First Experience with Fillers - Walnut Creek, CA

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At age 43 I felt my face was starting to sag! I...

At age 43 I felt my face was starting to sag! I received Juvederm XC for tear troughs and lips, and Juvederm XC Ultra for marionnette and naso-labial folds. My dermatologist feels that Juvederm is a good choice for a first experience with fillers since the gel is 'softer' under the skin compared to Restylane/Perlane, so we went with that.

Day of treatment - first evening

OMG the pain and the tenderness. I can hardly touch my face and it's so grotesquely swollen and hot. Spent all my time just icing and taking Arnica, and texting bf (I'm not letting him see it lol). Wasn't hungry, felt nauseated and queasy. Had a tough time speaking; with the pressure of the lidocaine I really felt like my lips were about to explode... Getting to sleep was really tough. I would never want anyone to see me like this, they would freak. I hope I get my face back!

Experience at the Dr's office

I forgot to write a bit about the whole experience. I washed my face and they took pictures from several angles and with different facial expressions; I went over what outcome I was looking for with the nurse who took notes. Then the nurse applied a numbing cream and let that sit about 15 minutes on my face. It was wiped off and I was handed ice packs and told to apply them to my face until the Dr arrived. The Dr then came to talk about what I wanted in detail and she did a good job of setting expectations. She then started the procedure by injecting lidocaine to all the sites; then she started with the Juvederm. She took her time and kept studying my face as she injected. For me the tear troughs were the most painful; overall it wasn't that bad on the pain scale although I felt like it took forever. She used a small needle to inject and changed it out once my lips were done. After the procedure she felt that I could have used another syringe but since it was my first time she wanted it to settle first and see how I felt about the result; she said she would schedule me back in a week to look at the result and top up if wanted. The nurse then applied an antibiotic ointment all over my face and I spent another 15 minutes in the room icing. I was given Juvederm-branded mini ice packs to take home with me along with some skincare samples, and I have a follow up appointment.

Day after procedure

I have one of those bed bases that elevates so I slept with the head of the bed up the first night (NOT a restful sleep, plus got up a couple of times to ice). I woke up this morning nauseated and heaving... I guess it was all the lidocaine injected in me yesterday. Had something to eat and was better after. I had a worker come in to replace something in my closet and he asked me what happened to my face - this was after I put lots of yellow concealer on plus foundation - yikes :( I think he suspected I had been beaten up, my lips were pretty swollen with the huge hematoma then all the bruising along the tear troughs. I decided I could not go into work and have tongues wagging, I just worked from home. I am really hoping I will be ok to go in by Monday.

The nausea crept in and out over the course of the day. My face is tender and painful, not as bad as last night but not easy... I didn't know what to put on my skin and the arnica gel is very drying so I layered triple antibiotic ointment on top which really helped keep moisture in, it immediately perked up and felt better. I used cocoa butter petroleum jelly on my lips. I iced face and lips on and off. Fortunately my lips started deflating during the day and looked a lot 'better' in the evening; the sides feel almost normal but the middle is still hard and swollen. The hematoma under my lip is much darker though, and reaches far into my mouth... also something else I noted, the skin inside my mouth (epithelial cells) peeled off in sheets where the injection sites. My face was a lot less painful in general by bedtime. I was kind of scared I'd never look normal again! I kept thinking of mama Elsa lol but I knew my derm had a reputation for really good work with fillers, plus the Juvederm boxes were unwrapped and opened in front of me so I knew it was not illegal silicone like what happened to Priscilla Presley.

I learned that I was taking the wrong dose of Arnica Montana - it's supposed to be 30c not 6c, 4 pellets 4 times a day. I did a rush order off of Amazon (there is no way I am going out in public like this) and also you're supposed to start taking it one week before the fillers and 4 days after, I'll know for next week when my derm sees me for a touch up. I appreciate that she went more conservatively since it's my first time and I'm more than happy to go back for a touch up instead of being overfilled. I do want more in my marionette lines, one side is good but the other still has a little droop from the mouth.

