About Fillers

Restylane®

Restylane® is another safe and natural dermal filler that restores volume and fullness to the skin. It can be used to fill deep furrows in the skin, or increase the fullness and appearance of the lips, as well as smoothing wrinkles. This treatment uses hyaluronic acid, naturally found in the skin, to deliver a longer-lasting effect than traditional collagen.

Restylane is FDA approved and is non-animal based. The hyaluronic acid in Restylane is a crystal-clear gel called NASHA™ , or Non-Animal Stabilized Hyaluronic Acid. NASHA is biodegradable and completely biocompatible with human hyaluronic acid. It rarely causes any allergic reaction since it a naturally occurring substance in humans.

A Restylane injection treatment normally takes from 15 to 30 minutes. Although bruising and swelling can occur, most patients can return to normal activity immediately following treatment. Results from Restylane can last from six months to one year, which is approximately twice as long as collagen fillers, which are derived from animals and require allergy testing.

Frequently Asked Questions

What is Restylane?
Restylane is a natural cosmetic dermal filler that restores volume and fullness to the skin. It is safe and used to correct moderate to severe facial wrinkles and folds, such as nasolabial folds.

What is the composition of Restylane?
Restylane is unique because it is made of non-animal-based hyaluronic acid. It is the first of its type. Hyaluronic acid is a natural substance that already exists in the human body and is used to provide volume and fullness to the skin. The hyaluronic acid in Restylane is a crystal-clear gel called NASHA™, or Non-Animal Stabilized Hyaluronic Acid. NASHA is biodegradable and completely biocompatible with human hyaluronic acid.

How does Restylane differ from other hyaluronic acid-based products?
Only Restylane is non-animal-based, which makes it different from other hyaluronic acid-based products such as those made from rooster combs. Because of this, Restylane virtually eliminates the risk of animal-based disease transmission or allergic reaction.

What should I do to prepare for treatment?
Because Restylane is virtually free from allergic reactions, no pre-testing is required. To reduce the possibility of bruising or bleeding at the injection site, it is recommended that patients avoid certain medications. This includes avoiding aspirin, non-steroidal anti-inflammatory medication, St. John’s Wort or high doses of Vitamin E supplements. Also, if you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to a recurrence.

Are there any side effects with Restylane?
Restylane can be used safely by physicians trained in administering the injections. It has been used worldwide since 1996. Allergy testing is not required since Restylane is non-animal-based and fully biocompatible. There is virtually no risk of animal-based disease transmission or allergic reactions. The most commonly reported side effects were temporary redness and swelling at the injection site. These effects typically resolve within two to three days.

Can Restylane be used anywhere on the face?
Restylane has been used worldwide for more than 10 million treatments since its introduction in 1996. In more than 60 countries, it has been used to correct a variety of wrinkles and to enhance the appearance and fullness of the lips. The current U.S. approval is for the treatment of moderate to severe facial wrinkles and folds, such as nasolabial folds.

How long do treatments last?
Based on research studies, the average Restylane treatment lasts approximately six months or even longer. The unique properties of NASHA help maintain the cosmetic effect until the injected material is nearly gone.

How often must I repeat Restylane treatments?
Treatments are generally scheduled twice a year since Restylane lasts longer than collagen. It is possible to have a touch-up treatment before the product is fully dissipated to enhance the lasting effect.

What is the difference between Restylane and Botox?
Botox is a drug that blocks nerve transmission and relaxes the underlying muscles to treat wrinkles. By contrast, Restylane is a natural, cosmetic filler. Many patients have been pleased after receiving treatment with both products.

What is the difference between Restylane and bovine collagen?
Bovine collagen is derived from animals (cow) and requires an allergy test. Restylane can be administered without a pre-test, thus eliminating any waiting. Restylane is proven to have a longer lasting effect than bovine collagen and virtually eliminates the risk of animal-based disease transmission or allergic reaction.

