Unfortunately, as we age we experience loss of facial volume and the formation of wrinkles. To counteract the aging process though, there are numerous treatments available. These treatments include volumizing face fillers, wrinkle-fighting injectables, and in some cases surgery (fat transfer). Because the face is ever-changing, our goal is to minimize how much one of these temporary treatments will cost, while maximizing the patient’s results.
To restore facial volume and to minimize wrinkling, let’s first look at the most invasive surgical option: fat injections.
Fat injections have been around for years, but it took the advances of NYC surgeon Sidney Coleman to identify how to make it successful. Coleman realized that it is critical for the surgeon to meticulously transfer small portions of fat throughout an area, rather than injecting large clumps, in order to maximize the effectiveness of the treatment. This key factor is vital to maximizing the percentage of fat that survives the injectables transfer. Dr. Schneider has been using this technique for fat injections for over 25 years to improve the look of the face, hands, breasts, buttocks, and other body regions.
With that said, fat injections are the most invasive option because it requires surgery to harvest fat from another part of your body. The procedure begins by harvesting a small amount of fat using our liposuction technique and a very small cannula. The fat is carefully harvested with minimal suction to preserve its viability, and then the fat is carefully washed and strained.
We no longer use a centrifuge once the fat is extracted because we do not want to apply excessive pressure to the fat that could harm the cells.
With the fat extracted, washed, and strained, the fat is meticulously injected in very small aliquots throughout the area that Dr. Schneider intends to augment.
The procedure is usually performed with the patient sedated in our AAAHC certified office surgical suite. Patients may have some bruising, though this is rare, and there is almost no postoperative discomfort.
In Dr. Schneider’s opinion, fat injections are great if you are already having an operation and are under anesthesia. However, if you are looking for a less-invasive treatment, and a quick office visit, then other volumizing face fillers would be more advantageous.
Face Fillers (Injectables)
Sculptra is an excellent injectable to increase facial volume, and it is the only injectable that works by stimulating the formation of the body’s own collagen. All other injectables function as a typical face filler, meaning their volume fills out the volume of the face.
Because Sculptra modulates the formation of tissue collagen, it takes several weeks to see the finished result.
Sculptra is usually used deep in the tissues to fill out their volume. However, when Sculptra is injected just under the skin, it causes the skin tone to be noticeably improved as well.
Patients typically require 2-3 Sculptra treatments, each separated by 6 weeks, to have the same finished effect as a fat injection treatment. That said, Sculptra is performed without the need for sedation, and patients may immediately return to their normal activities. In fact, Dr. Schneider injects Sculptra in his own face and has gone to the gym to workout several hours later.
Patients usually see a benefit from Sculptra for a minimum of 2 years.
Juvederm®, Voluma®, Restylane®
Other face fillers include Juvederm®, Voluma®, and Restylane®, all of which are Hyaluronic Acid Face Fillers. These injectables are smooth gels that will fill out wrinkles and folds, including those highly visible ones around the lips, eyes, and mouth. They are also used extensively for lip augmentation.
We apply a topical anesthetic to the skin for about 30 minutes prior to any treatment involving these hyaluronic acid face fillers so that the patient does not feel the needles. These face fillers also include a numbing medicine in them that lessens the discomfort.
Juvederm®, Voluma®, and Restylane® are also FDA-approved for instantly adding volume to the cheeks. Voluma® is typically used for this at a much deeper level, much like how fat, or Sculptra, is used in order to create facial volume. Unlike Sculptra however, Voluma’s results are instantaneous.
The results from most hyaluronic acid face fillers typically last 8-12 months.
Additionally, patients also have the option of Botox® for minimizing wrinkling. Botox is not a filler though. Instead, it is an injectable that works by paralyzing the underlying muscles that cause wrinkles.
Radiesse is different from hyaluronic acid face fillers in that it is composed of calcium hydroxylapatite microspheres suspended in a water-based gel carrier. Hydroxyapatite is usually found in bone, though in Radiesse, it is synthetically produced.
Dr. Schneider likes to use Radiesse deep in the facial bone to add to its volume. As we age, our facial bones shrink in size, and this, combined with facial fat loss, leads to the characteristic changes of aging we see in the face.
Though products like Sculptra and Voluma can be used to fill out these areas on top of the bone, Radiesse offers an opportunity to use a similar type filler (bone to bone) to create a more youthful facial appearance.
Radiesse works immediately for restoring facial volume to smooth out the signs of aging. Once injected, it also stimulates the production of natural collagen for results that may last a year or more. Visible results can be seen immediately.