Fillers Gallery

A woman in her early 60’s who has had significant weight loss after a gastric bypass is bothered by her deep set nasolabial creases.  She is deeper on her left side.  She received 2 syringes of Restylane Defyne and returned 2 weeks later for 2 more syringes.  She is shown 2 weeks after the second treatment.

Discussion: The volume loss seen with aging is often made worse by significant weight loss.  Proper replacement of the volume can give a significant improvement.  Enough product needs to be used to correct the deficit, and this is frequently more in patients in their 60’s or older.  She has a pleasing improvement

A woman in her mid 70s who came in to ask about a face lift. She was not a good candidate for a facelift because of poor skin quality from prior smoking and sun exposure.
“It’s not just the tailor, it’s the fabric we are working with” is a saying that emphasizes that the expected results are impacted greatly by the quality of the skin.

She does have age related volume loss and elected instead for 4 syringes of rha 3 to the “marionette Lines” and 4 syringes of RHA 4 to the cheeks. She is shown 10 months after placement of the rha 3 and 1 month after placement of the rha 4. The resilient hyaluronic acid fillers are a new line of Non animal stabilized hyaluronic acid fillers from Switzerland that were brought to this country in November of 2020 by Revance and allow a correction in parts of the face that move without looking stiff or abnormal- they are “resilient” and move with the face. They have been used in Europe for 6 years and the doctors there report that they are lasting 22 months or so.

A woman in her early 60’s who is shown before and again 2 weeks after the placement of 3 syringes of the RHA-3 .

We are pleased to be one of the first practices in the United states to be able to offer the Resilient Hyaluronic Acid fillers, which are manufactured in Switzerland by Teoxane and have been used in Europe for more than 5 years. They have just been brought to the US by Revance. They are still hyaluronic acid, and therefore have the same safety profile as the Juvederm collection from Allergan and the Restylane collection from Galderma. But they differ in being more Resilient, which allows them to move naturally with the face. This is described as the difference between a steel girder bridge and the golden gate bridge. They are both strong, but one is more flexible. This now allows me to treat the nasolabial creases and areas around the mouth without bunching or moving, and they are expected to last for 18 months. Our patient here is seen at rest and smiling. The correction is significant but appears absolutely natural with movement of the face.

A woman in her late 20’s who is bothered by submental fullness and weakness of her chin. Although she could consider liposuction of the submental area and a chin implant, her schedule did not allow for surgery and recovery at this time. She is shown 2 months after 3 vials of Kybella to the submental area, and 1 month after 2 cc of Restylane Lyft to the chin.

A woman in her late 20’s who is bothered by submental fullness and weakness of her chin. Although she could consider liposuction of the submental area and a chin implant, her schedule did not allow for surgery and recovery at this time. She is shown 2 months after 3 vials of Kybella to the submental area, and 1 month after 2 cc of Restylane Lyft to the chin. There has been no change in her weight.

A woman in her mid 20’s who is bothered by a hollow under her eyes. She is shown before and again, 1 month after the placement of a single syringe of Restylane Lyft to the “tear trough” area, with good correction that should typically last for a year or longer. The “chin down” view emphasizes the hollow area under the eyes. “dark circles” are not typically improved by filler because they represent the muscle just underneath the skin.

A woman in her mid 50’s who had blepharoplasty elsewhere 18 months ago and was still bothered by the appearance around her eyes. On examination she has some brow ptosis from the normal deflation that occurs with aging, and the excess skin around her eyes corrects as the brow is elevated. She also has prominent crow’s feet lines with smiling. Although we could consider a brow lift I thought it would be prudent to try Botox first and see how much shaping of the brows and lateral brow elevation that we might obtain. She also has some deflation of the midface and Juvederm Voluma was placed. She had 45 units of Botox and 2 syringes of Juvederm volume. The effect on her brows was dramatic. Her cheeks appear more youthful as well. Additional Juvederm Voluma could be placed to the cheeks but we plan to wait until she returns to repeat her Botox, typically at 4 months.

A woman in her later 40’s who wanted fuller but still natural appearing lips. She is shown before and again, 2 weeks after a single syringe of Juvederm Ultra. Her lip has shape and fullness but is not overly prominent. She does not have “duck lips” or “the trout pout” which my patients do not like. Her friends notice that she looks better but are not sure why.

A woman in her mid 70’s who would like to look a little more rested in her appearance but without surgery. She has prominent “11’s” (corregator lines) of the forehead at rest. Because of age related volume loss the “marionette” lines ( chin-cheek creases) and nasolabial lines (lip cheek creases) are prominent. She is shown before and after Botox to the corrugator muscles and Restylane to the deep “11” lines. The Botox weakens the over active muscles here and the Restylane fills the “ditches” that have formed from this area being creased over and over . This gives her a less stressed look. 2 syringes of Restylane Lyft were placed to her “Marionette” lines and 2 syringes of Restylane Lyft to her nasolabial lines. This gives her a nice improvement that looks better in a natural way.

A woman in her early 60’s who is bothered by an aged appearance and wants to look better, but is not ready to consider surgery. She is bothered by brow asymmetry with her right eyebrow always being higher. Analysis of her face shows a strained appearance in the frown area ( sometimes called the “11’s”), age related volume loss of the midface and jowls, as well as prominent crow’s feet lines around the eyes at rest and with smiling. We decided on a plan of step wise correction. She first had Botox to balance the brows along with Restylane to the deep frown lines and Restylane lyft to the naso labial creases ( sometimes called “the parentheses” ) and chin –cheek lines ( sometimes called “marionette lines” after the lines around a puppets mouth). I then saw her 2 weeks later and placed some Juvederm Voluma to the cheeks. Finally, she returned for Restylane lyft to the “chin notch” and groove in front of the jowls.
She is pleased by her improvement which is natural in appearance. Friends ask her “if she has had her hair done”. This is one of my greatest compliments, because it means that others notice that she looks better but because it is natural, are not sure why, so they attribute the improvement to a new hair style.