Archive for the ‘Juvederm’ Category

« Older Entries

How do I prepare for a filler and what kind of post care should I think of after a filler?

Friday, July 23rd, 2010

Fillers (Dr Young from Aesthetic Facial Plastic Surgery, PLLC in Bellevue, WA) are products that are used to volumize your face.  As you age, you lose volume in your face and these fillers replace this volume.  The most common fillers include restylane, radiesse, juvederm, and perlane.  These are the top four products being used.  So what are some of the things you should be thinking about with filler.  Well to begin with you should not be allergic to any of the products including hyaluronic acid, calcium hydroxyapatite, carboxymethocellulose, gram positive bacteria especially streptococcus, lidocaine or amide type local anesthetics, or a history of multiple allergies or severe reactions to certain medications.  I usually tell people to refrain from high dose vitamin E, herbal medications, supplements, fish oils, omega 3’s, anti-inflammatories (naproxen, aleve, ibuprofen, advil, indomethacin, motrin, excedrin, piroxicam, sulindac, etc.), aspirin 2 weeks before and after the procedure included with this list are some obvious ones like warfarin, coumadin, heparin, lovenox, plavix. Here is a more formal list of medications to avoid from our website.  I do this because these elements / medications can cause bleeding and if you avoid these during this time frame you can avoid extra bruising and swelling.  Arnica and bromelein have shown some benefits but are still being studied and are not a standard in treatment for plastic surgeons so I don’t really recommend it.   This pre filler care will help with the post care.  You should discuss during your consultation the risks and benefits of the use of restylane. During the filler you will have some choices for the type of anesthesia you can get for the filler injections. Now most fillers have lidocaine in the preparation to make it more tolerable.  These are the options:

1. Use ice then inject. Can work but by numbing the area with the ice.  With the local in the filler, you may feel it go in initially with each stick in any new area. But subsequent injections will be more numb with the anesthesia in the filler itself

2. Use topical anesthesia first and then inject.  This is a good option.  The topical makes the skin numb, you may feel the injection go into the deeper layers. But like ice, it will feel like a stick in the new area and then get better with subsequent injections.

3. Local anesthesia and regional anesthesia, so called “dental blocks” to numb the nerves that innervate specific regions.  This is the best way to make it so that you don’t feel anything.  For some it is over doing the anesthesia.  Sometimes, people who get anxious can get reactions to the local anesthesia and you can get an anxiety situation where your heart rate goes up as well as your blood pressure.  This happens about 1 out of 25o times a filler gets done with local / regional anesthesia.

After the filler, you should ice the area especially for the first 48 hours.  I usually suggest 10 minutes for every hour.  I also stress that you should not have the ice directly on the skin but have a barrier to prevent damage to your skin.  This icing will keep the swelling down and also the bruising to a degree.

For the first two weeks, I usually suggest people to massage the area of the filler if there are certain areas that are more elevated and pronounced than the other areas.  Most of this uneveness if it is present will be improved with this.  When the filler is in the lower eyelid area, you need to pull down the swelling over the bone and then massage it from there to effect it.  After the first two weeks, I then suggest to consider more massage if the elevations are subtle and if large then you can consider enzyme injections or hyaluronidase injections which are very potent in reducing unwanted swelling from filler.  Now with radiesse there is no enzyme that will do the same and you have to just massage the area to make it go down to a point that you like.

If you have any questions you can always email me or ask me through this blog

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane, Uncategorized | No Comments »

Can fillers like restylane cause blindness if injected into the tear trough?

Wednesday, July 14th, 2010

Fillers (like restylane, perlane, radiesse, juvederm by Dr Young in Bellevue near Seattle, WA) in the tear trough can theoretically lead to blindness but there are precautions that you can take to prevent it.  The veins around your eyes and nose and center of the face are valveless and do not prevent particles from traveling back into the deeper tissues like your eyes and brain.  It is possible to cause the particles that are injected with fillers to go back into the eye to cause blindness.  But this is extremely rare.  You can take some precautions to prevent this though.  When you inject, you should not apply to much pressure with injecting.  Also when you inject it you should never be in one place and your needle should always be moving and distributing the filler evenly.  This prevents a load of filler being place in one spot and in the case that you are near a vessel the one spot is not being filler aggressively and possibly back into deeper structures like your eye. Also local anesthesia prevents the vessels from being injected by constricting the vessels so that it is less likely for the filler to get into the vessels. This is a video on fillers around the eyes.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Blepharoplasty / Eyelift / Eye Lift / Dark Circles / Eye Bags, Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane | No Comments »

I have a line on my cheek and I was wondering what kind of cheek lift or filler I can use.

