Dr. John Hilinski
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Injectable Fillers

Surgical procedures are not the only method of achieving facial enhancement. Wrinkle therapies involve a wide variety of non-surgical procedures designed to give you a more vibrant, youthful look with minimal downtime. Most wrinkle therapies involve the use of injectable soft tissue filler materials such as Restylane®, Perlane®, Juvederm®, Artefill® and Radiesse® that can plump out or erase unwanted deep creases and wrinkles. For instance, the inevitable deep smile crease that can develop between the cheek and the mouth is especially well suited for this type of treatment. Wrinkle therapy involves a quick office-based procedure that gives you immediate results without the downsides of a prolonged surgical recovery.

RESTYLANE®, PERLANE®, AND JUVEDERM®

Restylane®, Perlane®, and Juvederm® are very popular choices for many patients looking to erase unwanted wrinkles or lines. In addition, Restylane®, Perlane®, and Juvederm® can be used to effectively enhance volume-deficient areas of the face, such as the lips and cheeks. Restylane®, Perlane®, and Juvederm® are predominantly made of hyaluronic acid, which is a natural substance found in the body. Hyaluronic acid is highly attracted to water and binds moisture with great affinity. This feature givesRestylane®, Perlane®, and Juvederm® their ability to fill in wrinkles and creases by bringing water to the area of concern, allowing for a soft supple enhancement that looks very natural. Additionally these fillers have a very low side effect profile. In our experience a very small percentage of patients will develop bruising or swelling at the treatment site lasting beyond 24 hours. The vast majority of people who are treated are thrilled with the results and appreciate the immediate return to their busy schedule. There have been a few reports of hypersensitivity reactions, but because it is so unlikely the FDA does not require skin testing of patients.

Because Restylane®, Perlane®, and Juvederm®have been proven to last longer than collagen (6-12 months), they have essentially replaced collagen as one of the primary wrinkle therapies.

Most candidates for Restylane®, Perlane®, or Juvederm® injection are concerned with unwanted facial creases and moderately deep wrinkles. One of the most popular areas for treatment is the nasolabial fold, or smile line, that is formed by the border of the cheek and upper lip. Other patients elect to have Restylane®, Perlane®, or Juvederm® to simply enhance or sculpt the overall shape of the face in a minimally invasive, nonsurgical manner. Many of these patients are unhappy with areas of the face that appear excessively hollowed, flat or deflated, such as the upper and lower lips. Restylane®, Perlane®, and Juvederm® may also be used to contour enhancement of the lower eyelids, cheeks and jowl region to mimic a non-surgical facelift. Performed in the office setting, Restylane®, Perlane®, and Juvederm® treatment usually takes less than fifteen minutes to complete. Topical anesthesia with or without a nerve block may be administered to maximize comfort during the procedure. More recently, all three products have been offered with numbing medication pre-mixed into the filler, which has made a significant improvement in patient comfort.

Click here to view Restylane®, Perlane®, and Juvederm® patient photos.

Q – What is Restylane®, Perlane®, and Juvederm® made of?
Restylane®, Perlane®, and Juvederm® are predominantly made of hyaluronic acid. This is a natural substance found in the body that is highly attracted to water and binds moisture with great ease. As such, Restylane®, Perlane®, and Juvederm® can fill in wrinkles and creases by bringing water (and therefore volume) to the area of concern, allowing for a soft, supple and very natural-looking enhancement.

Q – Who is a good candidate for Restylane®, Perlane®, and Juvederm® treatments?
Most candidates for Restylane®, Perlane®, and Juvederm® injection are looking to improve unwanted facial creases and moderately deep wrinkles.

Q – Where is the Restylane®, Perlane®, and Juvederm® treatment performed?
Restylane®, Perlane®, and Juvederm® treatments are performed in the office setting.

Q – What type of anesthesia is used for Restylane®, Perlane®, and Juvederm® treatment?
Topical anesthesia with or without a nerve block may be used for the Restylane®, Perlane®, and Juvederm® injection to maximize the patient’s comfort.

To see a case example of Restylane® injection for lower eyelid enhancement, please use this link here.

Do you have additional questions about Restylane®, Perlane®, and Juvederm®? Click here to visit our frequently asked questions page or contact our office to schedule your consultation.

ARTEFILL®

Artefill® is an alternative to other fillers that can also be used for treating unwanted facial lines and volume deficiencies. Unlike other injectable fillers, Artefill® is non-absorbable. In fact, it is currently the only FDA approved filler that is considered to provide a more permanent result when compared to other dermal filler products. Artefill® is comprised of micro beads of polymethylmethacrylate (PMMA) suspended in a collagen paste. The PMMA is the permanent, non-absorbable component of the filler. The collagen is used as a carrier that allows the PMMA to be injected much like other fillers. Once placed, the collagen component of Artefill® dissolves away as your body’s own collagen is laid down around the PMMA crystals. This results in a natural, non-absorbable matrix that provides a permanent volume enhancement to your face. Because the collagen within Artefill® is generated from a bovine source, skin testing is required prior to treatment.

