Today, both of these concerns have mostly disappeared. There are a wide selection of products, mostly varying in how long they last, and how deep they are injected into the tissue. Today the mainstay of soft-tissue fillers are composed with any of the following:
Non-permanent injectable:
- hyaluronic acid (e.g. Juvederm® family of products)
- calcium hydroxylapatite (Radiesse®)
- polymethylmethacrylate (Bellafill®)
- poly-L lactic acid (Sculptra®)
- micronized human dermis (Cymetra®)
- autologous fat (patient's own fat)
First a word about permanency. Dr. Baeke will tell all his patients, "Do you know what the worst thing is about soft tissue fillers? Answer: They don't last forever. Do you know what the best thing is about soft tissue fillers? Answer: They don't last forever.
We have all seen Hollywood stars and starlets with overly injected lips, some might even call then "duck-lips". Some desire that look, others do not.
A telltale sign (in Dr. Baeke's opinion) of a poor lip augmentation result, is loss of the middle upper lip contour, called the "cupid's bow". This is the most attractive contour of gorgeous feminine lips and should always be protected (again, Dr. Baeke's opinion). Beautiful lips should scream, "Kiss Me!"
More often, what we don't recognize are all the other celebs with fabulous injection results, as they have such a natural look.
With few exceptions, patients who regret having the procedure should take comfort in knowing that most fillers, are not permanent, and will slowly disappear over a few months to 2 years.
This lack of permanency also applies to injections using your own fat. In concept, the idea of using your own tissue makes sense, but in practice, much (?most) of the fat may not "take" and absorbs over time. It too can leave firm scarring in its place and irregularities.
Few injectables are truly permeant. However, some physicians will promote various injectable products as being "permanent" even though they only last 1-2 years... and that (mis)characterization is allowed by the F.D.A. Possibly some of these products might be better described as "long-lasting".
Of those products listed above, at least in Dr. Baeke's experience, the product which lasts the shortest is hyaluronic acid; while others, such as calcium hydroxylapatite often last 2 years or longer.
Dr. Baeke advises every patient considering a soft-tissue filler to "stick your toe in the water before diving in". In other words, first try a shorter-acting filler (hyaluronic acid). If you like the results, then later repeat with something more permanent.
Injection procedures take only a few minutes, and are usually performed under local anesthesia. Many patients request the procedure be performed in combination with some other surgery where they are already asleep, thus totally eliminating feeling any sting of the injection. Afterwards, there will be mild swelling which should resolve rapidly. Generally, final results are achieved in 2 weeks.
For any consultation, it is helpful if the patient brings in photos from magazines or web giving examples of the look they desire. This is particularly important when asking for lip injections. Plan on leaving copies of those photos to be placed with your medical record.
Finally, not all soft-tissue fillers are for purely cosmetic purposes. These same products have a valuable role improving scar deformities. Common requests Dr. Baeke receives are for help to improve unsightly acne ("ice pick") scars and depressed C-section or other surgical scars. These products do provide hope.
The FDA's list of approved sites for injectables is rather short. Physicians will occasionally recommend use of these products in areas outside of this list. Patients should be informed of such off-label use, but this is an accepted practice.
Dr. Baeke expects any person desiring use of any of the above products will have visited the manufacturer's websites for other important patient information as well as before/after photos.
Juvederm Ultra | Juvederm Ultra Plus | Juvederm Ultra Plus XC | Juvederm Ultra XC for lip augmentation | Juvederm Ultra SC for wrinkles & folds | Juvederm Vobella XC | Radiesse | Bellafill | Sculptra | Cymetra | Autologous fat | Silicone | SurgiSil Perma Facial Implant