Thursday, May 6th, 2010

You can inject both Restylane or Juvederm (Dr Young is a filler expert in Bellevue Washington) in your cheeks.  They are both very safe when injected by someone with experience.  There are some differences in both of them.  Restylane has been approved for 6 month duration and juvederm for 9 months.  I think they are about the same in terms of length of duration in my experience ranging from 6 months to a year.  One thing to realize is the Restylane comes in 1.1 milliliters or cc’s and Juvederm comes in about 0.8-0.9 ml or cc’s.  You get a little more restylane than juvederm.  Some people think that Juvederm is smoother and results in less lumps but I think that hasn’t been the case for me.  The great thing about Juvederm, Restylane, Perlane is that you can mold these products a bit and if after 2 weeks you have some augmentation that you don’t like you can always inject some enzymes into the areas to decrease the amount of augmentation to get the very best results.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane | No Comments »

What is the best treatment for laugh lines? Fillers or Botox?

Monday, February 22nd, 2010

Juvederm is commonly used for laughl lines as well as botox.  It is important to know what you mean by laugh lines.  Many refer to these as the lines around the eyes, or crows feet.  Others mean when the say “laugh lines”, the lines around their mouths or nasolabial folds.  I have a blog that defines those areas if you are interested to know the terms.  But the nasolabial folds are the folds that run from the nose along the sides of the mouth. Whereas the lines below the mouth on the sides are commonly refered to as the marionette lines or puppet lines.  The crows feet can be improved by botox and they can also improve the nasolabial folds to some extent.    Fillers like juvederm can also fill in the nasolabial folds, marionette lines and also help with the crows feet.  In order to really understand how they work a visit to a facial plastic surgeon would be helpful.  Now the difference between fillers and botox is that fillers replace volume that is lossed during aging.  When you lose volume there is an excess amount of skin compared to the underlying tissues.  More skin for a set amount of volume leads to more folding of the skin and hence more wrinkles.  Fillers replace that volume and hence fill in the skin and thereby decrease the ability for the face to make wrinkles.  Botox, which is a neuromuscular agent can make the muscles less likely to contract.  Hence they are most beneficial for dynamic wrinkles, or the wrinkles that are caused by muscular activity.

I hope that helps.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Botox, Dysport, Botulinum, Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane, Wrinkle Treatment | No Comments »

Can hyaluronidase leave scars, holes? Does the enzyme break down a persons own acids and what affects are there?

Monday, January 25th, 2010

Hyaluronidase is an enzyme that breaks down hyaluronic acid such as fillers used for cosmetic purposes like restylane, juvederm, perlane, etc.  It doesn’t seem to affect natural hyaluronic acid and has a predominate affect on filler injected.  The reason for this is due to the fact that natural hyaluronic acid is found around a substructure within the skin.  When natural hyaluronic acid is degraded it is reformed almost just as quickly.  In fact, natural hyaluronic acid is turned over on a daily basis so your body naturally degrades its own hyaluronic acid and replaces.  With your natural foundation, the hyaluronic acid is formed all the time so the enzyme injected and its effects will be reversed quickly.  It does not leave scars or holes,  except in the area of previous filler injections.  You have to be conservative in the amount that you use otherwise you can get depressed areas in the previous area that you augmented.  That is the only temporary risk.  Some suggest a skin test for the enzyme in case of an allergic reaction.  But I know of hundreds to thousands of patients who ht tave received this in surgery centers with no issues at all.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Fillers / Facial Fillers, Juvederm, Perlane, Restylane | 2 Comments »

