If you have wrinkles, fine lines, deep lines or hollows in your face, as we often see in the dry climate of Inland Empire, California where I practice, you may be wondering about your best solution. A facelift is the ultimate answer for many of these problems. But even the best facelift surgery cannot address the loss of volume that causes facial hollows. And if you’re not ready for a facelift but still want to get rid of the wrinkles, lines and hollows in your face, you’re probably wondering what to do. You may have heard that dermal fillers like Juvéderm, Restylane, Radiesse and Bellafill can help these issues, which we see in Inland Empire where I practice and across the country. They can. But which one is the best solution for which problem? I’d like to give you the benefit of my years of experience.
Editor’s Note: Dr. Brian Machida is a double board-certified facial plastic surgeon who practices in Ontario, CA, part of California’s Inland Empire. He has an exceptional level of experience and taught for years at the University of Southern California’s Keck School of Medicine. So far in his career, Dr. Machida has performed nearly 4,000 facelifts.
What causes wrinkles, lines and facial hollows? Volume loss is a major factor
Three factors cause a lot of facial aging. First, UV light from too much sun can damage your skin. Second, as you get older, your collagen and elastin production begin to decline. Collagen forms the building blocks of new skin and elastin helps skin stay firm and tight. And third, fat starts to leave the fat pads under your face (volume loss) and get deposited elsewhere. Your face can lose its youthful rounded edges and your features sharpen. Wrinkles, lines and hollows begin to form.
There are two ways to deal with these problems. If they’re advanced, a surgical procedure like a facelift, browlift, blepharoplasty or neck lift can work wonders. But while these will tighten your skin, they won’t address volume loss. And if you’re younger, volume loss may be the main thing you need to replace. Dermal fillers are one popular and effective way to replace it. Here are some of the fillers I recommend and where they’re most effective.
What you need to know about fillers before starting injections
Filler injections can work wonders to smooth wrinkles, soften or eliminate lines and restore facial hollows to more pleasing contours. It’s important to remember, though, that fillers are outside substances that are injected into your body. For that reason alone, it’s vital to use fillers that are FDA approved for the specific use you want. Injecting the right filler is important.
A skillful injector is also crucial for a good result. Board certified facial plastic surgeons, plastic surgeons and dermatologists have special training on the best and safest methods. The more experienced a board certified specialist is, the more likely you are to get the great new look you want. Trying to save a little money by having an injector who’s not properly trained or certified can lead to real problems you don’t want.
Your body best accepts fillers based on substances it naturally produces. Artificial fillers like silicone can cause some real problems, especially if they’re administered by anyone other than a board-certified plastic or facial plastic surgeon or dermatologist. One major reason is that silicone can cause inflammation. It also can migrate to another part of your face. Both can cause disfigurement. In addition, silicone can only be removed by surgery, which can cause scar tissue to build up. The media is full of horror stories about silicone injections going wrong. Trying to save money by injecting liquid silicone can lead to getting the kind of new look no one wants.
FDA-approved fillers are based on natural body substances that are processed to make them work to fill wrinkles, lines and facial hollows. Many are based on hyaluronic acid. This body fluid is present in your eyes and helps to lubricate your joints. The body generally tolerates it very well.
Restylane, Juvéderm and Voluma are all based on hyaluronic acid. Your body will absorb this filler gradually after it’s injected. In about a year after injection, you’ll notice your wrinkles, lines and hollows starting to reappear. In order to keep your great new look you’ll have to plan on getting reinjected every 12 months or so.
Longer-lasting FDA-Approved Fillers
Radiesse is a natural substance (calcium hydroxylapatite) composed of the same material that makes up the mineral content of human bone. It contains calcium microspheres that provide volume. Collagen will form around the calcium. This can make its effects last up to 1 ½ years.
Bellafill, the longest lasting filler, uses PPMA – a substance used in orthopedic bone cement – to provide scaffolding for your own natural collagen. It delivers both instant and long-lasting results. Bellafill has millions of round microscopic particles (microspheres) of PPMA evenly suspended in bovine collagen, a once popular filler that provides immediate results. Your body will absorb the bovine collagen in just a few months. But during that time, Bellafill’s PPMA microspheres will attract your body’s own natural collagen, which will start growing around them. And, as your own collagen forms around the microspheres, you’ll continue looking good for a long time – up to 5 years or even longer.
Is Juvederm, Restylane or Bellafill the right filler for you?
An experienced board certified facial plastic surgeon, plastic surgeon or cosmetic dermatologist can recommend the right filler for the facial improvement you need. Here’s what my training and experience has taught me are best:
- Fine lines and wrinkles – Juvéderm, Restylane or Bellafill
- Deep lines – Radiesse or Bellafill
Of course, your individual situation makes a difference in which of these fillers is best for your particular needs. Bellafill can last 5 years or longer. While it initially costs more, in the end you’ll save because you won’t need additional injections every year or so, as you will with other fillers. However, some people are allergic to bovine collagen, so you’ll need to be tested before using it. Neither Radiesse nor Bellafill are reversible. For that reason, I inject patients progressively to avoid over-filling.
Therefore, if you want to look your best immediately, perhaps for a special occasion, choose Restylane or Juvéderm. If by some chance your wrinkles, lines and facial hollows get over-filled, injecting another agent can reverse that immediately. But if you have time and want a longer-lasting solution, Radiesse or Bellafill are best. I favor Bellafill because its results can last so long.
You should be able to find an experienced injector among the board certified facial plastic or plastic surgeons or cosmetic dermatologists in your area. If you’d like Juvéderm, Restylane, Radiesse or Bellafill injections to fill your facial lines, wrinkles or hollows and you’re in Inland Empire east of Los Angeles, California, you can find me at STC Plastic Surgery in Ontario.