Are Restylane treatments painful?
You should experience a minimum of discomfort during a Restylane treatment because only tiny amounts are injected directly into the skin by an ultra-fine needle. The entire procedure is simple and convenient and results are practically instantaneous. Depending on the areas of treatment, Dr. Vasquez may recommend some topical anesthetic for the treatment area.

What is the cost of Restylane treatments?
Dr. Vasquez will help you determine if Restylane is the proper treatment to accomplish your particular goals. Because the treatment is customized to your needs, costs vary from patient to patient. However, the long-lasting effects of Restylane make it cost-effective over the long-term when compared to other treatments, which are about the same in initial cost.

For additional information on Restylane, click here.

Radiesse®

Radiesse is a next-generation cosmetic dermal filler which has advanced calcium-based microsphere technology to naturally restore facial beauty and a youthful appearance. It is a longer-lasting filler than its predecessors and works to both restore volume and naturally promote the growth of a patient’s own collagen to create fullness. Radiesse provides an aesthetic correction that has been shown to last about one year or longer without surgery or the risks associated with permanent implants.

Radiesse is gently injected into the skin in small amounts with a very fine needle. Its tiny calcium-based particles replace volume loss and stimulate new collagen growth for longer-lasting cosmetic results. The tiny particles of calcium-based powder form a scaffold around which the body produces new collagen to naturally restore the full, youthful beauty of the face. The tiny microspheres gradually break down into calcium and phosphate ions that are naturally absorbed by the body over time. Because Radiesse is a robust, full-bodied material, it provides an excellent level of malleability and finesse for facial aesthetic applications.

The result is a longer-lasting solution to treat wrinkles and folds, such as the ones that form with age from the nose to the corners of the mouth. Now approved by the U.S. Food and Drug Administration (FDA) for the correction of facial wrinkles and folds, next-generation Radiesse is available for women and men desiring immediate, visible improvement with longer-lasting results.

Frequently Asked Questions

What is Radiesse?
Radiesse is a safe, next-generation cosmetic dermal filler that is setting a new standard for the correction of facial lines and wrinkles such as Nasolabial Folds. Years of rigorous clinical studies prove that Radiesse lasts longer than the former leading filler, to safely fill and correct smile lines, Nasolabial Folds and wrinkles around the nose and mouth. Radiesse is made of unique calcium-based Radiesse microspheres suspended in a natural gel that is injected into the skin through a simple, safe and minimally invasive procedure. Simply put, Radiesse treatments deliver a natural look that lasts.

How does Radiesse work?
Radiesse works below the skin’s surface. Tiny calcium-based microspheres form a “scaffold” to support and stimulate the growth of your own collagen to create a natural, full, youthful look. Radiesse does more than just temporarily fill-in facial lines and wrinkles ─ it rebuilds your skin’s foundation, without the risks associated with permanent fillers.

Is Radiesse safe?
Yes. Over 250,000 patients have experienced Radiesse and more than 4,000 physicians have been trained to provide Radiesse treatments. Through years of rigorous industry and independent research worldwide, Radiesse has been shown to be safe and effective. With Radiesse, you get safe, clinically tested, FDA-Approved reliability.

Why “fill in” wrinkles with Radiesse?
Over time, tissue volume diminishes, leaving what is commonly seen as lines and wrinkles, including the deepening of Nasolabial Folds, accentuated smile lines (sometimes called “marionette lines”), fallen cheek pads and sagging jaw lines. Radiesse can be injected into the skin in order to compensate or correct these areas. By using your body’s ability to grow collagen and regenerate tissue, Radiesse produces natural-looking results for a fresh, rested, healthy appearance that still looks like you.

How is a Radiesse treatment performed?
Radiesse is injected into the skin through a simple, safe, quick, and minimally invasive outpatient procedure. Typically administered in a doctor’s office, with the use of a local anesthetic, Radiesse treatments have little to no downtime, with most patients returning to normal activities soon after treatment.

