FILLERS
EVERYONE WILL NOTICE. No one will know
Add volume to LIFT and contour the cheek area for up to 2 years.
Add subtle volume to the lips and SOFTEN the appearance of vertical lip lines for up to 1 year.
Add the desired range of fullness to PLUMP the lips for up to 1 year.
Add subtle volume to SMOOTH moderate to severe facial wrinkles and folds for up to 18 month.
Add volume to FILL moderate to severe facial wrinkles and folds beyond 1 year
Correct moderate to severe facial wrinkles and folds for up to 1 year.
Please visit our instagram for many before and after pictures.
Dr. Izadi's actual patient, subject to copyrights
Dr. Izadi's actual patient, subject to copyrights
Dr. Izadi's actual patient, subject to copyrights
Dr. Izadi's actual patient, subject to copyrights
Infomation from the FDA
The FDA is warning health care providers and patients not to use any Juvederm Ultra 2, 3 or 4, because these products are not approved for use in the U.S. As such, the safety and effectiveness of these products cannot be assured. A list of approved products and indications for use in the U.S. can be found in the table below.
The FDA has NOT approved liquid silicone or silicone gel for injection to fill wrinkles or augment tissues anywhere in the body.
These days, people across the country are seeking treatments to smooth smile lines and crow’s feet and to plump up their lips and cheeks.
One treatment involves injecting dermal fillers into the face. In studies of dermal fillers approved by the U.S. Food and Drug Administration, people generally report they are satisfied with their treatment results.
But injectable dermal fillers are not for everyone and may not be indicated for people with certain conditions (such as bleeding disorders or certain allergies). If your health care provider confirms that dermal fillers are an option for you, know that all products have benefits and risks. The FDA advises you to work with a licensed health care provider and to understand all of the risks and benefits before receiving treatment. (See more safety tips below.)
What are dermal fillers, and how are they used?
In general, injectable dermal fillers are intended to help fill in wrinkles and give a smoother appearance. They are generally injected into the skin with a needle and are regulated by the FDA as medical devices.
Temporary fillers include the following materials:
• Collagen injections, made of highly purified cow or human collagen
• Hyaluronic acid gel, a protective lubricating gel, produced naturally by the body
• Calcium hydroxylapatite, a mineral and a major component of bone
• Poly-L-lactic acid (PLLA), a biodegradable, biocompatible, synthetic material
These products are used for correcting soft tissue defects in the face, such as moderate to severe facial wrinkles and skin folds, lip and cheek augmentation, and to restore or correct the signs of facial fat loss in people with human immunodeficiency virus (HIV). An FDA approved dermal filler is also used to fill in the back of the hand.
Most FDA-approved fillers are temporary and achieve a smoothing or “filling” effect, which lasts for about six months or longer in most people. (These injectable dermal fillers are temporary because the body eventually absorbs them.)
That said, not all products have been approved for every indication. You can find specific information on each product by reading the FDA’s list of approved dermal fillers.
The FDA has approved only one permanent wrinkle filler, which contains “polymethylmethacrylate” beads. These are tiny round, smooth, biocompatible plastic particles that are not absorbed by the body. The filler is FDA-approved only for correcting facial tissue around the mouth.
Although the FDA has approved certain injectable dermal fillers for use in the face (for example, to enhance lips and cheeks) and the hands, the FDA has never approved any injectable fillers for large-scale body contouring or enhancement.
That means you should never get an injectable filler intended as a breast filler, “butt filler,” or muscle filler. And you should never get any type of injectable filler for any other large-scale body contouring or body enhancement.
Dermal fillers are not FDA approved for large-scale body contouring and can lead to serious injury, permanent scarring or disfigurement, and even death. (Read “The FDA Warns Against Injectable Silicone for Body Contouring and Enhancement” to learn more.)
What are the risks of FDA-approved fillers?
Remember to work with a licensed health care provider to ask what you can expect for FDA-approved fillers. Then contact your health care provider if you are concerned about a particular side effect.
