Signs of facial aging
Face fillers are a variety of materials that can be injected into the face to help add volume in specific locations. While it may sound odd to add volume to the face, loss of volume is one of the first signs of facial aging. The addition of volume helps restore a more youthful and attractive contour to the face.
Not all injectors have the same degree of skill. Merely filling in lines, will lead to a mediocre result at best. Dr. Shah’s focus is on the face. As such, he adds volume throughout the face, so that the face is enhanced in a global and more attractive way. This unique way of injecting was learned from several of the world’s top injectors.
Safety is dependent on a skilled injector and utilization of appropriate injectable materials. Specific skin types often have improved results with specific types of dermal fillers. Dr. Shah utilizes a conservative approach in dermal fillers. He utilizes fillers which have a proven track record of safety and minimal complications. Lip augmentation is another application of dermal filler placement in the face.
Application of dermal fillers
Many physicians from a variety of fields inject dermal fillers. However, there is an art to successful use of dermal fillers. An analogy can be made between hairstylists and the application of dermal fillers. A successful hair cut brings new life into not just the hair but the entire face itself. With dermal fillers, standard applications of fillers can lead to flat results which do not create the desired visual impact. With the appropriate application of fillers, the entire face appears younger, balanced, and more refreshed.
Face Fillers treatment
In order to treat a patient with facial aging, one must understand how we age and the anatomy of aging. Soft, subtle changes are preferable to harsh, obvious contours. In the African-american face, I inject in order to provide even volumetric balance to the face and provide a slight lift to the entire face. Most injectors, essentially, try to fill in the lines. However, this approach does not adequately address facial aging including the midface, malar region, perioral region and entire face. Often times, patients are treated with a series of injections to slowly transform the face.
Evaluation of facial anatomy
Here you will find a map of the face illustration where each filler is used. Dr. Shah evaluates each person’s facial anatomy as well as the patient’s individual concerns to determine which filler and which areas should be treated.
- Temples (all)
- Number 11’s (all fillers except for Radiesse)
- Nose (Juvederm, Restylane, Perlane, Juvederm Ultra Plus)
- Smile Lines (all fillers except for Sculptra)
- Cheek hollowing (Juvederm Ultra Plus, Perlane, Radiesse, Sculptra)
- Prejowl sulcus (Radiesse, Juvederm Ultra Plus, Perlane, Restylane)
- Nasojugal sulcus (Juvederm, Restylane, Perlane)
- Lower eyelid cheek interface (Juvederm, Radiesse, Restylane)
- Lip Augmentation (Juvederm, Perlane, Restylane)
- Fine lines (Restylane)
Injectable fillers available for patients
Guide To Hyaluronic Acid
There are a large number of injectable fillers available for patients to utilize. Not all injectable fillers are the same, even injectables approved by the FDA may not have an excellent safety record. Dr. Shah only utilizes dermal fillers which have been studied extensively and minimize any risk to the patient.
Safety is dependent on a skilled injector and the utilization of appropriate injectable materials. Specific skin types often have improved results with specific types of fillers. Dr. Shah utilizes a conservative approach in fillers. He utilizes fillers that have a proven track record of safety and minimal complications.
Specific applications of fillers can be used to augment the malar region (also known as the cheekbone) to create a subtle but discernable difference in cheekbone height creating a more youthful appearance. There is little to no downtime with dermal fillers and they serve an important role in the rejuvenation of the aging face.
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- Real patient
Dermal Fillers approved by the FDA
Dr. Shah has learned from several master injectors of the face including a world-famous facial plastic surgeon in Beverly Hills. This approach is known to a handful of surgeons in the world and is heavily guarded. Dr. Shah does not describe any of these techniques on this website or in the scientific community due to the strict confidence in which these techniques have been taught. Below you will find a list of dermal fillers by name, main component, side effects, and more.
| Name | Date Approved by FDA | Main Component | Skin Testing Required? | Allergy Components | Side Effects | How long does it last? | Onset of results |
|---|---|---|---|---|---|---|---|
| Radiesse | August 2006 | Calcium Hydroxyapatite | no | minimal | Possible, Not reversible, can not be used in lips or nose, | 8 months -3 years | immediate |
| Elevess | July 2007 | Hyaluronic Acid |
no | Not to be used in patients with lidocaine sensitivity, gram-positive bacterial proteins | Local reaction, swelling | 4-6 months | immediate |
| Juvederm Ultra Plus | June 2006 | Hyaluronic Acid |
no | Gram-positive bacterial proteins | Local reaction, swelling | 4-6 months | immediate |
| Juvederm Ultra | June 2006 | Hyaluronic Acid |
no | Gram-positive bacterial proteins | Local reaction, swelling | 4-12 months | immediate |
| Perlane | May 2007 | NASHA (non-animal hyaluronic acid) |
no | Gram-positive bacterial proteins | Local reaction, swelling | 4-12 months | immediate |
| Restylane | December 2003 | NASHA (non-animal hyaluronic acid) |
no | Gram-positive bacterial proteins | Local reaction, swelling | 4-6 months | immediate |
| Sculptra | August 2004 | Poly-L- Lactic Acid |
no | Possible | granuloma formation, possible nodule formation, not reversible | 8 months- 2 years | immediate |
| Cosmoplast | 2003 | collagen derived from human | no | Not to be used in patients with lidocaine sensitivity | allergy | 1-6 months | immediate |
| Hydrelle | Late 2009 | Hyaluronic Acid |
no | Sulfites (Red wine derviatives ) |
local reaction swelling, granuloma | 4-12 months | immediate |
Frequently Asked Questions
Generally speaking, I do not utilize Restylane in African American patients. I have found the visual impact and longevity not to be much less effective than its counterparts. I have treated a number of patients who have told me that Restylane does not work. Restylane is a highly effective product when used with the right candidate and the appropriate location.
It depends on the type of fillers utilized. The filler used in the photographic example should receive benefit from one to three years.
Typically you can return to work immediately.
Dr. Shah believes the injection of a facial filler is an art form and should not be underestimated. Some of the newer dermal fillers last longer than traditional fillers, as such application of these fillers demands appropriate placement. In addition, knowledge of the latest fillers allows for the right filler for the right patient.
There have not been any reports of a keloid after use with a facial filler. A facial filler is typically placed in an atraumatic approach and thereby effectively eliminating facial keloids.