Soft-Tissue Augmentation:
Hyaluronic Acid (Restylane, Perlane, Juvederm, Hylaform), Collagen, Radiesse, Sculptra, and Fat Transplantation
Many patients develop wrinkles that begin to be more noticeable over time. Specifically, the skin ages by losing its underlying supporting structure, which is known as soft tissue atrophy. Soft tissue atrophy is one of the most prominent signs of the aging face, and our surgeons are expert in the identification and treatment of this condition. There are a myriad of options available for the treatment of atrophy, and they are collectively referred to as soft tissue augmentation. The ideal products for soft tissue augmentation are natural feeling and long lasting. Our staff physicians offer a number of treatment options that are designed to afford our patients with a variety of choices to tailor treatment to their individual needs. The most common areas affected by soft tissue atrophy, and the resultant aging appearance, are the lips, chin, cheeks, under the eyes, corners of the mouth, and nasolabial folds (crease running between the nose and the side of the mouth).
Restylane, Perlane, Juvederm, and Hylaform
We now finally have a long lasting, safe way to improve wrinkles with minimal downtime. Restylane, Perlane, Juvederm, and Hylaform are natural occurring hyaluronic acid products that produce superb, reproducible results that last six to twelve months. They can be injected in a 15-30 minute session to erase wrinkles, eliminate some scars, and augment or contour the lips and cheeks.
Two major types of wrinkles can be treated with Restylane, Perlane, Juvederm, and Hylaform: the "smile line" or dynamic wrinkle, and the static wrinkle, caused by aging, overexposure to the sun, and/or cigarette smoking. Soft tissue injections are most commonly used to treat the furrow that develops between the eyebrows (glabellar wrinkles), the wrinkles around the eyes (periorbital wrinkles), the lines that run from the nose to the corner of the mouth (nasolabial fold), and acne scars. It is also used to fill in and augment thin lips, sunken areas on the cheeks and chin, and to correct the sad expression that appears at the corners of the mouth (marionette lines) with advanced age.
Occasionally, our physicians will use topical or local anesthesia to make the procedure more comfortable, especially when treating the lips. Restylane, Perlane, Juvederm, and Hylaform are quite technique dependent, and the doctors at SkinCare Physicians are recognized around the world as skilled pioneers in the injection of these materials and continue to teach other physicians how to attain the most aesthetic results.
Collagen
Collagen, a natural substance that is present in skin, can help eliminate or improve some of the facial wrinkles and lines that are an inevitable part of aging. SkinCare Physicians uses safe, purified collagen manufactured specifically for this purpose. A simple skin test may be done to determine whether someone is allergic to the collagen.
The procedure is safe, effective, and usually takes about 20 to 30 minutes. To maintain optimal results, repeat treatments are usually performed every 3 to 4 months.
Radiesse
One of the newer materials available for soft tissue augmentation is Radiesse. Made from calcium hydroxylapatite, Radiesse is a soft and long lasting. With a longevity ranging from 12-18 months, Radiesse is a nice option for those patients who seek a longer lasting correction. Radiesse is extremely useful for correcting the nasolabial folds, jowls and jawline contours, as well as augmenting the mid cheek to create a more youthful mid face.
Sculptra®
Sculptra® is an enduring treatment for restoring fullness to facial folds, creases, and for facial fat loss. Facial fat loss and redistribution results in hollow cheeks, indentations, and folds. It is approved by the FDA for restoration and/or correction of the signs of facial fat loss in people with human immunodeficiency virus and it has been used extensively for healthy individuals with facial fat loss or redistribution. Sculptra® is a safe, synthetic, and biocompatible material that is injected below the surface of the skin in the area of fat loss. It provides a gradual and significant increase in skin thickness, improving the appearance of folds and sunken areas.
Sculptra® is a synthetic injectable material known as "poly-L-lactic acid". Poly-L-lactic acid is biocompatible (a material that does not harm the body) and biodegradable (able to be broken down by the body).
At your first treatment visit, it may appear that Sculptra® worked immediately because of swelling from the injections and the water used to dilute Sculptra®. In a few days, when the swelling goes down and the water is absorbed by your body, you may look as you did before your treatment. Sculptra® takes time to gradually correct the creases and folds in your skin. Repeat treatments are usually performed every 3 to 4 weeks, and patients usually require 3 to 6 treatment sessions before seeing optimal results.
Treatment results and longevity differ for each person. In one clinical study, results with Sculptra lasted for up to 2 years after the first treatment session. Touch-up treatments are usually needed to maintain the desired effect.
Autologous Fat Transplantation
For patients who desire a permanent, natural appearing result, autologous fat transplantation is a superb treatment option. Autologous fat transplantation offers two advantages over other methods of erasing wrinkles. First, the fat we use is your own tissue, eliminating the risk of allergic reactions. Second, most of the fat that is transplanted will remain permanently, resulting in fewer repeat treatments.
Fat transplants are used to fill in contour defects, such as the groove that runs from the nose to the corner of the mouth (nasolabial folds), cheeks, temples, jaw line and to improve the appearance around the corners of the mouth, which often begins to sag with age.
Before the Procedure
To obtain fat for transplantation, a small liposuction procedure is performed in which cells are harvested from the abdomen, buttocks, outer thighs or hips. Virtually painless, this procedure takes less than 30 minutes. Afterwards, the fat tissue is processed for implantation. A small portion of the harvested fat is used for immediate transplantation, and the remainder is processed and stored in our specially designed facility for future use.
The Procedure
After a small amount of local anesthesia is administered, the patient's own tissue is inserted using special small instruments. Sutures are not required. Careful attention is paid to the fat insertion technique, ensuring that the results are both smooth and symmetrical. It is imperative that the surgeon have a keen eye for aesthetic contours, and use precisely controlled movements to create a wrinkle-free appearance. Fortunately, our surgeons have performed hundreds of fat transplants over the years, and have refined the skills needed to produce superb results on a daily basis.
Recovery
Post-operative care is minimal after this procedure and recovery is quick. Results can be seen within 24 to 48 hours after the swelling recedes and the newly transplanted tissue settles in place.
Bruising is uncommon, and is usually covered easily with makeup. If additional wrinkle correction is desired by the patient, a small touch-up procedure can be performed 3 to 6 months after the initial procedure.
Our physicians have pioneered novel techniques for fat transplantation, producing longer lasting, natural, beautiful results. It is an elegant procedure for those patients seeking to soften the signs of facial aging.
