Dermal Fillers

Dermal fillers are injectable treatments that are either deposited into or beneath skin layers to smooth wrinkles and creases, restore volume, enhance contours, and reduce signs and symptoms of aging. Fillers are measured in cubic centimeters (cc) or syringes. Fillers are often provided in 0.5 cc or 1 cc syringes and are graded based on viscosity, also referred to as “G” or “G-Prime.” The higher the G, the more viscous and rigid. The lower the G, the softer the consistency. ⁽¹⁾ Injectable dermal fillers have grown in popularity with both non-hyaluronic acid and hyaluronic acid fillers seeing an 8% increase in procedures performed between 2022-2023. ⁽²⁾

Dr. Michael A. Howard is a board-certified plastic surgeon and provides some of the highest level care for those in the greater Chicago area. Since 2005, he has performed over 10,000 procedures, dedicating extensive time to furthering his craft. Dr. Howard is a top-rated surgeon, having been the recipient of numerous awards, as well as having been elected to the American Association of Plastic Surgeons.

Take the first step in your dermal filler treatment by scheduling a consultation with Dr. Howard or a certified injector at our office. Please call (224) 271-4250 or fill out our contact form to reach any one of our convenient locations in Lake Forest, Chicago, or Glenview.

About Dermal Fillers

Dermal filler treatments are specially formulated gel-like injectables that are administered beneath the skin to enhance one’s appearance. These fillers can help correct signs and symptoms of aging, augment certain features, and restore lost volume. These fillers are temporary and are absorbed by the body over time. ⁽³⁾ Many patients opt for dermal fillers as they provide noticeable and near-immediate results with a minimal recovery time. ⁽¹⁾

There are many types of fillers available today, each with a different design to help restore youth to the face.

Hyaluronic Acid (HA)

Many dermal fillers are made from hyaluronic acid (HA), a natural substance produced in the body. Over time, the body’s production of hyaluronic acid slows, leading to reduced skin elasticity and the formation of wrinkles. These fillers are temporary, but often provide immediate enhancements that can be long-lasting. HA fillers are known to be hydrating and support the skin while restoring a youthful appearance in a way that looks natural.

Calcium Hydroxylapatite (CaHA)

Calcium hydroxylapatite (CaHA) is a naturally-occurring compound that can be found in our bones and teeth. This filler is long-lasting but not permanent, with the microscopic calcium particles offering more structure and viscosity compared to other options. CaHA fillers can help improve the skin over time as the material naturally stimulates the production of collagen in the body. ⁽¹⁾

Poly-L-Lactic Acid (PLLA)

Poly-L-Lactic Acid (PLLA) is a synthetic, biodegradable material that is used to help replace lost volume throughout the face. PLLA fillers are also biostimulating, meaning that these fillers help stimulate the production of collagen in the skin. PLLA fillers offer gradual results, meaning that the quality of the skin continues to improve for several months after treatment. ⁽⁴⁾ Patients can expect long-lasting results as the effects of PLLA fillers can last several years.

Polymethylmethacrylate (PMMA)

Polymethylmethacrylate (PMMA) is a biostimulating, synthetic filler composed of plastic microspheres suspended in bovine collagen gel. PMMA fillers are permanent as the microspheres are not absorbed into the body. Over time, the collagen gel is broken down by the body, and the space is filled with newly produced collagen. ⁽⁴⁾

Benefits

There are many benefits to receiving dermal fillers. Patients can see almost immediate improvements following their treatment, resulting in an improvement in facial volume. This procedure is minimally invasive with minimal downtime, leaving no scarring and allowing patients to return to their daily routine after treatment. Certain dermal filler materials can help stimulate the production of collagen in the face, leading to gradual improvements such as healthier-looking, rejuvenated skin. This procedure is fully customized to each individual to help target their unique concerns, restoring a youthful look and boosting confidence.

Candidates

The ideal candidates for dermal fillers are those interested in reversing the signs and symptoms of aging, as well as those interested in restoring lost volume to the face. Candidates experiencing a loss of volume or lack of fullness in the temples and cheeks may be interested in this treatment. Patients interested in eliminating or minimizing the appearance of deep lines and wrinkles may find this procedure ideal, as well as those interested in restoring volume to the lips and under-eyes. All candidates interested in dermal fillers should be in good overall health with no underlying conditions that may impair the healing process.

