Profile view of a male teenager's face with acne

Dermal Fillers

It is natural to see gradual changes in the appearance of our skin as we get older. Some of these changes can be more prominent, such as wrinkles, while others are less noticeable, like fine lines. Wrinkles commonly appear on the face, back of the hands, neck, and the forearm. Wrinkles and other creases on the face could leave you unsatisfied about your appearance. Injectable dermal fillers provide a minimally invasive approach to reduce facial lines and wrinkles while restoring the volume and fullness of the skin. Every year in the United States, more than 3 million people choose to get dermal fillers. It is the second most frequent non-surgical cosmetic procedure performed in the USA (1).

The staff at Saguaro Dermatology are dedicated to providing you with the highest quality of care, innovative practices, helpful resources, and state-of-the-art technology to prevent and treat a multitude of skin disorders for patients in the Phoenix and Mesa area. Our physicians are experienced in injectable dermal filler treatment and are ready to help you achieve the look you desire.

How does your skin change with age?

Our skin is kept smooth by nicely packed collagen and elastin fibers in the dermis, a layer found just under the surface of the skin. In between these fibers, there is a chemical filler called hyaluronic acid which acts as a cushion and help to maintain young look of our skin.

As we age, the amount of collagen and elastin fibers along with hyaluronic acid decrease drastically. It will reduce the skin integrity and strength. With less filling and support under the surface of the skin, you will notice wrinkling and creases appearing on the skin. Premature development of facial lines and volume loss can also occur due to certain medical conditions.

Profile view of a male teenager's face with acne

Figure 1: Changes in skin composition as we age.

Neuromodulators and dermal fillers are two types of injectable cosmetic rejuvenating treatments provided by our office. Botox® is the most widely known injectable neuromodulator. Botox contains botulinum toxin type A produced by the bacterium Clostridium botulinum. Botulinum toxin blocks the signal transmission from nerves to the muscles preventing the muscle from contracting. When muscles underneath the skin are unable to contract, the wrinkles on the surface of the skin soften and relax. Botox injections are FDA-approved neuromodulator treatments for lines and wrinkles in the upper face area.

Injectable dermal fillers contain soft gel-like substances that can be injected under your skin to temporarily fade fine lines and wrinkles. Dermal fillers can make your skin look fuller and reduce other signs of aging.

The FDA has approved four categories of dermal fillers to be used in the face, lips and the hands.

  • Hyaluronic acid – A chemical found naturally in our skin. Hyaluronic-acid dermal fillers are most popular to use in the lower one-half of the face, from the nasolabial folds to the vertical lip lines of the lips, the marionette lines around the mouth and in the thinning of the lip itself. These fillers can also be used for volume enhancement of the cheeks (2).
  • Calcium hydroxylapatite (CaHA) – A non-permanent filler which contains uniform CaHA micro beads suspended in a water-based gel carrier (3). It is considered a long-lasting filler as it can stimulate the natural collagen production in your skin.
  • Poly-L-lactic acid – An absorbable, semi-permanent dermal filler that can gradually restore volume and stimulate collagen formation. It is commonly used to correct nasolabial fold deficiencies, facial wrinkles, and facial fat loss.
  • Polymethyl methacrylate (PMMA) – PMMA dermal filler is FDA approved for the correction of nasolabial folds and acne scars. PMMA beads are suspended in a gel that contains collagen. Effect of PMMA fillers could last longer as it helps to grow collagen in the skin (4). PMMA based fillers are not absorbed by the body as PMMA beads are tiny, smooth, plastic beads.

Where are dermal fillers used?

Dermal fillers are approved for specific uses in people aged 22 and older. Those uses include:

  • Correcting moderate-to-severe facial wrinkles and skin folds
  • Increase fullness of lips, cheeks, chin, under-eye hollows, jawline, and back of the hand
  • Restoring facial fat loss
  • Correcting acne scars
Profile view of a male teenager's face with acne

Figure 2: Areas of the face where cosmetic procedures including dermal fillers can be used

The FDA recommends against using dermal fillers or any injectable filler for body contouring and enhancement to:

  • Increase the size of the breasts or the buttocks
  • Increase the fullness of the feet
  • Implant into bone, tendon, ligament, or muscle
  • Inject the area between the eyebrows, nose, forehead, or the neck.

Dermal fillers are delivered through needles. Therefore, a little discomfort may occur during the procedure. Some dermal filler gels have numbing agents such as Lidocaine in the formula to keep you comfortable during the procedure. We can also apply topical numbing cream prior to the procedure to prevent any discomfort that may occur during the procedure.

Dermal filler procedures are popular because they:

  • Can reduce the signs of aging
  • Can give you a more youthful look for a fraction of what a traditional facelift would cost
  • Can make your facial features more symmetrical
  • Can be performed within a short period of time
  • Have a shorter recovery period
  • Are non-surgical procedures that are less painful
  • Can be customized to meet the needs of each patient

Are dermal fillers safe?

As with any medical procedure, there are risks involved with the use of dermal fillers. Most side effects occur shortly after injection and go away within a few weeks. Common risks include:

  • Itching, rash, and signs of inflammation such as redness, swelling, pain and tenderness.
  • Unintended injections into blood vessels- The most serious risk associated with dermal fillers is accidental injection of fillers into a blood vessel. Fillers that enter a blood vessel can cause skin necrosis (death of tissue), stroke, or blindness.
  • Having to remove the fillers- If you want to have fillers removed or reduced because of the side effects, you may need additional procedures to reduce the filler or surgery to remove it. In some cases, it may be difficult or even impossible to remove some filler material.

