Posts Tagged ‘Restylane’

HOW LONG WILL THAT FILLER LAST?

Wednesday, May 5th, 2010

Richard M. Foxx, MD

Perhaps the most common question patients ask about wrinkle fillers (after “will I look natural?” and “will it hurt?”) is “how long will it last?” And the answer, of course, is it depends upon how you define “lasts.”

Wrinkle fillers are used to minimize the folds that run from the nose to the corners of the mouth, the marionette lines that bracket the chin, and to replace the lost volume in the cheeks. A correction is usually at its peak the first week after it is performed and begins to lose its effectiveness over time in a somewhat linear fashion such that a filler that would be expected to last a year will be somewhat less than half absorbed in six months. Patients who smoke, have a high metabolic rate, or are very athletic will note the volume of their correction will diminish more quickly.

Hyaluronic acid-based fillers such as Restylane® and Juvederm® typically last from seven months to a year. Fillers such as Juvederm are approved by the FDA to last “up to a year.”

The calcium-based fillers such as RADIESSE® are generally thought to last a year or more. There are other, longer-lasting fillers such as ArteFill that will last even longer but those products can have other problems that preclude their use in my office. Products such as Sculptra® are not wrinkle fillers but are, instead, collagen builders and can last up to two years but require at least three initial treatments over a month and a half.

The answer then should always be “it depends.” And the solution, for almost everyone, is to proactively address the longevity issue by replacing the product before it is all gone. There is simply nothing that will make it last longer.

Richard M. Foxx, MD is the Founder and Medical Director of The Medical and Skin Spa in Indian Wells, CA. He may be reached at 760-674-4106 or at drfoxx@medicalandskinspa.com

LIP RESTORATION

Sunday, September 7th, 2008

LIP RESTORATION

Richard M. Foxx, M.D.

As if lips weren’t on our minds enough they jump out at you from countless ads, on the amazing faces of stars from Angelina to Scarlett, and in certain places large deep red lips stare out at you from billboards, newspaper ads, and even on car doors.

No wonder we miss them when they start to leave.

With the passage of time lips lose volume, get smaller and thinner. Eventually the skin around the lips begins to fold up and crinkle and lines began to radiate away from the borders creating the perfect place for lipstick to bleed into. That wonderful Cupid’s bow under the nose, the place where the angel touches you just before you are born, disappears and the compound curve that makes up a youthful lip gives way to a flat line.

If you dreamed there might be an antidote, your dreams have come true. There is now a virtual cornucopia of products, called dermal fillers, that can plump lips and restore lost volume, erase the radial lines and recreate some of the youthful anatomy. But here, as in almost no other aesthetic treatment, it is really caveat emptor, let the buyer beware.

Lips are about volume, to be sure, but more importantly they are about shape. Lips that are enhanced with filler should meet certain definable proportions and should definitely not wind up looking like a trout pout.

For starters, the lower lip must be 1.6 times larger than the upper lip. The area above upper lip should not protrude like a duck’s bill and the rolled edge that marks the border between the lip and the skin of the face should be recreated in a subtle way. And as Cupid’s bow is the defining aesthetic of the upper lip, it should be enhanced naturally, without exaggeration.

To make all of this happen you need a doctor whose aesthetic sense matches yours, an artist rather than a technician, and sometimes the only way to find one is to ask, discreetly, when you see someone suddenly looking more youthful. Chances are you won’t be aware of a good lip correction otherwise. You don’t want lips that flash “I’ve been done” from a mile away and need their own Zip Code.

Ask questions of your doctor. World-renowned Arnold Klein, MD, who holds a dermatology chair in his name at UCLA’s David Geffen School of Medicine spends about 45 minutes on a lip correction and advises patients to be wary of doctors who allot much less time than that.

And stay away from permanent fillers such as silicone or Artecoll in favor of hyaluronic acid fillers such as Juvederm™ or Restylane®.

Properly done, a lip augmentation can be exquisite, the perfect coda to the maturing face.

Doctor Foxx is the Founder and Medical Director of The Medical and Skin Spa in Indian Wells, CA, at Hyatt Grand Champions Resort.  He may be reached at drfoxx@medicalandskinspa.com or at 760-674-4106