Facial Fillers

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Deep lines and wrinkles on the face and around the eyes can make us look aged or tired. While many of these concerns can be improved with surgery, in some cases, a non-surgical approach may be best. In these situations, a commonly used technique is the injection of fillers into these deep lines to smooth the area and lessen how deep the wrinkles are. This can restore a youthful appearance and provide a great non-surgical result.
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I didn’t know fillers can be used to treat wrinkles! Tell me how that works?

Wrinkles are more complicated than we think. In fact, as surgeons, we separate wrinkles into 2 main types. First, dynamic wrinkles are the common lines we see when we emote. Smiling, for instance, pulls our cheeks upwards and causes us to slightly close our eyes. This forms lines on the outside corner of the eyes. These dynamic wrinkles are treated best with medicines that relax the muscles, like Botox. The other type of wrinkles, called static wrinkles, are visible on our faces regardless of facial movement. These lines form as a result of creasing of the skin from years of again and facial expression. Other lines also form as a result of gravity causing movement of large areas of the face such as the cheek and jowls. As these areas are pulled down by gravity, we see lines, such as the nasolabial fold, form. This is a deep line that extends down from the nose to the corner of the mouth. Fillers work great for this type of line.

What about around the eyes? I’ve heard filler can be used there as well!

Filler can be used around the eyes for particular applications. A common area is called the tear trough and the area along the cheek bone just under our lower eyelid. For patients with a lack of volume in the tear trough, they may appear tired, or as though they have a black eye. Fillers can be used to add volume under the skin in this area and restore a better contour to the eye. For other patients, lower eyelid “bags” are visible because of the volume difference between the eyelid and the cheek bone. Fillers placed along the cheek bone will help to hide the eyelid “bag” and smooth the transition from eyelid to cheek.

What are the risks associated with filler use around the eyes?

Fillers are fundamentally volumizing materials. What that means is that they are meant to occupy space. They do this by being materials that take the body a long time to metabolize and get rid of. But they also draw water from the surrounding tissue and “plump” over a period of time, adding to their volumizing effect. Because of this, care has to be taken to avoid placing too much filler around the eyes. Additionally, the many blood vessels around the eyes poses a risk. If filler gets into the blood stream, or compresses a blood vessel, it can block blood flow the skin and surrounding tissue, causing damage to those areas. This must be treated immediately to avoid long-term problems. Lastly, because the skin around the eyes is very thin, and fillers are generally clear in color, some patients can experience a “blue” tinge to the skin over the filler. This is an optical illusion that occurs because of how light hits the skin on top of the filler. Unfortunately, the only treatment for this is to remove the filler or cover it with makeup.
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Is filler permanent?

There are specific types of filler that are designed to be permanent. These fillers are designed to be used to build up bone structure and are typically not used around the eyes. Most injectable fillers used these days are temporary. Depending upon the area being injected, the filler may last 8-12 months, though in some cases, we see filler around the eyes last up to 18 months.

What happens if I don’t like the filler?

Injectable fillers are typically made of a compound that our body already makes, called hyaluronic acid. This is excellent because patients do not typically have reactions to the filler. However, if the appearance isn’t right or if the filler needs to be removed, an enzyme called hyaluronidase can be injected into the areas the filler was placed. This enzyme will very quickly dissolve the filler and remove it from where it was injected.

I know there are different types of fillers. Does it matter which one I have injected?

While most injectable fillers are made of the same basic material, hyaluronic acid, they do all differ in their properties. Some fillers are more moldable than others, some absorb more water than others, and some last longer than others. Some fillers also spread more, while others lay flatter in the tissue. Because of the different properties of each filler, the choice of filler can make a significant difference in your overall results. Depending upon the location that the filler is going to be injected, Dr. Dewan may select different fillers to achieve the best result for you.
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Can fillers be used if I am also considering surgery?

In most cases, if surgery is being considered, Dr. Dewan will recommend having the surgical procedure first. This allows the surgery to be performed in the most natural way. If fillers need to be used, they should be injected after all swelling and healing have occurred, typically no sooner than 6 weeks following surgery.

I want a doctor to inject my filler! Who does the injections at your office?

At Eye Plastic Surgery of Minnesota, we guarantee that your consultation and injections will always be performed by Dr. Dewan.

How much do fillers cost?

The cost of filler is based on how much is necessary. Fillers are distributed by their manufacturers in pre-filled syringes. Because syringes can only be used for 1 patient, your cost is based on the number of syringes necessary for your treatment. In most cases, fillers around the eye use only 1-2 syringes. Dr. Dewan will provide you with a formal quote for the cost of your treatment during your consultation.
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