In this blog, Dr. Frederick Lukash talks about the variety of injectable products currently available, and his preference for use. Dr. Lukash is a certified injectable trainer with Galderma, the parent company of Restylane. Long Island Plastic Surgical Group is proud to be one of the first practices in the area to have access to Restylane Refyne and Restylane Defyne, the newest additions to the Galderma family of fillers.
With the variety of injectables on the market, as physicians, this means we have many options to treat patients to give them their desired outcome. There are products for almost each anatomical area of the face.
Treatments for the Frame of the Face
A youthful face is an oval face. The frame of the face changes as we age, most commonly with temporal hollowing and the loss of volume in cheek area. One of the injectables I use most often in my patients is Sculptra. I like to think of Sculptra as more of a volumizer. It is collagen stimulator, increasing volume by creating a sub-clinical inflammatory response, allowing the tissue to regenerate more collagen. With Sculptra, 2-3 treatments are usually necessary. There is not an immediate response, the results will begin to become visible between 60-90 days. You need to be a patient patient! When the end aesthetic correction is achieved, the result will last at least 2 years. It’s longer lasting because it is stimulating your own collagen.
Treatments for the Mid Face
The mid face refers to the tear trough, upper nasiolabial folds, and the lips. While Sculptra works well for the frame of face — the temples, lateral cheek, and jawline – Restylane Lyft works well for deep tissue injection in the cheek/cheek bone area to further accentuate the “inverted cone of youth.” Restylane Lift has the patented Non-Animal Stabilized HA (NASHA)TM technology. NASHA technology creates a firmer gel texture for a more pronounced lifting capacity. I prefer to use Restylane Silk for the tear trough area to fill in the hollow under the eyes.
Restylane, Restylane Lyft, or Restylane Silk are ideal for the modiolus, the area inside the nasiolabial folds and inside marionette lines. This area is typically not fixed by a facelift. The more central you go, the thinner the filler product should be to allow for optimal mobility.
Treatments for the Mid to Lower Face
The mid to lower face is the expression area. Restylane Refyne and Restylane Defyne are fantastic new options for nasolabial folds, which are the skin folds that run from each side of the nose to the corners of the mouth. They also work well for marionette lines, which are the lines that run from the corners of the mouth to the chin that can make you look unhappy. What’s different about these gels is that they are made with a flexible hyaluronic acid filler which uses XpresHAn Technology – so they offer a wide range of flexibility as well as support. These filler gels move and mold with your natural movement, so they are ideal for the areas of the face where there is a lot of expression.
Refyne is a less firm product than Defyne, so Refyne works best in more superficial wrinkles, Defyne is designed to be less flexible and provide additional support, so it is a better option for deeper wrinkles and folds. Patients can expect some bruising and slight swelling for about 24-48 hours after treatment, but the results are apparent immediately. Both of these fillers last up to 12 months compared to regular Restylane which lasts approximately 6-8 months.
Fillers are not one-size-fits-all. To learn about what injectable products are best for you, schedule a consultation with a plastic surgeon.