Soft tissue augmentation using injectable fillers involves injecting a substance into or under the skin to correct wrinkle, depressions, and scarring. When injected beneath the skin, these fillers plump up creases and sunken areas of the face. They can add fullness to the lips and cheeks. Injectable fillers may be used alone or in combination with other procedures such as Botox, laser, or surgery. Fillers are usually not sufficient for severe lines and wrinkles on the face, such as multiple vertical "lipstick" lines around the lip. Instead other treatments such as laser skin resurfacing may be the answer. Likewise deeper folds and creases in the face and brow may be more effectively treated using cosmetic surgery. Today there are several substances used for this purpose, primarily Restylane, Radiance or your own fat. The development of newer and longer lasting products has made these techniques even more effective.

Restylane

The gold standards are Restylane and Perlane (hyaluronic acid.) These are biodegradable-engineered, non-animal based fillers. They are injected in the skin (dermis) and usually last 4-6 months. Since they can be injected near the surface of the skin, this filler gives the best correction but not the longest one. As I said before it is the gold standard for filling lines and wrinkles because it corrects the best, has the least swelling and usually allow you to go out that evening and look fine. This is popular for nasolabial folds, marionette lines, lip edges and even under the eyes (circles).

Radiesse (Formerly Radiance)

This is a great new filler, which although it has to be injected just under the skin, it has the advantage of lasting 1-2 years. Radiesse frequently requires a second treatment in three months after the first using about ¼ of the amount of the first treatment. This is useful for the nasolabial lines, especially near the nose, for the cheeks, malars and deep marionette folds.

Scupltra (New-Fill)

This is another new filler from absorbable crystallized suture material, which is injected and may last up to 2 years. It is also injected under the skin but in three injections about 3 weeks apart. This is best for general atrophy of the cheeks where the patient needs general plumping. Dr. Loeb does not use this often as it seems to have no advantage over Radiesse.

Fat Transfer

Fat can be removed from one area of your body and then transferred to another. The most common procedure is to remove it from your hips or buttocks and transfer it to the nasolabial fold. Usually 40 - 50% of the fat "take" is permanent. We preserve your fat and that frozen fat can then be added if needed at suitable intervals. This can be done as an office procedure but is most commonly done when a bigger procedure is being performed in the O.R. You will be swollen for a few days and perhaps bruised for a week, but the results are well worth it.

Silicone

Another method to augment the edge or the body of the lip is using liquid silicone as injected filler. Sterile special medical grade silicone which is FDA approved can be used "off-label" to add volume to any part of the lip. What's great about this is there is no surgery, its soft and fleshy and you can always add more. There are issues about silicone to discuss with you surgeon - and you must use the 5000 weight, sterile, medical grade silicone...so buyer beware - only consider this with a reputable doctor - and don't overdo it because it's not reversible.

Gortex/Soft Form