A ^Retired Plastic Surgeon's Notebook

Facial Non-Surgical Procedures » Injectable Fillers

Injectable Fillers e.g. Perlane, Prevelle, Juvederm, Restylane by Seattle Plastic Surgeon

Procedure Illustrations

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HA fillers have revolutionized the treatment of facial aging. These fillers come under many names including Restylane, Juvederm, Perlane, Voluma and others. They are all variations of the same stuff, hyaluronic acid.  Hyaluronic acid is a naturally occurring substance that is present throughout the body.  For example, HA provides support and hydration of the skin and it lubricates joint spaces.  No one is allergic to hyaluronic acid so there is no need for a skin test prior to injection.

Facial aging  involves many factors; gravity causing sags and bags, thinning of the skin and fat of the face causing deflation, and creases in the caused by sun damage or facial movement.  Fillers can address all three of these problems and, to some extent and for some areas, are actually more effective than surgery.  Fillers do not tighten or thin the face and well done filler injections look very, very natural (very, very important is a city like Seattle). HA fillers have become my treatment of choice for some types of facial again and for lip enhancement.

Most HA fillers last about 6 months although I have many, many patients who have had lasting results up to two years. The longevity of the filler depends on the type of filler and the location of the injection.  One of the newer fillers used to add volume to the midface, Voluma, lasts for at least 2 years.  There is also a new fill for use in the lips called Volbella.  It lasts for about a year.

Almost all the fillers now have a local anesthetic incorporated into the HA and therefore most patients can be injected with either some icing of the area or a local anesthetic cream.  Most patients can resume normal activities a day or two after injection.  It’s a good idea to avoid medication or supplements that can cause bruising for about 10 days before injection.  These include aspirin, Motrin, Advil, other NSAIDs, fish oil, flax seed oil, etc.

One really great thing about the HA fillers is that they are fully and quickly reversible if the patient does not like the result. This is done by injecting an enzyme that dissolves the HA overnight. I have done thousands of injections and have used this reversal enzyme only twice, but it is nice for patients who are nervous about fillers to know that quick reversal is available.

For long lasting and often permanent filler results, I do fat transfer.  I do a very painstaking and finicky method for harvesting the fat from where ever there is excess and then inject the fat in tiny parcels into the areas that need filling.  Since the arrival of HA filler, I have done fewer fat transfer a.k.a. lipostructure procedures.  Fat transfer requires an anesthetic, time off work and social activities for bruising and swelling to resolve and is not as predictable as the HA filler.  But for certain patients and certain problems, it’s the way to go.

Check out my photo gallery for some examples of filler injection.

I charge $100 for a filler consultation which is applied towards the filler injection.  As of 2015, I charge $600 for the first syringe of Juvederm or Restylane and $500 for subsequent syringes injected the same day.  I charge $900 per syringe for Voluma.  The newest filler, Volbella is $400 for a syringe.  Sticker shock?  These fillers really work wonders with very little down time and I do all of my own injections.  Oh, one more thing:  Patients who skimp on product tend to be less satisfied that patients who agree to as full of correction as possible.  If cost is a barrier, I think it’s good advice to save up for a full correction.  Also, I am very aware of all the pillow face ladies out there (not too many in Seattle but lots in People magazine!) and I don’t go there.  I also don’t do trout pout.

Check out these blogs about HA fillers.

View this video of me doing lip enhancement with Juvederm.

View this video of me doing cheek bone enhancement with Voluma.

If you would like to schedule a consultation, please give my office a call at 206 467-1101.  If you want to have filler injected on the same day as your consultation, let the person scheduling your appointment know so we can book a longer appointment.