The most common side effects include:
• bruising
• redness
• swelling
• pain
• itching
Additional side effects less commonly reported include:
• infections • lumps and bumps • discoloration or change in pigmentation
• infections • lumps and bumps • discoloration or change in pigmentation
Rare but serious risks include:
• scarring, blurred vision, partial vision loss, and blindness if the dermal filler is inadvertently injected into a blood vessel. It is recommended that health care providers take care to avoid injection into blood vessels (especially around the forehead, nose and eye area) for these reasons.
• allergic reaction that may lead to a severe reaction (anaphylactic shock) that requires emergency medical help.
Most side effects occur shortly after injection and go away within two weeks. In some cases, side effects may emerge weeks, months, or years later. Talk to your licensed health care provider if you have questions or concerns.
5 Tips for Consumers About Injectable Dermal Fillers
- ALWAYS work with a licensed health care provider who uses properly labeled, sealed vials for treatments. You also can ask to confirm that you are receiving an FDA-approved filler. And never get injectable fillers from unlicensed providers or in non-medical settings like hotels or private homes.
- ALWAYS request and read the patient labeling information on FDA-approved injectable wrinkle fillers from your licensed health care provider.
- ALWAYS know the type of product to be injected and all of its possible side effects. Know where each product used is to be injected. Talk to your licensed health care provider if you have any questions.
- NEVER buy dermal fillers on the Internet. They may be fake, contaminated, and/or harmful.
- NEVER get any type of filler or liquid silicone injected for body contouring. This means you should never get breast fillers, “butt” fillers, or fillers for spaces between your muscles. These products, which include certain types of injectable silicone, can be dangerous and can cause serious injury and even death.
Also know that the safety of these products is unknown for use in pregnant or breastfeeding women or in patients under 18 years of age. The safety also is unknown if used with Botox or other wrinkle therapies. (The FDA regulates Botox Cosmetic as a drug. See the section below for more information.)
You should discuss the different types of FDA-approved dermal fillers and the results you want to achieve with your licensed health care provider.
Ask your licensed health care provider if you have specific questions.
More About Botox
Botox Cosmetic and other botulinum toxin type A products such as Dysport and Xeomin are indicated to treat wrinkles. Remember that they are injectable drugs but not dermal fillers. They work by keeping muscles from tightening so the wrinkles don’t show as much.
Adverse events reported in clinical trials include facial weakness, eyelid drooping, and brow drooping. Other adverse events included localized pain, swelling, reddening, and bruising at the injection site.
The FDA has approved these products only for the temporary improvement in the appearance of frown lines, forehead lines, and crow’s feet. If you have questions about these products, talk to your licensed health care provider.
Fillers we use at Pristine Wellness Center
- patients should not wear make -up during the first 12 hours after injection
- patients should not take high dose vitamin E, aspirin, anticoagulant for one week prior to the procedure. Patients must not discontinue such treatment without talking to their prescribing physician.
- patients should minimize exposure of the treated area to excessive sun, UV lamp exposure and extreme temperature ( cold weather, sauna) at least during the first 24 hours or until initial swelling and redness has resolved. Exposure to any of the above may cause or exacerbate or extend the duration of temporary redness, swelling, itching at the treatment area.
- patients should notify the provider if any of these occur:
1.RHA collection of fillers:
There are 4 different type of RHA fillers:
A. Redensity ( RHA collection of fillers #1) : contains Hyaluronic acid with a concentration of 15 mg/g obtained from b acterial fermentation using Streptococcus equi bacterial strain, crosslinked with BDDE ( 1,4-butanediol diglycidyl ether) and reconstitued in a physiological buffer ( PH =7.3) and 0.3% lidocaine to reduce pain.
Indication: correction of moderate to severe perioral rhytids, in adults aged 22 and older.
Duration of Effectiveness:
More than 90% of patients reported to be satisfied 8 weeks after treatment and the rate of satisfaction remained at more than 88% at one year.
The hyaluronic acid gel is created via bacterial fermentation of the Streptococci culture in a sterile laboratory environment. Hence, there is very small risk of disease transmission.
Nevertheless, certain groups of people are advised not to use this skin treatment due to an inadequate safety profile status, including:
People with gram-positive bacteria allergy;
People with hypersensitivity to hyaluronic acid and/or lidocaine;
People with a tendency to develop hypertrophic scars;
People with a history of anaphylactic shock;
Children;
People who are pregnant or breastfeeding.
patients suffering from untreated epilepsy.
