As we grow older and lose facial fat, our faces may take on the sunken, wrinkled appearance we commonly associate with age. For these concerns, volumizing treatments such as injectable dermal fillers may be an effective and low-downtime treatment option. Furthermore, with the popularity of social media and photo filters, younger patients are requesting more defined lips, sharper jawlines, and camouflage of under-eye circles or tear troughs. Medical advances have brought about a wide variety of safe and effective volumizing and hydrating dermal fillers to meet patients’ and physicians’ demand for long-lasting and reliable treatment choices. Recent years have seen a boom in dermal filler popularity: according to the American Society for Aesthetic Plastic Surgery, more than $1 billion was spent on injectable treatments in 2018.
Aviva Plastic Surgery is passionate about our injectable practice. Our facial plastic surgeon and only injector Dr. Inessa Fishman uses her intricate knowledge of anatomy, aesthetic vision, and the latest treatment techniques to give her patients best outcomes. An artist at heart and in practice, Dr. Fishman enjoys learning patients’ aesthetic goals and desires, and blending those with her expertise and aesthetic eye, to provide safe, effective, and excellent dermal filler results.
The non-invasive nature of dermal fillers also means that the procedure requires little to no downtime. Most patients are able to return to work or their next errand with only minimal redness and swelling and little to no bruising. As such, dermal fillers have developed a popular reputation for being the perfect “lunchtime” procedure—patients can visit Aviva Plastic Surgery over their lunch and then get back to work without anyone ever knowing.
In addition to helping highlight one’s natural features like lips and cheekbones, cosmetic fillers can help some patients stave off surgery. When used early during the aging process, these treatments stimulate collagen, restore youthful and volumized contours, and either prolong the effects of surgery or help delay it.
Before the introduction of dermal fillers, patients had to resort to plastic surgery to tighten loose skin and hide wrinkles. While procedures like facelifts and browlifts remain popular options, they treat significant signs of aging like sagging skin and jowls and do not restore youthful volume. For men and women with mild to moderate skin laxity and wrinkling, facial plastic surgery procedures may be overly aggressive and dermal fillers may be more effective treatment options.
Most of today’s top dermal filler treatments are made from hyaluronic acid (HA)—a naturally occurring sugar substance produced by the body that helps skin retain moisture and gives the skin a full, smooth appearance. As we age, our genetics, sun exposure, smoking, pollution, and a host of other factors can cause the skin to lose its youthful collagen and hyaluronic acid content, resulting in deflated, duller skin and more noticeable wrinkles and fine lines. Hyaluronic-acid-based injectables can help reverse these unwanted signs of aging, helping men and women look more youthful almost immediately.
Dermal fillers are a popular treatment option for enhancing a variety of facial features. Our facial plastic surgeon Dr. Inessa Fishman uses volumizing, hydrating fillers to restore volume to sunken temples, sculpt beautiful cheeks, enhance lips, smooth dark undereye shadows, reshape noses, and contour jawlines, among others.
Dermal filler treatments typically require little to no downtime, and are enjoyed by many of our patients, such as the young woman to the right, who wanted to improve the contour and symmetry of her lips. With elegant, natural outcomes in mind, we can help treat many concerns–such as cheek contours, nose concerns, too-small lip and chins, acne scars–with dermal fillers.
We believe that aesthetics are very much both an art and a science, and great outcomes have more to do with who’s holding the syringe—as opposed to what’s in it. We rely on impeccable training, evidence-based medicine, years of expertise, and a passion for aesthetics to give you the best treatment results
Like the many color choices on an artist’s palette, dermal filler options are varied, with numerous indications. As injectable fillers have become a mainstay of cosmetic treatment, scientists have tweaked their molecular characteristics to ensure treatment options for different concerns, lines, and signs of aging across the face or body. At Aviva Plastic Surgery, we offer several leading injectable filler options for our Atlanta and Sandy Springs, GA patients. Our selection includes the top hyaluronic acid-based fillers, as well as alternative formulas consisting of calcium hydroxyapatite, poly-L-lactic acid, and more.
A classic, Restylane® is one of best-known dermal fillers for a reason. The hyaluronic acid-based formula first gained popularity as an anti-aging solution and is approved for use correcting moderate to severe wrinkles that run from the nose to the corner of your mouth (so-called nasolabial folds or smile lines) as well as wrinkles that can develop between the mouth and chin (marionette lines). In recent years, this filler has gained new popularity among younger patients looking to enhance the shape and volume of their lips and camouflage under-eye depressions, or so-called tear troughs. Dr. Fishman uses Restylane® in several other off-label areas across the face and body.