Personal Consultation

We understand that it can be overwhelming to figure out which dermal filler may be right for you on your own. Our team meets with each patient to better understand their goals and concerns before offering the best recommendations to help them achieve facial rejuvenation.

To set up an appointment where we can discuss the best dermal filler choice for you, please call (224) 271-4250 or fill out our contact form.

Preparation

Before each procedure, Dr. Howard and our team of experts will properly instruct each patient on how to prepare their skin for dermal fillers. Retinoids, exfoliants, and other harsh skincare products should be avoided a few days before the treatment, and all patients should ensure they are staying hydrated and moisturizing the treatment area. Patients are asked to refrain from smoking or drinking alcohol a few days before the procedure to minimize any potential swelling and to optimize results.

To find out the best way to prepare your skin for dermal fillers, please call (224) 271-4250 or fill out our contact form, and a team member will respond as soon as possible.

Procedure

Depending on each patient’s treatment plan, comfort level, and chosen type of filler, local anesthetic may or may not be used. Certain types of filler have numbing agents mixed into their solutions to help ease discomfort, therefore eliminating the need for topical pain relief. A dermal filler treatment is typically brief–around 30 minutes or less–so that busy patients can get back to their daily routines. The injection pattern used by the injector depends on the goals and concerns of each patient, as there are numerous dermal filler options that come with their own unique benefits. ⁽⁴⁾

Injection techniques often utilized during dermal filler appointments include:

Linear Threading/Tunneling

Linear threading is a type of injection technique that consists of a line of filler being injected while the injector simultaneously withdraws the needle from the injection site. The needle is inserted along a facial fold or crease, as this technique is primarily reserved for individual or isolated creases and folds.

Crosshatching

Crosshatching is an injection technique that is based on the linear threading technique. The injector will deposit several parallel lines into the treatment area. Following that, several more parallel lines will be injected. However, these lines will run perpendicular to the first set of injected filler, creating a grid pattern. This technique is ideal for correcting marionette lines and the hollows of the jowls.

Radial Fanning

The radial fanning technique consists of multiple threads of filler being deposited through the tunneling technique. Before the needle is completely withdrawn, it is reinserted into a radial pattern before another thread is injected. This technique is primarily used in the mid-face and cheek regions and the injector can repeat until the desired effect is achieved.

Serial Puncture

The serial puncture technique involves multiple small portions of filler being delivered to a treatment area through the use of multiple separate punctures or injections. This method is often used to help deliver filler to fine lines often found above the nose and between the eyebrows.

Recovery and Results

Following their injection session, patients may experience minor redness or swelling in the treatment areas, but these effects will subside within the following few days. Patients will be able to return to work immediately but should avoid intense physical activity for the next 24 hours.

Depending on the type of filler received, patients may notice either immediate or gradual results that continue to improve over time. Patients can expect to see an improvement in facial volume and fullness and an overall improvement in aesthetics. The results of a dermal filling treatment can be long-lasting.

References

1. Khalifa Al‐Ghanim, Richards R, Cohen S. A practical guide to selecting facial fillers. Journal of Cosmetic Dermatology. 2023;22(12):3232-3236. doi:https://doi.org/10.1111/jocd.15867
2. American Society of Plastic Surgeons ® Endorsed Partner.; 2023. https://www.plasticsurgery.org/documents/news/statistics/2023/plastic-surgery-statistics-report-2023.pdf
3. Witmanowski H, Błochowiak K. Another face of dermal fillers. Advances in Dermatology and Allergology. 2019;37(5). doi:https://doi.org/10.5114/ada.2019.82859
4. Sánchez-Carpintero I, Candelas D, Ruiz-Rodríguez R. Dermal Fillers: Types, Indications, and Complications. Actas Dermo-Sifiliográficas (English Edition). 2010;101(5):381-393. doi:https://doi.org/10.1016/s1578-2190(10)70660-0
5. Clark NW, Pan DR, Barrett DM. Facial fillers: Relevant anatomy, injection techniques, and complications. World Journal of Otorhinolaryngology – Head and Neck Surgery. 2023;9(3):227-235. doi:https://doi.org/10.1002/wjo2.126
6. Guo J, Fang W, Wang F. Injectable fillers: current status, physicochemical properties, function mechanism, and perspectives. RSC Advances. 2023;13(34):23841-23858. doi:https://doi.org/10.1039/d3ra04321e