Hyaluronic Acid Fillers
Hyaluronic Acid (HA) is sugar, found naturally in the body that gives support to the skin. The aging process, sun exposure, and smoking damage the body’s naturally occurring HA causing it to decrease which results in the formation of wrinkles and folds. A “HA” filler’s job is to replace the natural HA that has diminished over time or was insufficient to begin with, as is the case with thin lips.
Why is HA important?
Young skin is smooth and elastic and contains a large amount of HA which helps the skin to look healthy. Since HA helps to bind water, as the natural HA decreases with age, the ability of skin to retain water also declines. As a result, the skin becomes drier, thinner, and less able to restore itself. The loss of HA with age causes loss of facial volume. The skin becomes looser which leads to wrinkles, folds, and an older appearance.
HA is such an important part of hydration that it exists in the same form in almost all species on earth. Now with this remarkable scientific advance HA can be replenished whenever it is needed.
What is the difference between all of the Fillers?
The HA fillers which Dr. Nunnally prefers are Juvederm Ultra XC®, Juvederm Ultra Plus XC®, Restylane®, and Perlane® which all have different densities. Because they have different densities, they are each placed at different levels in the skin depending on the degree of volume loss. Perlane® is used for deeper injections where more support is required. Perlane® is sometimes used as a “base filler” which is then topped with a less dense filler such as Juvederm®. Because of the different HA densities, tiny lines as well as deep folds can be corrected. Dr. Nunnally selects the combination of fillers that is right for each patient’s needs. With these fillers, injected directly into areas where the body’s support structures have been weakened, depressions can be raised to the level of the surrounding skin. These fillers are used to soften and smooth smile lines, marionette lines, and also used to fill thin lips, hollow cheeks and certain types of acne scars.
How are HA filler procedures performed?
The HA’s are injected directly into the skin in tiny amounts with a fine needle. Numbing cream is also used for added comfort. The process is quick and the results are practically instantaneous. Recently, with the addition of lidocaine to all of the HA products there is very little pain associated with the injections.
Fear of being "OVERDONE" and "UNNATURAL"
Dr. Nunnally prefers a natural look whether it's with HA fillers or Botox®. One should look relaxed, more well rested with an enhancement of your own features. She does not believe in overdoing any procedures which have a tendency to make people look very unnatural.
Can I use HA’s with Botox Cosmetic®?
Yes, and in many cases Dr. Nunnally recommends this wrinkle fighting technique. Botox Cosmetic® helps relax the muscle which decreases the activity in the area allowing the HA used in that area to last longer.
How long will the results of HA’s last?
The effects typically last about one year.
Will HA’s work for me if I have facial hollows?
HA’s are an excellent facial filler and lip volumizer, but they have limitations. For hollowness in the face which comes with fat loss (a natural result of aging for many women and men) a collagen stimulator like Sculptra®, may be the best choice. Sculptra® is able to add volume to the entire face rather than fill individual lines and folds.
Prior to Treatment
All HA injections can result in bruising. The risk of bruising is decreased if aspirin or aspirin containing products, Advil, other non-steroidal anti-inflammatory products, vitamin E, or herbal supplements are avoided 10 days prior to the procedure. There is usually some swelling after the injections so the area should be iced after the procedure and exercise avoided for 24 hours.