Injectable Fillers

Your Filler Options

The best-known filling agent is probably collagen. Today, collagen treatments have practically disappeared because it proved to be a very temporary filling agent. Thus, short-lasting products such as Zyplast® and COSMODERM®, so popular a few years ago, are now not available and are seldom used. Products like those listed above, and many others, such as RADIESSE® and JUVÉDERM VOLUMA, are only a few in the long and growing list of available injectable fillers – the most popular wrinkle-filling agents in Canada at this time.

Hyaluronic acid is a molecule already present in our skin and joints, but it has been modified with chemical “cross linkages” to allow these products to persist for many months. As mentioned, hyaluronic acid is the chief component of Teosyal, Restylane, Perlane, JUVÉDERM, and JUVÉDERM VOLUMA, a few commonly used dermal fillers. Hyaluronic acid is a molecule that attracts water and is therefore ideal for plumping up areas where we have lost tissue.

Other types of dermal fillers, including RADIESSE® and Sculptra®, use different formulas to stimulate collagen and elastin growth, resulting in long-term restoration of lost volume. At our Mississauga and Toronto locations, we offer a variety of injectable filler options. Our cosmetic nurses can help determine the best filler for you.

For safety reasons and to get good results, you should be assessed by medical personnel who are experienced in evaluating facial anatomy and contours, and who have expertise in treating patients with fillers.

Facial Rejuvenation With Injectable Fillers

The hallmark features of aging are loss of tissue in the face and the descent of subcutaneous tissue caused by gravity. This results in hollows in the cheeks and under the eyes, deepening of folds around the mouth, and the formation of jowls. These facial changes, which can sometimes contribute to a tired, worn-out look, can be corrected with injectable fillers. Commonly treated concerns include:

• Nasolabial folds
• Puppet lines
• Tear troughs
• Nasojugal folds
• Pre-jowl sulcus
• Thin, flat, or uneven lips
• Lines around the lips

Injectable Filler Treatments

Our injectable filler treatments usually take about 20 minutes to complete; the results are immediate. When treating particularly sensitive areas, such as during lip enhancement (augmentation), our Toronto area patients may choose to have freezing; but, in most other areas discomfort is manageable with a topical numbing agent and simple ice. The comfort of filler injections has been enhanced in recent years, since many of the products are now manufactured with a local anesthetic agent, lidocaine, incorporated into the products themselves.

As with prescription wrinkle injections, there is always some risk of bruising or swelling, which is usually easily concealed with makeup. You can return to your usual activities, including work, immediately afterward. In very rare instances, more serious skin reactions have occurred, including infections, or lumps and bumps. There are mercifully very rare case reports of complications involving occlusion of blood vessels, which could lead to skin breakdown. One of the advantages of hyaluronic acid fillers is that they can be broken down and reversed by an enzyme, hyaluronidase. Thus, there is an effective therapy available to help deal with lumps, bumps or other undesirable side effects. All the potential side effects of these agents should be discussed in detail with you at your appointment before treatment.

Hyaluronic Acid Fillers

Mature patients who have developed hollows under the eyes or in the cheekbones with age, or folds and lines from mouth to nose (“nasolabial” lines) or from mouth to jawline (“marionette” lines) or jowls caused by gravity may be excellent candidates for any of the hyaluronic acid fillers, including those already mentioned (Teosyal, Restylane, Perlane and JUVÉDERM). See our section on eye and eyelash extensions for more information on rejuvenation of the eye area in particular.

Younger patients can also benefit from filler treatments. We use injectable fillers, for plumper, more defined, sensuous lips and to prevent lipstick from bleeding into small lines that sometimes develop around the mouth.

Sculptra®

Another novel temporary injectable filler is Sculptra®, or poly-L-lactic acid. This is a synthetic material derived from fruit acids (which have been used in suture material for many years). It is biocompatible and biodegradable, meaning it is harmless to the body and is naturally broken down and eliminated.

Sculptra works by stimulating the body to produce its own collagen, and therefore results are not immediate and typically require 2 or 3 series of injections over a few months. Results, however, are long-lasting, often continuing for over 2 years.¹

Mature patients with multiple or large areas of marked volume loss in the face, particularly those with thin and loose skin, are often ideal candidates for Sculptra. It is also worth considering if you want a very long-lasting result or if you have been found that you get shorter-than-usual results with other fillers. Sculptra cannot be injected into the forehead, lips or neck.

Poly-L-lactic acid has been used for more than 30 years in dissolvable sutures and various types of surgical implants. It has been used for cosmetic injection since 1999 in 30 countries. After treatment, patients are instructed to massage the treated area fully and frequently for 5 days to reduce the risk of small palpable bumps. Side effects of Sculptra are otherwise similar to those already mentioned for hyaluronic acid.

RADIESSE®

Yet another temporary dermal filler receiving some attention in the press is RADIESSE®. RADIESSE is an artificial compound containing calcium hydroxyl apatite microspheres that are suspended in a carboxymethyl cellulose gel. The body’s own connective tissue grows in and around the microspheres. RADIESSE may have an advantage of being longer-lasting in some cases than hyaluronic acid fillers. However, like Sculptra, nodules or lumps and bumps are an issue. These may respond to treatment with steroid injection. RADIESSE is frequently used for improving the appearance of age-related changes in the hands.