lumps and bumps 3-4 days after lip augmentation with Restylane

Monday, December 7th, 2009

The swelling in the lips usually takes a while to go down after lip augmentation (lip filler, lip enhancement, lip plumper, younger lips, lip injectibles) with Restylane. Your lips are very vascular and with that comes easier bruising and swelling. 3-4 days is on the early side. I usually wait for the first 2 weeks for the swelling to go down.  During these first 2 weeks is when massage can really help dissipate the swelling.  Enzyme injections are also another way of removing restylane, juvederm, perlane but they are more of a permanent removal of the restylane.  If enzymes are injected during the first 2 weeks, this may be a mistake.  The swelling that would normally go down the first 2 weeks will further go down more if enzymes are injected the first 2 weeks.  Sometimes waiting at least 3 weeks is even better.  One thing to remember is that restylane and other hyaluronic acid fillers can be shaped though and you shouldn’t have to go through 6-9 months of a less than desirable result.  Enzyme’s can help shape your results after 2-3 weeks.  Notice how in the example that the lower lip in the after maintains the size that is 2 times greater than the upper lip.  From the viewer standpoint, it doesn’t look wierd to them.

Thanks for reading!

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Before Restylane Injections / Lip augmentation

Before Restylane Injections / Lip augmentation

After Restylane Injections / Lip augmentation

After Restylane Injections / Lip augmentation

Posted in Fillers / Facial Fillers, Juvederm, Lip Augmentation / Lip Fillers / Lip Injections / Lip Reduction / Lip Grafts / Lip Advancements / Fat Injections of the Lip, Perlane, Restylane | 7 Comments »

Fillers, Botox or Lasers for the Under Lower Eyelid Area?

Thursday, October 15th, 2009

This was a question I answered for someone recently:

Restylane is a filler and can be used to fill in the lost volume that is really the cause of the majority of the reason why your lower eyelid looks the way it does. Fat injections, the YoungLift, Juvederm, Perlane, Radiesse are other fillers that can be filled into the lower eyelid area.  The temporary fillers last from 6 months (restylane) to a year or more (radiesse) with perlane and juvederm in between.  Fat injections can last much longer but this isn’t guaranteed but is the best shot for a long term correction.

Botox prevents the muscle around the eyes from squinting which can make the wrinkles less noticeable. Dysport (or botox / bo tox / botulinum / neurotoxin / disport) is a great option.  But these do nothing for the surface quality of the skin and neither does the filler. But the fillers can decrease the amount of wrinkles by filling up the volume.

This is where the co2 laser or other resurfacing procedure (erbium yag, active fx, ultrapulse, deep fx, max fx, total fx, traditional co2 laser resurfacing, laser peel) can help with by decreasing the wrinkles and actually tightening the skin.  A small amount of volumizing also occurs with lasers with their creating of a thin collagen layer deep to the skin.

I hope that helps some!

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Botox, Dysport, Botulinum, Chemical Peels, Fat Transfer / Fat Injections, Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane, Wrinkle Treatment, YoungVolumizer | No Comments »

What are the options for sunken cheeks besides temporary dermal fillers?

Wednesday, August 5th, 2009

This is a questions I answered for someone that was wondering what option there were for sunken cheeks besides temporary dermal fillers. Fat injections or silicone implants can give you the long term volume you desire in the cheek.

Sunken cheeks is a natural aging process.  When you age you lose fat in your cheeks and this can lead to your tissues descending, wrinkles developing, folds developing, lower eyelid fat protruding, eyelid bags, etc.  Dermal fillers like restylane, juvederm, radiesse, perlane, are temporary and last from 6 months to a year or more.  Of these fillers radiesse is a bone product made up of calcium hydroxyapatite while the others are made up of hyuloronic acid.  There are more permanent fillers like silicone injections, and artefill.  The problem with permanent fillers is that they have the potential to cause infections, scarring and granulomas (balls of chronic infection) that can present years later after you think everything is okay.

Other more permanent options for sunken cheeks include fat injections and silicone implants.  Silicone is very compatible to place in the cheeks.  The silicone atom is one step below carbon on the atomic chart and hence makes it really compatible.  The infection rate with silicone is very low and its use has a long history of safety.  Silicone implants can be placed within the cheek to give a person a more permanent volumizing and lift up sunken cheeks.

Fat injections are another way of volumizing the cheek. Perrmanency depends on whether the fat survives.  This depends on many factors: technique, health of the patient, care of the patient after the procedure, etc.  If fat lasts for more than 6 months to a year, it will likely survive for many years sometimes 10-15 years or longer.

