Dermal Fillers Q & A


Dermal Fillers

Dermal fillers have become very popular nonsurgical options to help reverse facial changes that occur with aging.  As we mentioned earlier, dermal fillers, or fillers for short, are gel-like substances that are injected with a syringe to restore facial volume.  By restoring facial volume, skin is lifted and stretched, which results in smoothing and wrinkle reduction.  But to say that Fillers are just for wrinkle reduction is really an understatement because fillers do so much more.  Aside from filling in wrinkles, dermal fillers can plump thin lips, enhance shallow contours, soften facial creases, restore volume to facial hollowing, and improve the appearance of recessed scars.  They are considered a key component to restoring volume and fullness of the face and are considered a minimally invasive procedure because their injections are all done through very fine needles or cannulas. 


What happens to make us lose facial volume?

At around the age of 25, the body stops producing collagen and elastin, the two proteins that work together to keep our skin firm and elastic.  Worse yet, the collagen and elastin that we already have begins to break down at about 2% per year.  Yikes!  So, you can see, it doesn’t’ take too long before age-related facial changes begin to appear.  So, fillers are used to help restore our diminishing volume and lift the skin up off the bone to bring back a more youthful look. 

There are many different types of dermal fillers based on specific characteristics.  Some are thicker, some thinner, some absorb water more, some less, etc.  Different areas of the face behave differently, and so dermal fillers are designed to work best in a particular area.  For example, under the eyes, the skin is very thin, and the underlying tissue is very loose.  If a water absorbing filler is placed there, then under-eye bags will form due to water absorption, and most likely you will not be happy with the results. 


How long do dermal fillers last?

How long a filler lasts depends on its composition and its area of injection.  In a very general sense, most dermal fillers last 6-18 months.  Fillers around the mouth tend to be the shortest acting because we use our mouths so much that the filler is quickly broken down.  Conversely, fillers like Radiesse, which is firmer than most, may last 18 months. 


What can I expect when having a filler injection? 

Every physician has his own technique and so we can’t speak for everyone.  Our guiding principles are correct placement and painless.  We’re happy to report that we accomplish both of these goals every day.  Results can be amazing!

Dr. Damery uses the blunt cannula technique and so you may only have a couple of injection sites.  He will give you a very tiny numbing injection at each site and after that, most people don’t feel any discomfort.  Bruising is rare with this technique, making it a very nice procedure for the face.


When will I see results?

Ahhh, the beauty of fillers is that results are almost immediate.  Transformations can be amazing.  Even though you may develop a little swelling, don’t be alarmed, because the filler will settle in and enhance your beauty on its own time schedule.  If swelling occurs, all should return to normal in a couple of days.


Are there different types of dermal fillers?

There are several different types of dermal fillers from the various competing pharmaceutical companies.  They vary by their chemical properties, their thickness, their longevity, their cost, and their FDA approval.  Because of their different properties, each filler will work better in some areas, and not so well in others.  We will choose a dermal filler based on the areas you want treated to maximize your results.  There is one thing that is common to all fillers… they are all expensive thanks to the exorbitant wholesale prices from the pharmaceutical companies.  A small 1 cc syringe of dermal filler (1 cc = 1/5 teaspoon) will often cost anywhere from $399 to $799, depending upon the filler.  We’ve seen this behavior from pharmaceutical companies before.  Remember the long acting Depo-Provera contraceptive injection that wholesaled for $10 for many years, but then suddenly had a 1000% price increase.  More recently the EpiPen, which is an emergency life-saving injection, saw its price jump from $100 to $1000.  Not cool and very frustrating to doctors and patients alike. 

Dermal fillers can be categorized by their chemical composition.


Hyaluronic acid

Brand names include: Captique, Esthélis, Elevess, Hylaform, Juvederm, Prevelle, Puragen, Restylane

Hyaluronic acid is a viscous natural sugar found in the body. High concentrations are found in soft tissues and in the fluid surrounding the eyes. It's also in some cartilage and joint fluids, as well as skin tissue.  It is extracted and reformulated and now has become one of the most popular kinds of injectable fillers. If the term sounds familiar, it's because the same substance is often injected into the aching joints of people with arthritis to ease pain and provide extra cushioning.


Calcium hydroxylapatite

Brand name: Radiesse

Calcium hydroxylapatite is found naturally in human bones and is a mineral-like compound.  Calcium hydroxylapatite is biosynthetically produced, which means that no animals or animal products are used. This lowers your risk of an allergic reaction and no skin testing is required. This type of dermal filler is known to produce a very natural result, doesn't migrate and side effects are rare. This dermal filler was first used in dentistry and reconstructive surgery and has a long safety record.


Polylactic acid

Brand names include: Sculptra

Polylactic acid is a synthetic dermal filler that stimulates the body's own production of collagen, and is known as a stimulator.  It has been used for more than 40 years as suture material in the operating room.

Polylactic acid is unlike other dermal fillers because it doesn't produce immediate results. Instead, it stimulates the body's collagen production, and so results appear gradually over a period of a few months.  You will likely need about 3 monthly treatments to achieve your desired results.


Polymethyl-methacrylate microspheres (PMMA)

Brand names include: Bellafill

PMMA is considered a semi-permanent filler and has been used for many years in permanent surgical implants. Because of this, your surgeon will likely under-fill on the first treatment, adding more later if needed.

One of the downsides of PMMA is that a number of injections are needed to create volume and it can take up to three months to realize the full effects. It may also be visible under the skin.  Special injection techniques are needed with PMMA.

So, as you can see, there are many options available to you when it comes to dermal fillers. When you come in, we will perform a complimentary facial contour analysis and discuss your thoughts so that we understand your concerns.  Then we can develop a plan to achieve your goals.

Impressions MedSpa
2453 Bee Ridge Rd.
Sarasota, FL 34239
Phone: 941-444-5505
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