Hyaluronic Acid Dermal Fillers

Hyaluronic Acid (HA) is a glycosaminoglycan which is a long unbranched chain of repeating sugar units. They are highly polar and attract water. They are therefore useful to the body as a lubricant or shock absorber. HA is distributed widely throughout connective tissue, epithelial, and neural tissues. HA is also a major component of skin, where it is involved in tissue repair. HA is a common ingredient in skin-care products like Juvéderm® , a dermal filler. When HA gel is injected, it acts to support facial structures and tissue that may have lost volume or elasticity due to normal aging. It also draws water to the skin surface to keep it looking soft and youthful. 


Juvéderm® is injected using fine needles to sculpt the face by creating a lifting effect while softening prominent creases like the nasolabial folds. Dermal fillers, however, have their limitations. They can cause problems near the eye or forehead where they can cause tear trough occlusion or vascular compromise leading to tissue necrosis. For this reason, we avoid these areas and we monitor our patients for any signs of vascular compromise in other areas, namely severe pain and redness. In less experienced hands, the HA filler injector can chase a wrinkle and create a shape that looks foreign or unnatural to the person's face. These issues are not a problem when Juvéderm® is enhanced with Platelet Rich Plasma. For more information read about Regenerative Injection Therapy and the Vampire Facelift®. Our goal is to create a more youthful, refreshed, natural appearance. 


During consultation, you will be able to explain how you would like to improve your appearance. I will assess whether or not I can achieve the end results based on the available options and limitations. After consultation, a topical local anesthetic is applied for a period of 20-30 minutes, then removed. Subsequently, the treatment area is cleansed with an antiseptic solution. Juvéderm® is then injected using very fine needles. The topical local anesthetic will not provide complete total numbness, but enough coverage to make the treatment more comfortable. For lip augmentation, ice is also used for a deeper level of numbness. Patients are monitored thereafter and given discharge instructions.