I refined an amazing volumizing procedure called “the YoungLift”. This is an innovative technique that volumizes your face to bring out the younger and natural you without looking like you had something done. This is not a facelift and requires no incisions. Only pinpoint puncture sites are used and these heal imperceptibly. The YoungLift can be done without general anesthesia and without drains, and large bandages. You also have a lot less downtime and discomfort compared with traditional facelift procedures. I employ the very best techniques from around the world into one volumizing procedure and I use my internationally acclaimed understanding of facial beauty to create the youthful volume you once had.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Cheek Augmentation, Facial Implants, Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane, YoungVolumizer | No Comments »

Can a forehead augmentation be done after a brow lift?

Wednesday, August 5th, 2009

Forehead augmentation can be done but can affect the results of previous browlifts. You can augment the forehead with silicone after a browlift.  One of the issues is that the augmentation will affect what was done with the previous browlift and you will sometimes need to refix the brows and allow them to fixate in the newer position.  Browlifts depend on the fixation of the bone to the bone covering and the soft tissue that covers the forehead.  When you dissect to implant something into the forehead it will break that bond.  Also with the implant fixating the brows to a new position will present some challenges as well depending on where the implant is placed.  Implants placed in the forehead can establish needed volume that is lossed with aging.  Most of the time, however, forehead augmentation is used to fill in defects from trauma and for reconstructive purposes. Also depending on what implant is used and the size you may need longer incisions such as a variation of the coronal incision that goes from ear to ear.  Not all of this incision is needed most of the time.  In terms of augmentation, you can use silicone sheets / blocks, radiesse, restylane, juvederm, perlane, or fat augmentation.  Silicone and fat are the options that offer more of a longer lasting results with silicone being more permanent than fat.  Fat injections, however, can be done with no incisions most of the time with less downtime associated with long incisions. Augmenting the forehead can potentially help with wrinkles in the forehead, eyebrow drooping, extra eyelid skin and temple hollowing depending on how and where the augmentation is done.

I refined an amazing volumizing procedure called “the YoungLift”.  This is an innovative technique that volumizes your face to bring out the younger and natural you without looking like you had something done.  This is not a facelift and requires no incisions.  Only pinpoint puncture sites are used and these heal imperceptibly.  The YoungLift can be done without general anesthesia and without drains, and large bandages.  You also have a lot less downtime and discomfort compared with traditional facelift procedures.  Dr Young employs the very best techniques from around the world into one volumizing procedure and he uses his internationally acclaimed understanding of facial beauty to create the youthful volume you once had.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Browlift / Eyebrow Lift / Brow Lift, Fat Transfer / Fat Injections, Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane, YoungVolumizer | No Comments »

Will Juvederm totally take away the smile lines and nasolabial folds?

Thursday, July 9th, 2009

This a question someone asked me on line about whether Juvederm completely removed the nasolabial folds because she hoped that some of it remains so that she can still smile:

With augmentation with Juverderm, the nasolabial folds will be reduced but they will not completely go away.  When you smile the nasolabial folds will deepen with the action of the muscles but will not be totally gone with juvederm injections.  Also juverderm will only last around a year or less.  This is a temporary treatment.  Also if you don’t like the augmentation or what was done there is an enzyme injection that can be administered that will take away some of the juvederm if you desire.  Experience is important to make sure that too little or too much is given with these injections.

I refined an amazing volumizing procedure called “the YoungLift”.  This is an innovative technique that volumizes your face to bring out the younger and natural you without looking like you had something done.  This is not a facelift and requires no incisions.  Only pinpoint puncture sites are used and these heal imperceptibly.  The YoungLift can be done without general anesthesia and without drains, and large bandages.  You also have a lot less downtime and discomfort compared with traditional facelift procedures.  I employ the very best techniques from around the world into one volumizing procedure and he uses his internationally acclaimed understanding of facial beauty to create the youthful volume you once had. The YoungLift techniques can help with filling up the lips as well.  You can great results with fat injections in the lips.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Fillers / Facial Fillers, Juvederm, YoungVolumizer | No Comments »

« Older Entries