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Phone 512.401.2500 | Fax 512.401.2501
2745 Bee Caves Road, Suite 101
Austin,
Texas
78746
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Question:
My cheeks droop a little bit. Pictures of me make me appear older than I am. Is fat grafting involved in fixing a problem like mine or are non-surgical procedures used?
Answer:
Usually the aged appearance of the cheek is improved through volume enhancement. This can be achieved with autologous fat or through the use of fillers such as Restylane, Juvederm, Radiesse or Sculptra. A consultation with assessment of your particular situation will aide in deciding which procedure is most appropriate.
Posted by Dr. Buckingham
Question:
I heard that you can get something of an upper eyelid lift with fat injections to the temples. Is this effective?
Answer:
You can certainly get some lifting with fat injections into the temple and upper orbital rim area, however I would not recommend doing it. If you are going to undertake volume restoration for the temple area only, I would use something like Sculptra or Radiesse instead. If you were looking to restore volume to the face as a whole, then temples can certainly be included. The results from this are not equal to an upper eyelid blepharoplasty for upper eyelid rejuvenation however. A consultation will be able to provide you with the necessary information to make an educated decision.
Question:
I’m looking for a way to add more definition to my cheeks. Are implants a good choice for this or are there any other options?
Answer:
There are essentially two options available to improve the definition of the upper cheek. Those are implants or fillers. The fillers can be injectable such as Sculptra, Radiesse, Juvederm or Perlane, or can be your own fat cells. The injectable fillers are performed in the office with minimal down-time, but time-limited results. Facial fat injections are the procedure of choice in middle-aged and older patients because they have usually lost fat in their face and we are merely replacing what has been lost. In younger patients, fat injection is an option, but they have to understand that large weight shifts later in life may have detrimental effects. In those cases an implant may be a better option.
Posted by Dr. Buckingham
Question:
Is it possible to get a facelift while Radiesse is still present in my face at the nasolabial folds?
Answer:
Absolutely. A facelift will not really do much to improve your nasolabial folds and so if these areas concern you, you are going to need fat or filler anyway. The Radiesse will not alter the surgical procedure or outcome of the Radiesse.
Posted by Dr. Buckingham
Question:
I am 49 years old, male and I have very deep smile lines that remarkably are still there even when I am not smiling. I believe that I would like injections of Radiesse into these folds. Is this product permanent? Will these injections make my face appear fatter?
Answer:
Radiesse is a reasonable filler for smile lines. It is not a permanent product and I do not recommend permanent products for smile lines. If the injections were placed in the appropriate location a fatter face should not be a problem.
Posted by Dr. Buckingham
Question:
I am a 26-year-old woman interested in an injectable filler for my lips. Which one (Juvederm, Perlane, Radiesse, Restylane, Sculptra) would be the best option for me?
Answer:
Any of the hyaluronic acid fillers are appropriate for lips. Those would include Restylane, Juvederm or Perlane. We usually will utilize Juvederm for the lips however as it has a slightly softer feel and perhaps more longevity than the other fillers.
Posted by Dr. Buckingham
Question:
I have been reading about the different injectable fillers (Juvederm, Perlane, Radiesse, Restylane) and don’t really understand their differences. What differentiates them, and how are they used?
Answer:
The fillers you have mentioned, Juvederm, Perlane, Radiesse and Restylane, represent two classes of fillers. Juvederm, Perlane and Restylane are all hyaluronic acid fillers. Juvederm is made by Allergan and Perlane and Restylane by Medicis. Hyaluronic acid is a naturally occurring molecule in the body. It is found in skin and joint fluid. As a filler, it is a clear gel which is easy to inject in all locations of the face and produces a smooth result. If for some reason the result is unsatisfactory, the filler may be reversed with an enzyme. Radiesse is made of calcium hydroxyl-apetite. It is also a naturally occurring molecule in the body however it is more associated with bone formation. When injected into the soft tissue however, it does not cause bone formation but merely soft tissue augmentation. Radiesse is a better filler for deep tissue filling like cheek augmentation. It is not good for the lips however it can be used for areas such as nasolabial folds and marionette lines. In some patients it has better longevity and hyaluronic acid, but not all.
Posted by Dr. Buckingham
Question:
Everyone is always ranting and raving about Botox and I rarely hear anything about other brands of fillers. How does Botox differ from other injectable fillers?
Answer:
Botox is not an injectable filler. Botox is a neuromodulator or muscle relaxer. It is useful to relax the muscles that cause wrinkles associated with certain expressions. Fillers are substances used to fill in lines, wrinkles or folds. There are different types of fillers and different brands within some of those subtypes. Hyaluronic acid fillers are the most common and include Restylane, Juvederm and Perlane. Calcium hydroxyl appetite is a second and is commonly called Radiesse. Sculptra is a third and is made of poly-L lactic acid. Each filler has its own characteristics. They are discussed further on this site.
Posted by Dr. Buckingham
The facial aging process is complex and volume loss is a substantial component. Replacement of facial volume loss can be accomplished through the use of autologous fat transfer, which is using the patient’s own body fat cells and transplanting them into the face, or through the use of syringe based fillers. The most common types of fillers used are hyaluronic acid (Restylane, Perlane, Juvederm) and calcium hydroxylapetite. (Radiesse) Poly-L Lactic acid (Sculptra) is another filler which can be used for volume loss however it requires multiple treatments to appreciate the results and therefore we do not frequently use it. We prefer to use Radiesse for subcutaneous tissue augmentation as the results are immediate and the longevity approaches that of sculptra. Autologous fat transfer is another topic for another Blog. We will talk more about the use of syringe based fillers.
We usually use a combination approach for overall facial rejuvenation with fillers. We utilized Restylane for the teartrough deformity of the lower eyelid, Radiesse for deep cheek augmentation, and then a combination of Restylane, Perlane and Juvederm for perioral rejuvenation. The tear trough or orbital groove is a hollow at the junction of the lower eyelid and cheek. It is responsible for giving the lower eyelids their bag-like tired appearance. Restylane is very useful for filling in this groove. By filling up the hollow it changes the way light catches the eyelid cheek junction removing the appearance of the tired eye and adding light and therefore a refreshed appearance.
The loss of volume of the lower eyelid usually extends into the cheek region as well into what is referred to as a malar groove. It is an oblique line that separates from the orbital groove and extends down the cheek. When present the cheek has lost is youthful fullness and become a series of lumps and hollows again creating unsightly shadows. In this area we prefer to use Radiesse or Perlane to add the youthful fullness back to the cheek.
The other common area for facial rejuvination is the perioral area including the smile lines, marionett lines, and the pre-jowl sulcus which is the hollow along the jaw-line just in front of the jowl. By adding volume to this area the lines of age are again filled out to a more youthful configuration. The pre-jowl sulcus being filled hides the appearance of the jowl and leads to a cleaner looking jaw-line.
Fillers are great because of their ease of use and limited down-time. Dramatic results can be obtained through their use, especially if a total facial approach is utilized.