Day 3

I am finally starting to look normal, although the bruises are much darker and oh, the one under my lip is nasty :( my yellow concealer is not thick enough so I think I will head to Ulta for some help tomorrow morning (like way early before they get busy). I'm not in pain anymore except a little where the tear troughs and there is a lump left in my bottom lip. The derm instructed me to gently massage the filler 5 times a day for 5 minutes and roll my lips between my fingers. There are no lumps in my upper lip. I can see my lips and I really like the look so far, I'm hoping they won't deflate too much from now (except for the lump in my bottom lip). I found out that they make Arnica cream so I am using that as a face cream and put a layer on my lips topped with petroleum jelly. All of the skin on my lips peeled off in sheets, the skin looks so fresh now. I have a few needle marks in my NL folds but they are fading. New bruises have popped up around my mouth. Taking the Arnica 30c. I am grateful to be able to work from home today again and so glad the weekend is here and I have 2 more days to deflate before facing other humans...

Day 5

The swelling is mostly gone from my face; visited the beauty store for some help on concealing my bruises. Most of the bruises are getting yellowish now and the large hematoma under my lip is a lighter shade of purple. My top lip looks really nice but my bottom lip still has a lump in it; and one of the sides is collapsed (the side with the hematoma). My bottom lip is also numb/tingly where the lump is. 2 days until my follow-up appointment; I definitely need another syringe.

Pic from day 4

Procedure done on Wednesday, this photo was takin on Sunday. Swelling is down, bruising is more marked.

8 days after first round, 1 day after second round

Yesterday I had my top-up appointment with the derm and she injected me with a second syringe of Juve Ultra in my NL and marionettes. She mainly focused on my left side as a deep fold has developed there as a result of a nervous tic (biting on my lip). I am currently doing an Invisalign treatment which has really helped with the tic since I can't bite my lip with my aligners in :) This time I had little pain after the Lidocaine wore off (I iced it a couple of hours last night), no bruising at all and minimal swelling. She thinks she can get an even better result for my tear troughs but the area is still pretty bruised so I have another follow-up in a month, she didn't want to mess with it while there was bruising. I still think I need more in my marionette lines, the pictures look nice but in real life you can still see a shadow on my right side. I would have probably needed more than a syringe since she commented on how fast the syringe got emptied yesterday, I kind of wished I had spoken up and asked if we could do a second one. The bruises have really faded but I do have some yellow concealer on in this pic. I was able to return to the office today which would have never been the case last Thursday!! I am amazed at the difference in sessions. I am taking Arnica 30 and also Bromelain tablets, and made sure I avoided all caffeine.

12 days after 1st round, 4 days after 2nd round

I find my face is still changing from day to day. I still have a little numbness in a small part of my bottom lip, it's becoming annoying. I massage it every day and I think it helps. The left side of my mouth was kind of sagging and I'm not sure why it's become so apparent (compared to before fillers), so I started massaging the filler on the left NL in an upwards motion and now I can smile wider. On the down side the fold is more apparent but to me it's a lesser evil than having a lopsided mouth.
The injected areas around the mouth have small flesh colored bumps... I usually keep a highly exfoliating regimen so I suspect it's dead skin buildup around the injection sites? This morning I used my Clarisonic for the first time since the injections and it really helped. My usual regimen is Perricone Blue Plasma, Cold Plasma and Ester C cream layered, twice a day. I have some stiffness in the filler on the left side, and some pain from bruise on right. Massaging helps the stiffness., just have to wait out the pain.

21 days after 1st round, 12 days after 2nd round

The swelling and bruises are all gone and I think things have pretty much settled into their position. I'm glad I took the time to massage the filler on the left side of my face, the stiffness is gone and I can only feel the filler a little when I smile widely. Here is a picture taken from a similar angle to my 'before' pic and you can really see the difference with the NL! I also love my lips, I had asked for a conservative plump and that's exactly what I got. All of the numbness/lumpiness in my lips is gone... you really have to be PATIENT, it took at good 2.5 weeks for my lips to settle. There is still a little pain when I touch the right tear trough but every day things get better.. I also see some very slight discoloration on both of the tear troughs but easily gone with makeup. People keep telling me I look good but they can't give a specific reason lol. My next appointment is on the 26th so we'll see what she wants to do, the whole journey has been pretty exciting :) and I would totally do it again.

