Restylane, Juvederm, and Belotero are fillers that restore the youthful contours of your face in three dimensions. When injected, these fillers enhance volume, erase wrinkles, and augment lips. The active ingredient in each of these products is hyaluronic acid, a protein prepared from a similar protein that occurs naturally in our skin. In its natural state, hyaluronic acid surrounds collagen, a structural protein that resembles a rope in length, flexibility, and hardness. By coating collagen and other structural proteins, hyaluronic acid acts as a cushion for our skin.
The natural occurrence of hyaluronic acid is one of the reasons this substance is used as a filler. In fact, hyaluronic acid is used worldwide more often than any other material. It seldom causes allergic reactions and can be molded into place like putty or clay. It looks natural after injection and its effect can be reversed by simply injecting hyaluronidase, an enzyme that breaks down hyaluronic acid.
The brands of hyaluronic acid differ in several ways. One is how the strands are cross-linked. Proteins have long strands and sometimes parts of one strand become attached, or cross-linked, to one or more other strands. When protein strands become cross-linked their effects last longer than if they were free strands. The brands of hyaluronic acid also differ in how they are manufactured and in the size of the particles. Dr. Bodenstein uses only brand named products bought directly from the company.
All fillers approved by the FDA to fill the nasolabial folds (the lines that run from each side of the nose to the corners of the mouth)and Restylane is also approved for the lips.
How do I know if I need injectable filler?
If you want to look less tired, reduce wrinkles or improve the shape of your face, you may benefit from filler treatment. Fillers improve the cosmetic appearance of smile lines, frown lines, cheek wrinkles, thin or wrinkled lips and scars. It can also result in a more lifted look, and reduce the appearance of jowls and sagging.
Pregnant women or persons with allergies to filler ingredients should not receive injectable fillers.
How does the treatment work?
When injected, these fillers enhance volume, erase wrinkles, and augment lips. The active ingredient in each of these products is hyaluronic acid, a protein prepared from a similar protein that occurs naturally in our skin. In its natural state, hyaluronic acid surrounds collagen, a structural protein that resembles a rope in length, flexibility, and hardness. By coating collagen and other structural proteins, hyaluronic acid acts as a cushion for our skin.
The natural occurrence of hyaluronic acid is one of the reasons this substance is used as a filler. In fact, hyaluronic acid is used worldwide more often than any other material. It seldom causes allergic reactions and can be molded into place like putty or clay. It looks natural after injection and its effect can be reversed by simply injecting hyaluronidase, an enzyme that breaks down hyaluronic acid.
Although uncomfortable, we find most of our patients find the procedure to be much more tolerable than they imagined. The hyaluronic acid filler contains anesthetic (except for Belotero) and most of our patients tolerate the procedure well. The filler is injected slowly into each of the treated areas. If we treat your lips, which may be more sensitive, we may use additional anesthetic.
What benefits can I expect?
Achieving improvement that looks natural is an important part of our mission. You can expect a more youthful facial appearance that is consistent with the way you look now and your age range, as the lost volumes of key areas described above are filled with hyaluronic acid. The transformation may be profound or subtle, but looks natural and is safe. Family and friends often notice a change but may not be able to identify it.
The benefits of hyaluronic acid fillers are temporary. You can expect your improvements to last 4 to 12 months with Restylane and Juvederm, 6 to 15 months with Restylane Lyft, and 4-6 months with Belotero. Maintenance usually consists of one to two visits per year for touch ups.
What are the risks and side effects?
Bruising and swelling and some discomfort are expected. We tell people to prepare for 2-3 days of downtime but occasionally that can stretch to 2 weeks and very rarely beyond. Occasionally the material clumps in one place, resulting in a lumpy feel in that area. The provider can usually correct this by massaging the lumpy area, although sometimes this corrects without any intervention naturally within 2 weeks. If this does not work it may be necessary to inject hyaluronidase, an enzyme that breaks down the injected hyaluronic acid. The target area must be treated again when the lump is resolved. This is why we recommend a 2-week follow-up visit so we can smooth out such irregularities if they are present, as well as to make sure you are satisfied with the aesthetic result.
Prior to treatment all potential risks and side effects will be discussed with you by your medical provider and cosmetic coordinator.
How will I look and feel during and after the treatment?
The treated area will be swollen, red, and bruised. We recommend applying ice to the treated area regularly after the procedure. You may put on makeup immediately, although swelling and redness last 2 to 5 days and possibly 1 week or longer. Numbness from the anesthetic may persist for 1 to 2 hours. We ask you to return in 2 weeks to evaluate your improvement and satisfaction.
To minimize bruising, we suggest that you avoid aspirin, vitamin E, and non-steroidal anti-inflammatory drugs (e.g., ibuprofen) for 7 to 10 days before the procedure. Use of arnica (topical, oral, or both) before and after the procedure also seems to help. No other special preparation is necessary. If you have a history of cold sores on your face, let us know so that we may pretreat you with anti-viral medication.
Can this be combined with other treatments?
Yes. For example, botulinum toxins may be injected during your visit filler injection.
Botox Cosmetic helps to correct the upper one-third of your face while fillers help with the lower two-thirds. This combination is widely used because it provides considerable aesthetic improvement in only 1 to 2 weeks. If filler injection is combined with high-intensity laser treatment, we must wait 1 month after filler infection to use the laser to prevent overheating the filler-treated area.
What is the cost of Restylane, Juvéderm & Belotero?
The cost depends on how much filler is used. Cost ranges from $400 to $3000, but may be higher on rare occasions.
To learn more about injectable fillers, please call 201-288-1788 or contact us to make an appointment with one of our cosmetic coordinators.
*Please do not schedule dental surgery within 2 weeks of your injectable filler appointment.
Restylane (Restylane, Restylane-L, Restylane Lyft) is FDA approved for lip enhancement in patients over 21 years. JUVÉDERM® injectable gel (including JUVÉDERM® Ultra, JUVÉDERM® Ultra Plus, JUVÉDERM® Ultra XC, and JUVÉDERM® Ultra Plus XC) is indicated for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds). BELOTERO BALANCE® is FDA-approved for injection into the mid-to-deep dermis for correction of moderate-to-severe facial wrinkles and folds, such as nasolabial folds.