New Dermal Fillers

Hughes Dermatology was a participant in the 2006 "JET" (Juvederm Experience Trial) Program, so we are experienced and pleased with Juvederm Ultra Plus. Juvederm consists of more highly cross-linked hyaluronic acid than Restylane and flows a bit easier. This sustains its effect. It is used for lip volume enhancement and filling nasolabial and marionette lines. Juvederm Ultra Plus recently obtained FDA approval as lasting 12 months. It is "smoother" to inject than Restylane and patients generally prefer it in the lips. Perlane is newly available and competes with Juvederm Ultra Plus for durability.

For a more natural look, Dr. Hughes and Tichy will add "pillows" to the lower lip when doing lip enhancement.

Hyaluronic Acid Lip Volume Enhancement

Hughes Dermatology is offering "Sculptra" treatments as a volume filler for cheeks, nasolabial and marionette lines (not lips), producing a "lifting" effect as well. This is helpful for thin, fit women or men who have lost facial cheek volume (lipoatrophy) and have resultant looseness and wrinkling in this area. A recent article in Dermatology Times provides a nice overview of this treatment. Lasting 2 years (or more), it has been called a "liquid facelift."

Injections of biodegradable Sculptra are done every 8 weeks with volume improvement after each injection (secondary to new collagen production) occuring slowly over 8-12 weeks. Typically, 3 sessions are required for optimum correction. There is no down-time other than occasional bruising. Sculptra is initially expensive but is safe, cost effective and long-lasting.

Radiesse is a FDA-approved (12/06) biodegradable calcium hydroxylapatite microsphere filler that lasts longer (10-15 months) than the hyaluronic acid fillers. It is used primarily for nasolabial and marionette lines. It should not be used in lips. It is comfortably done using topical LMX5 followed with infiltration and cryoanesthesia. There is swelling that lasts a couple of hours, but then the improvement is immediate. Because it is injected deeper, it has more "lifting power." It can even be used as a non-surgical rhinoplasty ("nose job") in some patients, if part of the nose needs added volume. Our patients have been pleased with Radiesse.

Radiesse and Sculptra are both being used by Hughes Dermatology to add volume to the tops of hands, creating "hand rejuvenation." We use the new "depot" technique which produces less bruising.

Hand Rejuvenation

Evolence, a new J&J porcine-derived collagen filler, was approved by the FDA 7/1/08. Drs. Hughes and Tichy are Star-certified Evolence injectors. It is a long-lasting filler that now available in our office. It is particularly effective for ablating nasolabial folds, marionette lines and the pre-jowl sulcus. It can not be used in the lips.

Evolence: before and after

Elevess is another new filler. This one is hyaluronic acid with a local lidocaine anesthetic, making it a more comfortable injection. It is currently the least expensive filler.

Sidney Coleman, M.D. states, "Aesthetic surgery is moving rapidly away from excision and suspension procedures to augmentation procedures for rejuvenation in particular. The primary event of facial aging is atrophy or loss of fullness. The obvious solution for atrophy is restoration of volume or fullness." Before getting a traditional invasive face lift, consult with Dr. Hughes or Dr. Tichy to see if you are a good candidate for this noninvasive more natural alternative dermal filler.

Sculptra: before and after

Sculptra: before and after

Sculptra: before and after, 2 sessions

Sculptra before and after, 3 sessions