How soon can I expect results? How long will the results last?
The results are immediate. Radiesse continues to deliver results as it works with your body to stimulate new collagen and regenerate tissue. Results typically last a year or more, longer than the former leading cosmetic dermal filler, saving you time and money. Since results may vary, be sure to discuss your expectations with your doctor.

Could I have an allergic reaction to Radiesse?
Radiesse is biocompatible, meaning there is virtually no risk of an allergic reaction. You do not need to undergo skin allergy testing, common in certain animal-based or permanent filler agents, prior to treatment. However, if you believe you are having an allergic reaction to Radiesse, seek medical attention immediately.

Juvéderm™

New Juvéderm™ is a smooth gel filler that is eased under the skin to instantly smooth those “parentheses” lines on the sides of your nose and mouth. Recently approved by the FDA, Juvéderm injectable gel is a “next-generation” dermal filler. It is a smooth-consistency gel made of hyaluronic acid—a naturally occurring substance in your skin that helps to add volume and hydration. In addition, Juvéderm injectable gel is the first FDA-approved hyaluronic acid dermal filler that is proven to be safe and effective for persons of color.

Juvéderm injectable gel is a non-surgical treatment where the gel is eased under the skin using a fine needle to augment, or fill, the soft tissue of the dermis—the dense inner layer of skin beneath the epidermis—to add volume and diminish wrinkles and folds in the lower third of the face, like your “laugh lines,” “smile lines” or “parentheses” (nasolabial folds), or “marionette lines” (oral commissures). Juvéderm is made from hyaluronic acid—a naturally occurring substance in your skin that helps hydrate and add volume. Juvéderm restores the hyaluronic acid of your skin that can diminish with age, helping to smooth wrinkles and folds.

Juvéderm employs a unique manufacturing process to provide the highest concentration of cross-linked hyaluronic acid available for long-lasting results. The advanced manufacturing process also creates a smooth consistency gel that flows easily into the skin during the injection process and provides a smooth, natural look and feel. The smooth gel differs from the granular consistency gels of other existing hyaluronic acid dermal fillers.

Juvéderm is a non-surgical treatment and requires minimal recovery or downtime. Juvéderm injectable gel is available in two formulations—Juvéderm Ultra for versatility in contouring and volumizing facial wrinkles and folds, and Juvéderm Ultra Plus, a robust formulation for volumizing and correcting deeper folds and wrinkles.

Frequently Asked Questions

What is Juvéderm?
Juvéderm™ injectable gel is a “next-generation” smooth consistency gel dermal filler that helps to instantly restore your skin’s volume and smooth away facial wrinkles and folds like your “smile lines” or “parentheses” (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth). Juvéderm™ comes in two formulations—Juvéderm™ Ultra and Juvéderm™ Ultra Plus.

What does Juvéderm™ do?
Juvéderm™ injectable gel temporarily adds volume to facial tissue and restores a smoother appearance to the face.

Why does Juvéderm™ come in two formulations?
Juvéderm™ injectable gel is available in two formulations to allow your healthcare professional to tailor treatment to your unique needs. Juvéderm™ Ultra provides versatility in contouring and volumizing facial wrinkles and folds. Juvéderm™ Ultra Plus is a more robust formulation for volumizing and correcting deeper folds and wrinkles.

What makes Juvéderm™ different from other dermal fillers?
Juvéderm™ injectable gel employs its unique manufacturing process to provide the highest concentration of cross-linked hyaluronic acid of any currently available hyaluronic acid dermal filler for long-lasting results. This advanced manufacturing process works to create a smooth consistency gel that flows easily into the skin and provides a smooth, natural look and feel. All other currently approved hyaluronic acid dermal fillers are made of granular consistency gels. And, Juvéderm™ is the first hyaluronic acid dermal filler that has demonstrated its safety and effectiveness in persons of color.

What is hyaluronic acid?
Hyaluronic acid is a naturally occurring substance found in all mammals that helps to hydrate and add volume to your skin. In addition to its use as an aesthetic treatment, hyaluronic acid has also been used for more than 20 years for injection into arthritic joints to aid movement as well as for eye surgeries and wound repair.

