Injectable Fillers: Q&A
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Best Fillers for Large Hollowed Areas?
I'm a 37-year-old female. While my facial skin still looks quite fresh, my cheek bone and jawline areas are so hollowed they make me look tired and old. I've considered Sculptra and other dermal fillers, but I'd like to know if there's anything long-term or permanent for restoring these large hollowed areas.
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9 Doctor Answers |
Asked by
VEGASDOLL
in LAS VEGAS, NV
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Structural Fat Grafting or Microfat Grafting to Correct Facial Hollows
A number of 'soft tissue fillers' are available for temporarily improving facial areas that have lost volume.
Some synthetic materials are available which can be used in an attempt to produce a permanent soft tissue augmentation. Unfortunately, the body treats such materials as foreign objects, and as a result the placement of synthetic materials may lead to inflammation, infection, migration and granuloma formation. In general, synthetic materials are less likely to produce...
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Fat grafting is a nice, natural facial filler.
VegasDoll,
Not all fillers are appropriate for all people or all locations on the face. Around the lips and nasolabial crease, the HA products such as Restylane, Juvederm and Prevelle work well. Evolence, a collagen-based product is also good in these areas. For the cheeks, Radiesse or Sculptra are nice fillers as they provide more substance and structure after injected. Be very careful with permanent or long-term fillers since you can not easily remove them if you do not like the...
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We prefer LiveFill or Juvederm
Sculptra is a nice filler for deep areas and is approved for severe lipoatrophy associated with HIV. It usually requires several injections and eventually dissolves. The results seem to be longer lasting than with hyaluronic acid fillers, although the study for lipoatrophy allowed the doctors to reinject a few times before the study was done, clouding the results somewhat. We do not use Sculptra in our practice because of the current FDA limitations and the problems that have occurred...
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Sculptra fills hollows best
Hi- while most fillers will do an adequate job of improving moderate to deep wrinkles, the best (and only) filler I use to fill out hollowed areas is Sculptra. Sculptra, in fact, was designed for this purpose and before being used to treat the aging face, was used in the management of the facial wasting experienced by AIDS patients, with great success.
It wasn't long before the similarities between this wasting and the loss of volume that can occur with aging was noted, and Sculptra has...
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Fillers for cheek hollowing
Yes, Sculptra has been used in this area but it can be very expensive. Some other fillers are autologus fat grafting ( this may require multiple treatments) or Radiesse.
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Consider Radiesse as an alternative
An alternative to Juvederm, Sculptra and fat injections is Radiesse. Radiesse is composed of tiny, smooth microspheres of calcium hydroxylapatite suspended in a gel matrix. These microspheres form a scaffold through which normal collagen grows, producing a long-term filling effect. Because Radiesse contains a component naturally found in our bones and teeth, but does not contain animal collagen, it does not require a skin test. Radiesse can be used to build up areas given structural...
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Fat or Sculptra are your only good options
The areas which you are describing for fill routinely need 3-5 mls of fill per cheek. Fat is the only natural filler and also the only one available that can fill that area. Previous complaints about fat survival surround the use of the centrifuge, which kills many fat cells.
A new technique called The Viafill system has just been FDA approved and will provide a much higher content of live cells for injection. This system should be available in April from your local plastic Surgeon...
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Consider fat grafts
Loss of volume (fat) in the face contributes to the appearance of aging. A youthful face has more fat, and so grafting your own fat should provide a long-term and natural result. HA fillers such as Juvederm and Perlane work well, and should give a result lasting 6-12 months. I am not a fan of Sculptra, since it requires a series of injections and the results are not immediate.
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Fat Transfer Best for Long Term/ Permanent Restoration of Large Hollowed Facial Areas
Hi Vegas Doll,
The best long term/ permanent solution for your facial hollows is fat transfer. When performed properly, fat transfer has been shown to be permanent. The procedure is extremely surgeon dependent, so it is essential that you research and choose your treating surgeon most carefully.
See you at the 2009 World Series of Poker, until then put $25 on red for me. Good luck and be well.
Dr. P
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