Dermal Fillers: Liquid Face Lift

An attractive youthful face is characterized by smooth, round contours, high cheekbones and a thin, well-defined jaw line. These features, together, comprise the ‘triangle of beauty’ or ‘heart of face’, with its base at the top and summit below.

As we age, facial fat, bone and collagen loss, gravity and loss of the skin’s natural elasticity lead to reversal of this triangle’s composition, leading to a narrower, less youthful forehead and temple area, and a wider, heavier jaw line. In experienced hands, dermal fillers are artfully used to sculpt the face and restore balance and proportions by subtly adding volume to areas where this is lacking. The result is a restoration of the triangle of youth back to its original form and a softer and more youthful appearance.

Dermal fillers can be divided into ‘passive fillers’ that are made from hyaluronic acid (Juvederm® and Restylane®) and restore volume without stimulating collagen production, and ‘active fillers’ such as Radiesse®, Sculptra® and Bellafill®. Active fillers replace lost volume and stimulate patient’s own collagen production. The longevity of each dermal filler depends on its composition and properties and area of placement.

Different fillers have specific qualities that make them ideal for different areas of the face. In the delicate eye area, dermal fillers can be a powerful rejuvenation tool to improve the appearance of eyelid bags and dark circles, drooping eyebrows or asymmetric appearance. Extensive experience with the use of dermal fillers in the eye area is required to achieve the best results and avoid complications.

You should always look for a physician injector with the best qualifications and experience. This will translate into better cosmetic results with the least risk of complications.

Dr. Levin uses all commercially available fillers in her practice. She is a physician trainer and member of the physician advisory council for Suneva, the manufacturer of Bellafill®. Her experience is used in education, training and development of FDA research protocols.

What takes place during dermal filler injections

During the consultation, Dr. Levin will listen to your concerns, discuss your individual goals and design a treatment plan based on your needs and her examination. For some dermal fillers, treatment can be done on the same day (Juvederm®, Restylane®, Radiesse®) whereas for others (Sculptra® and Bellafill®), they may need to be scheduled on another day. A numbing cream is placed on the face for 15-20 minutes for comfort. Many fillers include anesthetic solution in them as well. After the numbing cream is removed, the face is cleaned with an antiseptic (anti-bacterial) solution. The areas to be injected may be marked with a skin marker. Dr. Levin uses a micro-cannula for most injections. This technique minimizes pain and bruising and can provide added safety. The injections can be completed in a matter of minutes. After the procedure, the markings are cleaned off and ice may be placed on the treated areas. You can resume normal activities right away and will receive post-procedure instructions pertaining to your specific treatment.

We discuss a number of dermal fillers in more detail below. If you would like to learn if you are a candidate for dermal fillers please contact us or call us today at (203) 557-6464.

To learn more about dermal fillers read this article, “11 things to know if you’re thinking about dermal fillers.”

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Bellafill® is a filler composed of collagen and PMMA microspheres. The collagen in Bellafill® provides immediate volume and lift while the PMMA microspheres remain in place and create a matrix that supports collagen production in your skin for lasting improvement. It is the only FDA-approved filler for the correction of facial wrinkles and improvement of facial acne scars for up to 5 years. A skin test is needed to ensure that there is no sensitivity or allergy to collagen.

How Bellafill® Works

Bellafill® is an injectable filler that’s FDA approved to treat nasolabial folds. These folds, sometimes called “smile lines,” extend from the nose to the corners of the mouth. Bellafill® provides instant smoothness, with long-lasting results: In the longest and largest study ever conducted on dermal fillers, Bellafill® was proven to be effective through five years. That means that you can enjoy your results for much longer than you would with hyaluronic acid-based fillers. Bellafill® has 2 main components:

• Smooth collagen gel (80%) forms the base of Bellafill, creating smooth, supple volume beneath the surface of the nasolabial folds.