What will treatment with Juvéderm™ injectable gel accomplish?
Juvéderm™’ injectable gel will help to smooth moderate to severe facial wrinkles and folds. Most patients need one treatment to achieve optimal wrinkle smoothing, and the results last about six months.

Can people with different skin tones/colors be treated with Juvéderm™?
Yes. In fact, Juvéderm™ injectable gel is the first FDA-approved hyaluronic acid dermal filler that has proven its safety and effectiveness in persons of color. Studies with Juvéderm™ showed no increased risk of hyper pigmentation or hypertrophy scarring in patients of color.

Sculptra™

Sculptra™ is injectable poly-L-lactic acid approved by the U.S. Food and Drug Administration to restore and correct the signs of facial fat loss or lines caused from aging.

Sculptra restores volume through a gradual increase in dermal thickness, which can remain effective for up to two years after the first treatment session.

Administrated by a trained professional, Sculptra is an injectable implant that contains microparticles of poly-L-lactic acid, a biocompatible, biodegradable, synthetic polymer from the alpha-dydroxy-acid family. Lactic acid polymers have been widely used for many years in resorbable sutures and are typically nontoxic even in large quantities within the body.

Frequently Asked Questions

What is Sculptra?
Sculptra is a synthetic material known as ploy-L-lactic acid that is injected into the skin. This material is biocompatible and biodegradable and has been used for many years in dissolvable sutures, soft tissue implants and other types of implants.

Who is a candidate for Sculptra?
Sculptra is intended for restoration and/or correction of facial fat loss due to lipoatrophy or nasal labial lines caused from aging.

How does Sculptra work?
Sculptra is injected below the surface of the skin in the area of fat loss to increase the thickness of the skin. Visible results generally appear within the first few treatment sessions. Sculptra will not correct the underlying cause of the facial fat loss, but will help improve the appearance in the treated area by increasing the thickness of the skin.

How soon will I see results with Sculptra?
The results are not immediate. At the first treatment, it may appear that Sculptra has worked immediately; however, this is typically because of swelling from the injections and the water used to dilute Sculptra. However, within a few days when the swelling is reduced and the water is absorbed into the body, you will appear as you did prior to treatment. Sculptra takes time to gradually correct skin depressions. Dr. Vasquez will continue to consult with you every few weeks to determine the need for more Sculptra treatments. Dr. Vasquez has received training in the use of Sculptra and can work with you to determine the number of treatments and the amount of Sculptra used during each treatment to achieve the maximum possible result.

How many and how often are treatments given?
The number of treatments depends on your particular situation. Follow-up is generally two to three weeks after each treatment to determine the need for further treatment.

How long do the effects of Sculptra last?
In clinical studies, effects lasted for up to two years after the first treatment. Every individual is different. In some cases, touch-up treatment may be needed to maintain the desired effect.

Are injections of Sculptra painful?
Sculptra is injected in small amounts with a very fine needle. However, there may be some discomfort as with any injection. Depending on your treatment area and the number of injections needed, Dr. Vasquez may recommend a topical anesthetic.

How should I prepare for a Sculptra treatment?
Dr. Vasquez will discuss the treatment process and the preparation with you. You should discuss all the medications you are taking, including over the counter medications. Avoiding aspirin and other blood thinners or medications that may interfere with clotting is recommended. All makeup should be removed and the area specified for injections will be cleaned with an antiseptic. Sculptra is injected in small amounts into the skin using a very fine needle. Multiple injections will be needed during a treatment. Application of an ice pack will help reduce swelling. After the treatment, the area should be thoroughly massaged to distribute the product evenly.

Are there any side effects from the Sculptra treatment?
The most common side effects of treatments with Sculptra are those associated with any injection and can include bleeding, tenderness or pain, redness, bruising or swelling. These side effects generally resolve in three to 17 days.