Like traditional Restylane®, Restylane Lyft® is made for individuals who want to reduce the appearance of deep nasolabial creases; Restylane Lyft also has an indication for cheek contouring and improving the appearance of the backs of hands. What sets this version apart from its original formulation is the weight and viscosity of the serum. Restylane Lyft contains larger molecules of hyaluronic acid, resulting in a more cohesive, firmer formula that is perfect for addressing creases that can develop on the backs of hands, cheeks, and chin. Dr. Fishman uses Restylane Lyft® to restore volume to the mid-facial region and lift sagging tissues in the lower face, and injects this filler to contour the nose, chin and jawline. Restylane Lyft® is a popular addition to many liquid facelift treatment strategies.
The newest member of the Restylane family, Restylane Kysse is a dermal filler specifically indicated for the treatment of lips, the corners of the mouth, and fine lines or wrinkles around the lips. This product helps Dr. Fishman create a hydrated and soft look to the lips, and has found immense popularity in our practice since its FDA approval in 2020.
Another popular injectable filler, Juvederm Voluma® is frequently used to treat sagging or sunken cheeks. Similar to Restylane Lyft, this formula uses hyaluronic acid to help skin cells retain water volume without creating an overtreated or over-filled appearance. Voluma is frequently used to restore facial definition to areas like the chin and jawline.
Not all injectable fillers use hyaluronic acid to improve facial volume. Juvederm® is a popular filler option that relies on the volumizing and hydrating abilities of hyaluronic acid (a sugar substance which is naturally-occurring in our skin and fluid that lubricates our joints) to plump treated structures and stimulate the body’s natural collagen production. Juvederm® is a popular dermal filler choice for lips, smile lines, and fine or etched-in lines about the eyes.
RHA (which stands for resilient hyaluronic acid) fillers are designed to adapt seamlessly to the dynamics of the face, and boast some of the least chemical processing, to mimic the body’s natural hyaluronic acid. Manufactured by the Swiss company Teoxane and distributed by Revance, the RHA family of fillers are designed to stretch and resist deformation with the face’s multiple and continued movements, and allow Dr. Fishman to continue creating beautiful, natural treatment results.
Not all injectable fillers use hyaluronic acid to improve facial volume. Radiesse® is a popular filler option that relies on calcium microspheres to stimulate the body’s natural collagen production. As a result, patients enjoy not only immediate volume, but can continue to notice improvements in their appearance for weeks to months after their injection thanks to new collagen development. Beyond treating facial lines, Radiesse® is a popular choice for men and women looking to add definition to their cheeks and jawline; treat volume loss along the backs of hands; and stimulate collagen formation within the skin of the neck, decolletage, and body. Dr. Fishman uses Radiesse both to add structure and volume to facial features and treat and thicken crepey, collagen-poor skin of the face, neck, chest, and hands.
Sculptra® is an injectable filler used for treating deep creases and volume loss. Like Radiesse, the formula is distinct from other fillers in that it uses poly-l-lactic acid (a different sugar substance than hyaluronic acid) to add volume to facial features. In addition to adding volume to sunken facial features, this unique substance helps stimulate collagen production – giving patients continued improvements well after their treatment is completed, in both facial volume and the quality of the treated skin, or the so-called “Sculptra glow.”
Designed for men and women with significant volume loss or depressed acne scars, Bellafill® is another non-HA injectable filler tailored to add volume long after the initial treatment. This is thanks to the unique polymethyl methacrylate microspheres within the Bellafill formula, which both stimulate collagen and create a scaffold upon which new collagen can form. A longer-lasting filler used for both cosmetic purposes and improvement of acne scars, Bellafill leaves patients with a youthfully smooth looking appearance that can last up to five years.
Wrinkles and creases aren’t the only sign of aging patients want to address. Age and genetics can contribute to excessive fat collections in unwanted areas, such as the neck and under the chin. While a double chin (submental fullness) can be a hereditary feature seen in younger patients or a characteristic of aging seen in some older individuals, it can be treated non-surgically with the fat-dissolving medication Kybella®. Kybella injections can give men and women the opportunity to regain jawline definition and a more defined neckline without turning to surgery.
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