• Polymethyl methacrylate (PMMA) microspheres (20%) are suspended within the collagen gel. These form a sturdy scaffold where your own natural collagen grows. Thanks to its 2 innovative components, Bellafill® creates instant results that you can enjoy as soon as you leave the office. As the original collagen gel fades away, your body naturally replaces it with your own collagen around the microspheres, for unparalleled long-term smoothness.

What is Bellafill® and how does it work?

Bellafill® is a smooth, collagen gel-based dermal filler that contains tiny PMMA microspheres. The collagen gel in Bellafill® provides immediate volume and lift to correct lines and wrinkles, smoothing them away for instant results. Even as the collagen is absorbed by your body, the PMMA microspheres remain in place, creating a “scaffold” that triggers and supports your own natural collagen production. Because your own collagen replaces the collagen gel from the initial injections, results last seamlessly through five years.

Is Bellafill® safe?

Yes. Bellafill® is FDA approved and has been proven safe and effective in rigorous clinical studies. Bellafill® performed very well in the largest and longest safety study ever conducted on dermal fillers. At the study’s completion, 83% of patients were still satisfied with their results 5 years after treatment. As with many injectable fillers, you may experience bruising, itching, pain, swelling, redness, discoloration, lumpiness, bumps, acne, or increased sensitivity at the treatment site. These side effects usually resolve themselves quickly.

What results can I expect with Bellafill®?  How long does it take to see them?

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Bellafill® creates a lasting improvement in your skin by smoothing out the lines around the nasolabial folds. There’s no required downtime after your treatment with Bellafill®. You can return to your normal routine immediately.

Sculptra® is a facial injectable that replaces lost collagen over time with gradual, natural, and long-lasting results. It is made from poly-L-lactic acid, which stimulates your own body to produce and replace lost collagen. The active ingredient is a biocompatible, biodegradable polymer, same as the material used in absorbable sutures and used by physicians for decades. We begin to lose volume as early as our late 20’s, although the effects may not become noticeable for many more years. Although we may notice aging in the area around the mouth, jaw line, and eyes first, this is the result of global loss of bone, fat and collagen in the face. Sculptra can be used in all areas of the face and restores the youthful facial contour and appearance. A full treatment usually entails 2-3 sessions over a few months, with results often lasting more than 2 years.

Juvéderm Voluma® is a hyaluronic acid gel filler that is unique in that it is specially formulated to be placed deep under the skin restoring the lost volume in the mid-face and cheek area, reduces the appearance of jowls, and improves the under-eye hollows. The results are natural and may last up to 2 years.

Four syringes were used in the model shown.

Restylane® Lyft (formerly Perlane) is a hyaluronic acid filler used to augment and replace lost volume in the face. Its stabilized, engineered formula is best for deep creases rather than shallow lines because of its large particle structure. Lifting the cheek area results in improvement of nasolabial folds and jowls, restoring youthful facial appearance. Restylane® Lyft is a very versatile product with a long, proven history of providing safe, precise and predictable results. The results are immediate and, in most patients, last up to 12 months.

Juvéderm Ultra® and Restylane® are hyaluronic acid-based fillers that have a smooth consistency for placement under the skin to treat wrinkles and folds in the mid and lower facial areas. Restylane Silk and Juvederm Volbella are newer products that have unique properties that make them ideal for treatment of the eyelid and lip areas. In the eyelids, precise placement of the filler material can improve the appearance of bags and dark circles thus improving the tired and aged appearance. Only a physician with unique qualifications and experience in the delicate eye area should be trusted to perform such treatment to achieve the best results. In the lip area, filler can be used to rejuvenate aged lips or make them fuller and improve the appearance of fine lines around the mouth.

Radiesse® dermal filler consists of calcium and phosphate ion particles, substances that occur naturally in the body. Radiesse® restores lost volume and support in the mid-face, creates a smoother jaw line without a surgical procedure and gives you immediate, visible improvement of folds and wrinkles. The treatment also stimulates the body to produce new collagen. In many patients, the effects may last a year or more.


Please call us today at (203) 557-6464 or request a consultation.