Most patients seeking Artefill® injection have similar concerns as those looking to have Restylane®, Perlane®, Juvederm® and Radiesse® treatment. This includes undesirable facial creases and deep lines. For instance, the FDA approved Artefill® injection for treatment of the nasolabial fold, or smile line. Like other fillers, Artefill® is also used off label for enhancement of volume deficient areas like the cheek, lower eyelid and chin/prejowl region. Unfortunately, Artefill® is not well tolerated when placed into the lip. Therefore, Artefill® should not be used for lip enhancement. Artefill® was one of the first available injectable fillers that came premanufactured with lidocaine, or numbing medicine, contained within the product. This provides patients fairly immediate control of the mild discomfort that would otherwise be associated with the treatment process.

Click here to view Artefill® patient photos.

Q – What is Artefill®?
Artefill®, is the only FDA approved non-absorbable, or permanent, injectable filler available in the United States. Just like other injectable fillers, Artefill® is considered an office-based treatment to address unwanted facial creases and deep wrinkles. This is accomplished by augmenting the underlying soft tissue immediately below the unwanted crease or wrinkle. Artefill®is also used to recontour the face in a non-surgical manner as a substitute for more invasive procedures.

Q – What is Artefill® made of?
Artefill® is primarily comprised of polymethylmethacrylate (PMMA) beadssuspended in a collagen paste. The PMMA beads are finely engineered to be of uniform size and shape, which limits the chances of an unwanted reaction by your body. Once injected, the collagen component of the Artefill® dissolves away leaving the permanent PMMA beads in their place. In the meantime, your body replaces the lost collagen with its own collagen. The end result is a permanent matrix of your own body’s collagen tissue mixed with the PMMA beads that provides you with a non-absorbable cosmetic enhancement.

Q – Where is the Artefill® injection performed?
The Artefill® injection is performed in the office setting in a fashion very similar to other injectable fillers.

Q – What type of anesthesia is used for the Artefill® injection?
The only anesthesia I use for Artefill® injection is that contained within the Artefill® syringe. It happens to come premixed with ananesthetic contained within the filler, which makes for a very comfortable treatment session.

Do you have additional questions about Artefill? Click here to visit our frequently asked questions page or contact our office to schedule your consultation.

RADIESSE®

Radiesse® (formerly known as Radiance FN) is an alternative to Restylane® for treating certain areas of the face. Radiesse® is composed of tiny crystals containing calcium hydroxyapatite, which is a naturally occurring substance in the human body. However, it is synthetic, which means it is not derived from human or animal tissue. Therefore, there is no risk of infectious transmission. Radiesse® is an ideal treatment for deep lines, wrinkles, and certain types of acne scarring. In addition, Radiesse® can be used to recontour or sculpt certain areas of the face as indicated in the adjacent photo diagram. Radiesse® can last in many cases for several years before retreatment is necessary.

Most candidates for Radiesse® injections have concerns about unwanted facial creases and deep wrinkles. The nasolabial fold, or smile line, is one of the most popular areas for treatment. Other patients undergo Radiesse® injections to enhance or sculpt the overall shape of the face and improve excessively hollowed, flat or deflated areas of the face. For instance, Radiesse® can be used to fill in and plump out the cheeks or jowls to provide a more rested and youthful appearance. Radiesse® treatment is an-office based procedure that usually takes less than thirty minutes to complete. Topical anesthesia with or without anesthesia may be used to maximize the patient’s comfort.

Click here to view Radiesse® patient photos.

Q – What is Radiesse®?
Radiesse®, previously known as Radiance, is an injectable filler that may be used during an office-based procedure to treat unwanted facial creases and deep wrinkles by augmentation of the underlying soft tissue. Radiesse® can also be used to reshape and recontour the face in a non-surgical fashion. This filler is commonly used to treat the nasolabial fold (smile line) and to improve hollowed, flat or deflated areas of the face such as the cheeks or jowls. Providing a more vibrant and youthful look with minimal downtime, Radiesse® is one of the most popular choices for an injectable filler. Radiesse® is comprised of calcium hydroxylapatite, a naturally occurring substance found in the human body. Compared to hyaluronic acid fillers, such as Restylane® and Juvederm, Radiesse® produces more volume enhancement (plumping) per amount injected under the skin. Radiesse® can produce long-term improvement with results that may last upwards of eighteen to twenty-four months on average.

Q – What is Radiesse® made of?
Radiesse® is primarily made of calcium hydroxylapatite, which is a naturally occurring substance found in the human body. However, it is synthetic, which means it is not derived from human or animal tissue. Therefore, there is no risk of infectious transmission and there is no need for skin testing. Radiesse® produces more volume enhancement (plumping) per amount injected under the skin compared to hyaluronic acid fillers and, as such, it must be placed deeper in the skin.

Q – Where is the Radiesse® injection performed?
The Radiesse® injection is performed in the office setting.

Q – What type of anesthesia is used for the Radiesse® injection?
A topical anesthesia with or without a nerve block may be used during the Radiesse® injection to maximize the patient’s comfort.

Do you have additional questions about Radiesse®?Click here to visit our frequently asked questions page or contact our office to schedule your consultation.

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