28 days after 1st round

It's been 4 weeks and all swelling/pain/stiffness is gone except for a small spot in the left tear trough, near the nose; it's not constant pain, only when I press down on it. The 'swelling' near my lip on the left side is almost gone, I am ok with how it looks at the moment. The discoloration through the tear troughs has lightened a bit and pretty much disappears under makeup. I can smile normally and I don't feel the need to massage any of the filler. It's a bit strange though; sometimes I look at myself in the mirror and I feel it is just perfect, and other times I can see a little drooping around the mouth still. Has anyone else experienced this, is it the filler swelling at certain times of the day? This will be my final update for these rounds; I will update again after my next follow-up derm appointment on 2/27.

3rd attempt to get things right

I was excited to have this appointment happen and hopeful it would be my last round of fillers for this first experience. I have some hollowing around my nose that creates shadows I used to always attempt to minimize with concealer. At my last appointment she injected a lot of filler around my left nostril and it had a definite 'lifting' effect which I was really happy with. This time I showed her what she did on the left side and asked her to even it out on the right side of my nose, I also asked her to finish off my marionnette lines properly as the sagging was still apparent when you looked at my profile. She felt around the filler on my left side of my nostril and seemed to understand perfectly what I wanted. Well it didn't go so well... she injected another bunch of filler on my left side (which I was perfectly happy with to begin) and hardly touched the right side ?!? Then she filled my right marionette and barely touched the left one; at mid point she let me have a mirror and I told her to add more on the left side, she said uh-huh and ignored me. Now my nose is even more lopsided than before (see pic). She abruptly decided she was finished and left the room without handing me a mirror to get an approval. I could see it right away that my nose was lopsided and my left marionette was still apparent I don't understand why she didn't. Now I am left with lopsided nostrils, a hollow around my right nostril only and my left marionette that still needs to be touched up. I made an appointment for a laser facial in a month and she said oh we can see if you need a touch up then. Well I can tell you that I am fed up of going through the healing process and managing bruises (I bruised again this time I have concealer in this pic it's actually very purple). I don't think it's appropriate to inject a bit at a time and have to go through the process multiple times; if I need 2 syringes just say so and do it now... or at least let me choose to add more if I'm not happy... I never got the choice. I am going to find another injector to fix my lopsided nostril and left marionette hopefully next week, I need to get this over with.

Finally got it right!

I found a new injector after browsing on realself; her name is Cynthia Silorio at EliteMD in Danville. They have a very nice facility, clean and modern equipment. It was a different experience... at first I showed her the lopsidedness, she was a bit hesitant at first and suggested I go back to my first provider but I told her I had been 3 times already and needed someone else to have a fresh eye... She saw the problem and set expectations, and the lopsidedness is fixed! She also injected some under the corner of the left side of my mouth to lift it up. Once she did that she had a half syringe of Juve left over and offered to even out the job on my lips; she carefully injected to create the 'white roll' that was missing on the bottom, and evened out the top lip. They look great now! After the injections were done they gave me this Arnica product called Sinecchi; you take a capsule immediately after the injections and then 3 more every 6 hours. I liked this a lot better than the granules. She remarked that I was a 'bruiser' so not much I could do except take the Arnica and use my Vitamin K cream twice a day.

I want to talk about the use of Lidocaine in the injection protocol. My first provider injected lidocaine on all the sites before the filler; my second injector did not. Her rationale is that Juvederm already has lidocaine in the filler mix; and also extra injections mean extra risk of bruises and believe me I would much rather take a millisecond of pain while the needle is inserted than an extra bruise to nurse over a week or two, not to mention the risk of discoloration... well she is right; my face and lips only had slight swelling, just 2 small bruises on my face and my lips are a little bruised. This compared to the Frankenstein face I had the first time, not to mention the icky side effects I had from all the lidocaine that was shot into my face. I will never accept lidocaine injections again, they aren't necessary for me and I will happily trade a little pain for less bruises. This completes my Juvederm review! Hopefully it will help others who are considering this treatment.
Walnut Creek Dermatologic Surgeon

Dr. Lee was very thorough in her explanations. She took lots of time doing the injections, the whole process seemed very artistic to me. However I had to go back twice after the first appointment and I still didn't have a satisfactory result; I ended up visiting another injector (Cynthia Silorio NP) who successfully achieved the improvements I was looking for.

3 out of 5 stars Overall rating
4 out of 5 stars Doctor's bedside manner
4 out of 5 stars Answered my questions
3 out of 5 stars After care follow-up
3 out of 5 stars Time spent with me
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
2 out of 5 stars Wait times
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