It is not advisable to buy or use injectable fillers that are sold directly to the public. Most of them are not FDA-approved and could be contaminated with chemicals and infectious organisms. The only FDA-approved dermal fillers are supplied by a prescription for injection by a licensed healthcare professional. We will discuss possible complications with you prior to your procedures.

How long do dermal fillers last?

Most of the FDA-approved dermal fillers are temporary, because they are made from material that the body eventually breaks down and absorbs. Therefore, in some cases the injection procedure may have to be repeated to maintain the desired effect. Depending on the filler type and the amount of filler used in the procedure, your healthcare provider can roughly estimate how long your dermal filler treatment would last.

You should consult with your board-certified dermatologist about what areas you would like to be treated with dermal fillers. They will recommend the type of filler or fillers and review possible side effects and recovery time with you. It is important that you provide a list of current medications you are taking, as some drugs can increase the risk of complications associated with dermal filler procedures. You should also let them know about any medical conditions such as allergies and history of bruising or bleeding after similar procedures, and any neurological problems.

As injectable dermal filler treatment is a non-surgical procedure, recovery time is minimal compared to a cosmetic surgery. But remember, everyone’s recovery time is different. Your recovery time depends on:

  • The type and the amount of the filler used for the procedure
  • The part of the body you received the treatment
  • Your overall health

Are dermal fillers right for me?

If you are unsatisfied with the appearance of your skin and not sure the dermal fillers are the right choice, make an appointment with us at Saguaro Dermatology today. We are happy to evaluate your skin condition and discuss the possible treatment options with you.

Price of dermal filler treatment depends on the type and the amount of the filler we use for each procedure. Prior to your session we can discuss and provide you with a better understanding of the cost for your procedure.

Final word on dermal fillers

Dermal fillers can smooth wrinkles and restore volume to provide a youthful look. People choose dermal fillers over cosmetic surgeries as the recovery time and the cost are relatively low. There are side effects associated with dermal filler treatments as with any other medical procedure. Do not hesitate to contact an experienced dermatologist to discuss your options. The team at Saguaro Dermatology has successfully treated individuals with different skin conditions. Our board-certified dermatologist, Dr. Dathan Hamann, and our caring and experienced staff are always ready to help you at Saguaro Dermatology, conveniently located at two campuses, Phoenix and Mesa, AZ.

Saguaro Dermatology team: https://saguaroderm.com/contact/
Botox®: https://www.webmd.com/beauty/botox-cosmetic
Botox treatment at Saguaro Dermatology: https://saguaroderm.com/services/cosmetic-dermatology/botox/
Hyaluronic acid: https://www.webmd.com/vitamins/ai/ingredientmono-1062/hyaluronic-acid?activeingredientid=1062&activeingredientname=hyaluronic%2Bacid
Marionette lines: https://www.healthline.com/health/beauty-skin-care/marionette-lines

Articles Cited
1. Ballin AC, Brandt FS, Cazzaniga A. Dermal fillers: an update. Am J Clin Dermatol. 2015;16(4):271-283.
2. Gold MH. Use of hyaluronic acid fillers for the treatment of the aging face. Clin Interv Aging. 2007;2(3):369-376.
3. Pavicic T. Calcium hydroxylapatite filler: an overview of safety and tolerability. J Drugs Dermatol. 2013;12(9):996-1002.
4. Ronan SJ, Eaton L, Lehman A, et al. Histologic Characterization of Polymethylmethacrylate Dermal Filler Biostimulatory Properties in Human Skin. Dermatol Surg. 2019;45(12):1580-1584.

Saguaro Dermatology Reviews

Itaro Elaisa
Itaro Elaisa

“I totally recommend this place to anyone who’s looking for a dermatologist who’s professional, informative, respectful and very helpful. They are quick to solve your problems and get you home.”

Wendy L.

I had an awesome experience with Dr Hamann and staff. I was very comfortable and i was able to have all my questions answered without feeling rushed. The staff was courteous and welcoming.

Kristin Ulrich-Uhles
Kristin U

“Dr Dathan and the team were very helpful, kind and knowledgeable. Plus, there was no wait time so I was able to get back to work faster than expected. I would highly recommend.”

Robert P.

Staff was friendly, & on time. office is super clean!! Doctor was awesome, felt like a family member taking care of me.

Sally Shepstead
Sally S.

“Very friendly and professional. I had a great experience, Dr. Hamann was very good at answering my questions and concerns. I will certainly come back for another visit.”

Amanda C.

Great doctor and friendly, professional staff. The doctor spends time listening and answering questions, something rare to find anymore. The office is beautiful and very clean. I love all the artwork with saguaros.

Kylin Chen
Kylin L.

“The office was recently renovated–it is a beautiful, clean, and calm environment. I would highly recommend this practice for anyone who is looking for a general dermatologist.”

L

Dr. Hamann is very knowledgeable, nice, and professional. You can tell that he truly cares about his patients by the way he operates. He took the time to listen to all of my concerns then address them with good, well-informed answers.

Saguaro Dermatology | Phoenix Dermatology

About Saguaro Dermatology

Our comprehensive dermatology clinic is dedicated to providing you with the highest quality of care, innovative practices, helpful resources and state-of-the-art technology to prevent and treat a multitude of skin disorders. Led by Carsten R. Hamann, MD, PhD, Dathan Hamann, MD, FAAD, and Millard Thaler, MD, Mohs Surgeon, our passionate team looks forward to serving you with respect and compassion.

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