Dr. MacDonald's Blog Thoughts


The Injectable Facelift
February 25, 2010, 8:24 pm
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The injectable  face lift is currently all the rage and its popularity is understandable… no downtime and it cost less than a quarter of a facelift surgery.

In this economy, it’s hard for average men and women to consider spending extravagantly on surgical procedures to improve their face or their body for that matter.  Fortunately for all of us, we can hide our bodies but our face isn’t as easy to conceal.  But guess what?  There’s hope!  Science has made it possible to achieve such heights thru injectable dermal fillers and the greatest thing about this is you’re spending a fraction of the cost.  You’ll actually be able to keep your savings for a rainier day.

Injectable dermal fillers offer an exciting alternative treatment to almost anyone who prefers not to undergo a facelift or other facial surgery.  The injectable facelift promises a more youthful appearance with no serious downtime under local anesthesia.  This procedure does not involve going under the knife.  The treatment injects dermal fillers such as Botox, Juvederm, Restylane, Radiesse, Hydrelle, Sculptra, or Fat Injections to improve the appearance of the skin’s texture.  They can help fill out deep facial wrinkles, creases and furrows, sunken cheeks, skin depressions and some types of scars.  They can also be used to add a fuller, more sensuous look to the lips and improve “lipstick lines”.

The most important fact to remember about injectable dermal fillers is that the results are not permanent.  Injected material is eventually metabolized by the body.  Depending on the type of facial filler used, the results may last anywhere from a few months to a year or more.  Researchers believe that age, genetic background, skin quality and lifestyle as well as the injected body site may all play a role in the dermal filler’s “staying power”.

BOTOX

Botox is used to help smooth creases caused by overactive muscles such as forehead wrinkles, crow’s-feet, frown lines and muscle bands of the neck.  When excess facial or neck skin is present, this type of aging is more appropriately treated by face and neck lifts or forehead lifts.

JUVEDERM

Juvederm is used to fill and smooth moderate (Juvederm Ultra) to severe (Juvederm Ultra Plus) facial wrinkles and folds.  It’s used for contouring and volumizing average-depth depressions/wrinkles such as nasolabial folds, forehead lines, mild-to-moderate nasal and cheek furrows and to plump up thin lips.  It is made of hyaluronic acid, a natural substance in the body that helps maintain skin volume and hydration as well as joint lubrication and cushioning.  It binds with collagen and elastin, transporting essential nutrients to these fibers which make up much of the support structure of the skin.

Longevity:   up to 4-6 months in the lips; up to 8 months – 1 year  in other areas of the face
Cost: $$$

RESTYLANE

Restylane is used for the correction of moderate wrinkles, fine lines, acne scars, other soft tissue contour deformities and for lip enhancement.  It is also made of hyaluronic acid, but is used mostly for moderate facial lines and wrinkles as opposed to lifting and contouring purposes.  Restylane is more cross-linked than Juvederm so it’s thicker and may be more painful when injected.

There are various factors that influence longevity o: the specific areas treated, age, amount of sun exposure (heat breaks Restylane down faster), ongoing muscle movement (clients with Botox in the same area may have a longer result) and weight loss.  Dehydration should be avoided as Restylane requires water to stay plump.  Generally, Restylane should last anywhere from 6 to 9 months.
Cost:  $$

RADIESSE®

Over time, tissue volume diminishes, leaving folds and wrinkles in several common patterns, including the deepening of nasolabial folds, accentuated smile lines (sometimes called “marionette lines”).  Radiesse is a synthetic solution made up of a compound known as calcium hydroxylapatite a compound similar to that found in teeth and bones.  This compound forms a scaffold through which your body’s own collagen can grow. This produces the desired long-term effect making Radiesse the ideal choice for facial shaping and contouring.  By stimulating the body to produce new collagen, Radiesse provides a natural look that lasts for a fresh, rested, healthy appearance that still looks like you.

Longevity:  Results are immediate and last as long as nine months.
Cost: $$$

HYDRELLE

Hydrelle is the latest dermal filler to be released into the aesthetics market.  The makers of Hydrelle claim that the dermal filler injection is around half the size of a typical filler injection.  This means that fewer injections will be needed around a wrinkle site.  Hydrelle is also the first dermal filler that combines hyaluronic acid with lidocaine anaesthetic meaning the injections are made less painful and the overall procedure is more comfortable for the patient.

Longevity:  Results that last as long, if not longer, than Juvederm or Restylane.
Cost:  $$

SCULPTRA

Sculptra is a product used to add volume to thin faces, hollow cheeks and aging faces.  The procedure consists of a series of injections into the skin of a Poly-L-Lactic Acid in a water based solution. Over time this solution stimulates skin to produce more collagen and increases the thickness of the dermis.  After the first treatment it may appear that Sculptra has worked immediately but it is merely some swelling and the water used to dilute Sculptra.  It works gradually to produce a natural effect.  Usually two to three treatments are required and results should be noticeable after approximately six weeks, (however, in some patients this may take longer or require more treatments).  Soon after initial injections, when the water has been absorbed by the body and the swelling has gone down you may look as you did before your treatment.  However once the product starts working results should be noticeable after approximately 6 weeks.

Longevity: Up to 12 to 18 months
Cost:  $$$$

FAT INJECTIONS

This type of filler is harvested from one’s own body.  This method’s use of the patient’s own tissue offers the advantage of natural-looking results, and a reduced likelihood of the body rejecting the injected tissue.  However, not all of the live fat cells survive when transplanted into the new site, so a fairly high rate of re-absorption is to be expected.  Because of this, the physician will usually over fill the area being treated which can leave the patient with a result that may look temporarily abnormal.

Longevity:  The short answer is that when fat grafts are done with proper technique, they may be rendered permanent.  This is not opinion, this is fact.  The classic teaching regarding fat grafting will tell you that you could lose 30% of the injected fat by 6-9 month following injection.  The newer techniques of fat preservation and gentle handling would deliver much better results and published data shows consistent results for several years.  This technique is largely surgeon dependent.
Cost:  $$$$$




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