One possible side effect with Sculptra can be small lumps under the skin in the treated area. These small bumps may not be visible and you may notice them only when you press down on the treated area. If bumps occur, they tend to appear within the first six to 12 months following the first treatment. These bumps can go away on their own. Visible bumps, sometimes with redness or color change, have been reported in some cases. Also, as with all procedures involving an injection, there is a possibility of infection.

What happens after treatment with Sculptra?
Most patients feel comfortable going back to their normal activities following treatment. Immediately following a treatment with Sculptra, swelling, redness, pain and/or bruising can occur in the treatment area. These generally disappear in a few hours to a few days. Some have been known to last up to 17 days. Dr. Vasquez will provide you with specific post treatment instructions, including massaging the treated area a few times each day for several days following treatment. For the first 24 hours following treatment an ice pack should be applied for a few minutes at a time to the treatment area to help reduce swelling. Avoid putting ice directly on the skin by wrapping the ice in a cloth. It is also recommended that you avoid excessive sun and UV lamp exposure until any initial swelling and/or redness has disappeared. Makeup may be applied a few hours after treatment if no complications are present, such as open wounds or bleeding.

Artefill®

Artefill® The Lasting Solution for Wrinkle Correction

Artefill is the first and only microsphere-enhanced collagen filler for the correction of nasal labial folds, or the lines from your nose to the corners of your mouth.

If you’ve used temporary dermal fillers in the past, then you know they are eventually absorbed by your body and require frequent repeat injections to maintain the results you’ve come to love.

Artefill is different. The unique microspheres contained within Artefill are not absorbed by the body, providing the support structure your skin needs for smooth, natural results. If you are looking for a long-lasting filler that you can have confidence in, then Artefill may be right for you.

Artefill is a dual-acting wrinkle filler. Once it’s injected into the deep portion of the skin under the wrinkle, the collagen in Artefill visibly corrects the wrinkle. Over time the collagen is absorbed by the body but the microspheres remain intact, providing the support your skin needs for long-lasting, natural feeling wrinkle correction.

This safe, in-office procedure takes a just a few minutes to administer. You will receive an
anesthetic to lessen the pain from the procedure and with proper placement you won’t feel a thing and can return to your normal daily activities. The results are immediate and will improve over time.

If you love the wrinkle correction you get from temporary fillers but are tired of returning for repeat treatments, then Artefill may be the ideal solution for you.

Artefill is the only soft tissue filler product on the market designed to last. Thousands of patients in the U.S. have been successfully treated with Artefill and those numbers continue to increase. Artefill is also one of the only products to report a patient satisfaction rating over 90% during its pivotal clinical trial. Listen to what some actual patients had to say about their experience with Artefill at

http://www.artefill.com/patient/before-and-after/successful-wrinkle-reduction.asp

Frequently Asked Questions

What is Artefill?
Artefill is the long-lasting solution for wrinkle correction. Artefill consists of a combination of microsphere enhanced collagen and lidocaine for comfort.

How does Artefill work?
The collagen gel acts as a carrier for the microspheres in Artefill. Gradually, your body absorbs the collagen while the microspheres remain to provide a long-lasting support structure below the wrinkle to sustain wrinkle correction.

Is Artefill safe?
Yes. Artefill has proven to be a safe and effective dermal filler for the correction of wrinkles and was approved by the U.S. FDA in October 2006. In clinical testing, Artefill was as safe as the control temporary filler.

Since the launch of Artefill in 2007, thousands of patients have been safely treated with Artefill and there have been no product recalls and no reported medical device events.

How does Artefill differ from temporary fillers?
Temporary dermal fillers are made of different kinds of natural or synthetic materials that are completely absorbed by the body over time and as a result, wrinkle correction usually lasts for only three-nine months.

The microsphere-enhanced collagen in Artefill remains intact at the treatment site and provides structural support to keep your wrinkle from returning.

Can anyone have Artefill treatments?
No. Some people are not good candidates for Artefill.

