dermal filler to help volumize this region and provide a more youthful look in a non-surgical manner. She chose to use Artefill, which is the only FDA-approved permanent filler on the market. Her treatment was completed in one office visit with minimal downtime. Photos below demonstrate the result. Notice an overall more youthful looking chin and jowl region with less skin creasing and wrinkling. Now she could certainly benefit from more procedures to further resurface her skin and provide her even more improvement, however, this particular patient wanted to keep things simple. She is quite happy with the natural appearing results that she has and had essentially no downtime at all! Plus, the cost savings versus having a surgical procedure were fairly significant. If you were ever considering a non-surgical option to help rejuvenate your lower face and upper neck region, give The Hilinski Clinic a call today.
Posted on November 3, 2010 in Botox, Dermal Fillers, Juvederm, Latisse
The Hilinski Clinic is now offering FREE LATISSE with purchase of either Botox or Juvederm! Latisse is the only prescription treatment available to help make your eyelashes longer, fuller and darker. Eligible patients can now receive a free box of Latisse (a $100 value) from the Hilinski Clinic with any concurrent purchase of Botox wrinkle treatment or Juvederm soft tissue filler treatment. Call us today to schedule your appointment. Visit us online at http://www.drhilinski.com
Posted on October 23, 2010 in Dermal Fillers, Juvederm
The Hilinski Clinic is now offering Juvederm XC for $425 per syringe! Juvederm XC is one of the most popular dermal fillers used to treat unwanted facial creases and wrinkles. This office-based, minimally invasive cosmetic treatment is now even better with Juvederm XC. This latest dermal filler product now comes prepackaged with lidocaine, which helps maximize comfort while minimizing discomfort. Our special is running from now until the end of November so call us today to schedule your appointment and kiss those lines goodbye!
Posted on October 21, 2010 in Artefill, Dermal Fillers, Facial Plastic Surgery
The Hilinski Clinic is proud to announce that Dr. Hilinski was chosen to be on the Suneva Medical Advisory Board for the upcoming year. Suneva Medical is the maker of Artefill, the only FDA-approved non-resorbable, aka permanent, dermal filler on the market. Dr. Hilinski is looking forward to becoming more involved with Suneva in advancing the use of Artefill in the field of facial plastic surgery.
Posted on March 4, 2010 in Dermal Fillers, Facial Plastic Surgery, Revision Rhinoplasty, Rhinoplasty
I just completed an interview today with an independent journalist here in San Diego who was researching the topic of injectable filler use for the nose. This idea has actually been around for many years but has been gaining increasing media attention. It has been called among other things the non-surgical nose job as well as injection rhinoplasty and lunchtime rhinoplasty. These names and labels all refer to the technique of injecting a dermal filler (like Restylane, Perlane and Juvederm) into the nose to reshape and contour. It is not a bad option in those patients who want to bridge the gap and buy time before they ultimately undergo an actual rhinoplasty or revision rhinoplasty. We have had many rhinoplasty patients over the years here in San Diego opt for this procedure and then end up having their rhinoplasty performed after the filler has gone way (6-9 months typically for the temporary fillers mentioned).
Posted on November 11, 2009 in Dermal Fillers, Facial Plastic Surgery
We have had a lot of inquiries lately about the return of the only FDA-approved permanent dermal filler on the market in the United States – Artefill. I am excited to report that Artefill is officially back as of several months ago. Artefill was previously manufactured and distributed by Artes Medical before they went bankrupt. Many patients were concerned about this development and mistakingly thought it may be due to something about the actual Artefill product. Fortunately, this is definitely not the case. Artes Medical, unfortunately, made a series of poor business decisions that contributed to the demise of the company. This had essentially nothing to do with the merits of the Artefill product and, in fact, some say occurred despite having one of the most promising dermal fillers on the market.
Artefill has now reemerged and is being manufactured and distributed by Suneva Medical out of San Diego, CA, with a whole new business model and phenomenal leadership at the helm. Because my practice is located in proximity to Suneva, I have been fortunate enough to see all the latest Artefill developments first hand. In fact, last month I joined several facial plastic surgery colleagues of mine from Beverly Hills down to San Diego for an exclusive visit to the company. We toured the manufacturing facilities and had an in depth group discussion about using Artefill for a variety of cosmetic uses in the face. This product, which contains finely engineered polymethylmethacrylate (PMMA) beads, is the only non-absorbable dermal/soft tissue filler that has undergone the scrutiny of the FDA and received approval for this particular use. It is currently FDA approved for use in the smile line region (nasolabial fold augmentation) but has had great success in other areas of the face like the cheek and prejowl regions (off label uses). Patients do require a skin test 7-14 days before injection to make sure they do not react to the collagen paste contained in the syringe (which only acts as a carrier for the permanent PMMA).
If you are a current Juvederm or Restylane patient or even someone who has never had a filler but desire a more permanent dermal filler option, I would strongly recommend you consider Artefill.
