Fillers Gallery

A woman in her early 80s who is shown before and again, 2 weeks after 100 units of Daxxify to the forehead and 1 Redensity to the upper lip At rest she actually has a few mm of eyebrow elevation.  The skin has a better appearance, something that patients are noticing after Daxxify that we don’t have an explanation for yet.

The redensity to the upper lip shows a nice improvement of the dynamic lines (sometimes called “smokers lines”) with a “whistle” view,  but no fullness of the lips at rest.  At 2 weeks she still has a small bruise.

A woman in her later 50s is bothered by dynamic lines of the upper lip (“smokers lines”) and wants an improvement but does not want the fullness of the upper lip. She is shown before and a few months after one syringe of Redensity to the upper lip.  No significant difference at rest but a dramatic difference with the pursing of the lips.

A woman in her later 50s wanted to improve the “smokers lines” of the white portion of the upper lip as well as correct some age-related collapse of the vermillion. But she still wanted a soft, natural look.  She is shown before and again, 1 month after one redensity to the white portion of the upper lip and 1 Kysse to the vermillion.

Redensity is the first filler that is approved for dynamic lines of the lip. Our patient in her late 50’s is shown before and 2 weeks after the placement of Redensity to the upper lips.  It does not add bulk to the lip at rest, but dramatically supports the soft tissues with motion.  It is another Non-Animal Stabilized Hyaluronic Acid filler from Revance and is the newest addition to their portfolio of Resilient Hyaluronic Acid fillers

A delightful woman in her early 70’s who is bothered by the tired and aged appearance of her face.  As we age, we lose volume in the face.  She has had additional bony volume loss because of dentures.  She is shown before and again, 5 weeks after initial correction with Botox to the corrugator muscles ( “ the 11’s”)  and procerus muscles, as well as the placement of  Resilient Hyaluronic acid ( RHA) to the corrugator lines and cheeks.  The RHA is “resilient” and highly flexible, moving as she moves her face in animation so that she has a natural appearance at rest and with smiling and talking.

A woman in her early 60s with volume loss around the cheeks and lower eyelids.  She is shown before and again, 3 months after 2 syringes RHA 4 to the cheeks, one RHA 3 to the upper nasolabial crease, and 1 Redensity to the tear trough.  Redensity is the newest addition to the Resilient hyaluronic acid lineup and is approved by the FDA for dynamic lines of the upper lip.  It is commonly used off-label in Europe for the tear trough area, the hollow under the eyes.  It is used here off-label, with good results.

A challenging patient in her early 60s is bothered by the deflated appearance of her lips and the area around her lips.  Her case is more challenging because she has dentures, and when patients lose teeth they also loose bony support for the lips.  She is shown before and then again, 2 weeks after her third treatment.  She initially had 1 syringe of RHA 4 and 2 syringes of rha 3 to the “marionette lines”  ( Melo labial creases)   She then returned for rha 2 to the “smokers lines” of the upper lips and Restylane Kysse to the pink’resu portion of her lip.  She then returned for additional RHA 3 to the melolabial creases.  The RHA 4 (“resilient hyaluronic acid) is thicker and is placed deeper in the tissues.  The RHA 3 is intermediate and is placed at an intermediate level.  The RHA 2 is thinner and is placed closer to the surface.  The Kysse is soft and flexible and good for augmenting the vermillion.  The combination gives her a soft and natural correction of a difficult problem. 

The “whistle” afterview shows that the lips and the area around the lips remain soft and natural in appearance and move normally with the movement of the lips. 

A man in his mid 50’s who is bothered by “tear trough” hollows under his eyes as well as lines of the forehead and crow’s feet lines around the eyes.  He is shown before and again, 10 days after Botox to the forehead and crow’s feet lines ( lateral orbicularis) as well as the off-label use of REDENSITY to the tear trough area.  REDENSITY is a Non Animal Stabilized Hyaluronic Acid Filler ( NASHA) that was recently released in this country for the treatment of active lip lines, which is the “on label” indication.  It has been used “off label” in Europe for the tear trough area and I am excited that we now have it available in this country for the off-label treatment of the tear trough area.  This is a challenging area to treat, because other NASHA fillers can become puffy and swollen in this area, and if this area is over corrected it looks funny.  Redensity is part of the RHA line of fillers which have been in this country for almost 2 years and in Europe for almost 8 years.  In Europe it is called Teoxane TEOSYAL RHA® 1

It is reversible if needed with the injection of an enzyme, hyaluronidase.

A woman in her early 50’s who started to notice “smoker’s lines” or “lipstick lines” when she puckered her lips.  She has stopped using a drinking straw in hopes this would help.  She is not a smoker.  This is typically related to subtle loss of soft tissue support with aging and is a perfect application for Redensity, the new RHA filler from Revance, and the first filler to be approved by the FDA for the treatment of active lip lines.    The RHA line has been in Europe for 7 ½ years where it is known as Teoxane, and has been in this country for the last 20 months.  It is a “Non Animal Stabilized Hyaluronic Acid” ( NASHA)  filler. Which can be dissolved with hyaluronidase, and is very flexible but strong, so it can move with the lip but still return to shape.  She is shown before and again, 11 days after treatment of the upper lip lines with one syringe. It does not add “bulk” to the lips but markedly improves the active lip lines.

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