Artefill is contraindicated in those who:

• have a positive reaction to the Artefill skin test
• have a history of severe allergies and hypersensitivity (anaphylaxis)
• are allergic to the anesthetic (lidocaine) in Artefill
• have a history of allergies to any collagen products
• are prone to thick scarring (hypertrophic) formation and/or excessive scarring (keloid)
• are undergoing or planning to undergo desensitization injections to meat product

Are there any other treatment concerns with Artefill?
Yes. If you have any skin outbreaks (e.g. cysts, pimples, rashes, hives, infection) near the injection site, you should postpone treatment until they clear. If you are taking aspirin (NSAIDs) or anti-inflammatory drugs or have any medical condition that affects your blood, you may experience increased bruising or bleeding at the injection sites.

In addition, you should inform us if:

• you have had any treatments for smile lines in the last six months
• you are receiving UV light therapy
• you are currently on immunosuppressive therapy (medication commonly prescribed for those who have undergone an organ transplant, or are suffering from rheumatoid arthritis, psoriasis, inflammatory bowel disease, or cancer)

Are there any further precautions with Artefill?
Yes, you should know:

• Artefill contains microspheres that help provide the support for wrinkle correction- the microspheres can only be surgically removed
• The safety of Artefill in pregnant or breastfeeding women, and individuals under 18, has not been established As with any injectable filler, there is always a risk of infection.

Are there any possible side effects with Artefill?
As with any injectable wrinkle filler, you can expect mild swelling and reddening at the treatment site. These side effects are usually gone within 24 hours. Occasionally, there is mild bruising that typically disappears in three to seven days. Less common side effects include rash and itching more than 48 hours after treatment, persistent swelling or redness, and increased sensitivity at some or all injection sites. Two other rare potential side effects of all dermal fillers may be lumps and granulomas, both of which can be treated by your physician.

When will I see results with Artefill and how long will the results last?
You will see results immediately. In the U.S. clinical study, full wrinkle correction was maintained for up to one year.

Is one treatment enough to get the look I want?
Most people get the results they want with one or two treatments, depending on the depth of their wrinkles and folds. When you have your follow-up appointment in four to six weeks, you can decide if you would like to further enhance your results.

How will my face feel following treatment?
With proper placement, Artefill may not be felt after treatment. You will see the results
immediately and be able to return to your normal daily activities.

How will I look as my skin ages after treatment with Artefill?
Studies have shown that patients injected with microsphere-enhanced collagen, still reflect a natural appearance in both their overall facial appearance as well as in the area treated five years from their initial treatment. These patients were surveyed and had a 90% satisfaction rating related to their wrinkle correction and experience with Artefill.

Why is a skin test required before treatment with Artefill?
The skin test is a safety precaution to ensure that you are not allergic to the collagen or anesthetic in Artefill.

What process did Artefill go through before it was FDA approved?
Several clinical studies were conducted in the United States to demonstrate the safety and effectiveness of the microsphere dermal filler technology. The data from our clinical trials were subject to a full and open review in a public hearing by an FDA review panel. Artefill was approved by the FDA in October 2006.

What is the long term safety of microsphere-enhanced collagen treatments?
A follow-up study of patients from the controlled clinical study were followed over a five-year period after treatment. Independent expert observers rated photographs of patient wrinkles at five years compared to before treatment and six months after treatment. The physician investigators of this follow-up study concluded that the treatment safely maintains significant correction of smile lines for at least five years post-treatment.

Are there any current studies being conducted on Artefill?
Yes. A post-approval marketing study was initiated in October 2007 to evaluate the long-term safety of Artefill. The study will follow 1,000 patients treated with Artefill for a period of five years.

How many patients have been treated with the product?
To date, thousands of patients in the U.S. have been treated successfully with Artefill.

I have heard some patients develop persistent lumps in their skin after treatment with Artefill, is this true?
Persistent lumps are a rare potential side effect of all dermal fillers, including Artefill, and can be treated effectively.

If I have had a negative collagen skin test previously, do I need to have another skin test with Artefill?
Yes, an Artefill skin test is required prior to treatment to make sure that you are not allergic to the collagen in Artefill.