We offer various soft tissue fillers and wrinkle reducers, including Restylane ®, Juvederm ®, Sculptra ®, and BOTOX® treatment, at our Palo Alto practice which serves patients throughout the Bay Area.
What are soft tissue fillers? As we age, we form fine lines on the face and around the mouth. Lips lose their fullness. The cheek starts to droop, causing a deepening of the nasolabial fold. The tear trough area near the eye. All these are subtle signs of aging, and many are due to loss of fat and soft tissue volume in the face. I find for most of my patients in their 30s and 40s volume loss, not skin laxity, contributes significantly to the aging of the face.
Collagen was the first filler to come out, and since then there has been a multitude of fillers on the market: Cosmoplast™, Restylane®, Juvederm®, Restylane Lyft (formerly called Perlane) ®, Radiesse®, Voluma®, and Sculptra® among others. Fillers are a nonsurgical procedure I perform in my Palo Alto office. There is little to no downtime. They provide a subtle improvement in aging. For the lips, Restylane® and Juvederm® make the lips a little fuller and get rid of the fine wrinkling around the mouth where lipstick bleeds. They can be injected into the lower eye at the junction of the cheek, the “tear trough” area, to give a nonsurgical lower eyelift. They can be injected into the cheekbone area to give the entire face a lift. When using Sculptra, it is injected throughout the face, including in the temple, eye, cheek, and jawline to give a subtle, natural “liquid facelift.”
I, like most of my Bay Area patients, like a natural, non-plastic surgery look. This can be achieved. I excel at natural, subtle improvements.
Dr. Greenberg works with fillers as well, and, again, the results are beautiful. Those lines around your eyes and mouth will smooth out and melt away. It’s you, it’s all you, just with the clock cranked back a bit.
– O.S., Belmont
Hyaluronic acids are a safe filler material used to reduce nasolabial folds and frown lines. It is made of hyaluronic acid – a naturally occurring substance in the human body responsible for giving skin its fullness. Unlike animal-based hyaluronic acid products, there are no animal proteins. This means no allergy test is required prior to using it. The results last about six months.
Restylane® is one of the best known fillers. I have used it for a long time and am happy with the results. It is natural , composed of hyaluronic acid, and will gradually break down in your body.Restylane® is a safe filler material used to reduce nasolabial folds and frown lines.
Juvederm® is Allergan’s version of the hyaluronic acid filler. I find it works just like Restylane. If you have tried Restylane or Juvederm before, and you found that it did not last the six months, I highly recommend you try the other brand. I find one brand tends to last longer in patients, but which one is better varies from person to person.
Restylane® Lyft (formerly Perlane®) is made by Restylane makers. It is a slightly larger sized particle which helps keep the lengthen the improvement seen. Due to its size, it is best in the nasolabial fold or cheek.
Voluma® is made by Allergan. It is for bigger volume, and has a longer duration of action. It is best in the cheek.
Sculptra® is the newest filler to be getting press. What is sculptra? You may have heard of the “liquid facelift.” Many of you use fillers like restalyne and juvederm to fill in those lines around the mouth, the nasolabial fold, or the tear trough near the eye. When you need a lot of volume or want something that is longer lasting, sculptra may be the answer. It is not a new product. Sculptra® is approved by the FDA for restoration and/or correction of the signs of facial fat loss, or lipoatrophy. In a clinical study, the effects lasted for up to 2 years after the first treatment session in most patients. It is a natural, gradual change. Studies have shown it lasts up to 25 months.
The results from Sculptra are not immediate; Sculptra provides a gradual increase in skin thickness. It is like seeding a lawn, and the grass will then grow in gradually. It usually requires three treatments spaced 6—8 weeks apart. It stimulates your body to produce its own collagen. There can be bruising with each round of injections which may last a week. It tends to cover more of the face. It is a good option for those who need volume and want a facelift but don’t want to do surgery. I have been injecting it for a while now, and am pleased with the results.
Radiesse®, and Radience® I have used in the past, but no longer use them. I found my patients that have tried the full spectrum of fillers from Collagen to Cosmoplast to Restaylne did not like the Radiesse. It is also not good for filling the volume of the lip. When looking at cost versus longevity, I did not find a benefit to using it.
Fat transfer is a really a surgical filler, so it is done in the operating room. Fat grafting can work well. Please see the section on my website about fat transfer to the face for volume.
Fillers are an injection, which means there can be bruising. Some people never bruise, some do bruise. If you have never done a soft filler injection before, don’t do it before a big event in case you do bruise. Bruising varies a lot by patient and by location of where you are injecting. If you are on any medication which increases bruising (examples are aspirin, advil, motrin, vitamin E, fish oil) you should ideally stop 2 weeks prior to injection. I have blogs on how to avoid bruising.
The appointment usually takes about 30 minutes. You can drive to and from the appointment. No pain killers are needed. There is numbing medication in the filler injection itself. Avoid working out right before and after the procedure to help minimize swelling and bruising.
For an in depth discussion, you can come into my Palo Alto office or receive a brochure.