Injection of filler in the temple area, makes the face look younger and helps to open the eyes and lift the eyebrows. Injection deep in the temple area is a very dangerous injection and should only be done by experts with adequate experience and training. If this injection is done by newbies, it can cause blindness. This beautiful lady had RHA filler in her temple, nasolabial folds, lips and marionette lines.
Dr. Izadi's actual patient, subject to copyrights
COMMON SIDE EFFECTS for all RHAs : ( these side effects might last from 3-14 days)
Pain: 27%
Redness: 33%
Swelling: 74%, might use ice pack for 10-15 min and be careful not to cause thermal injury since lidocaine already numbed the skin.
Firmness: 54%
Lumps, Bumps: 58%
Bruising: 78%
itching16%
Discoloration: 48% (Tyndall effect)
These effects should only last for up to 7 days I advise to avoid situations or places with extreme temperatures like direct sunlight, saunas, tanning sessions, and freezing temperatures. Drinking alcoholic beverages and performing strenuous exercise must also be avoided until the skin has healed completely.
contraindications for all RHAs:
Women who are pregnant or lactating
People with known hypersensitivity to lidocaine
People with known hypersensitivity to hyaluronic acid and/or gram positive bacteria
People who are inclined to get keloid scars
people with severe allergies , history of anaphylaxis or multiple severe allergies
Use with caution in patients on immunosuppresive medications.
Not for: Forehead wrinkles; Blood vessels; Inflamed/infected areas (e.g. broken skin, herpes, acne, rashes);
Areas where a permanent implant has been placed. Any recent aesthetic procedures (e.g. laser treatments, chemical peels), allow the skin to heal before the filler treatment.
B. RHA collection of fillers #2:
C. RHA collection of fillers #3:
D. RHA collection of fillers #4:
contains Hyaluronic acid with a concentration of 23 mg/g obtained from b acterial fermentation using Streptococcus equi bacterial strain, crosslinked with BDDE ( 1,4-butanediol diglycidyl ether) and reconstitued in a physiological buffer ( PH =7.3) and 0.3% lidocaine to reduce pain.
Indication: correction of moderate to severe dynamic facial wrinkles such as nasolabial folds, in adults aged 22 and older.
89.2% of all patients showed effectiveness of the treatment up to 16 months.
We may need up to 3 ml on each NLF to replace volume but the injection of more than 6 ml at a time is not supported by any studies and the safety of injection more than 6 ml for each treatment is not studied.
Fillers from Galderma, Sweden ( Perlane collection)
Restylane Lyft : 20 mg/ml HA, increase volume in mid-face, cheeks, temple area, jaw line).
Restylane Lyft with Lidocaine, formerly known as Perlane-L, is another amazing product from the Restylane dermal fillers family manufactured by Q-Med.
It is a transparent, injectable, dermal filler gel for anti-aging cosmetic treatments. Its main ingredient is of Non-Animal Stabilized Hyaluronic Acid (NASHA) origin. The hyaluronic acid in this product comes from fermenting streptococci bacteria, which makes it safe to use, with no prior allergy tests needed.
COMMON REACTIONS
- Redness
- Swelling
- Bruising/Pain
- Headache
- Itching
- Tenderness
- Light Bleeding
The chances of severe side effects are very rare, and they usually occur if the product is injected into a blood vessel.
RARE SIDE EFFECTS:
- Vision Abnormalities
- Stroke
- Permanent Scarring
- Temporary Scabs
Dr. Izadi's actual patient, subject to copyrights
Restylane Kysse: 20 mg/ml HA for lip injection.
Restylane Kysse’s hyaluronic acid-based formula instantly binds to water molecules in the lip tissue. This works to restore the lips’ lost volume and rehydrate them, giving a revitalized look. Plus, its lidocaine content helps to numb the lips, making the experience more comfortable.
After treatment, the patient should avoid exposure to both extreme heat and extreme cold until all signs of inflammation have disappeared. Additionally, laser treatments, chemical peeling, and other treatments that elicit an active dermal response may cause inflammation at the injection site. Patients should not undergo these procedures after injecting Restylane Kysse, and should be fully healed from them before using this filler.
HOW LONG DOES IT LAST?
The effects may last between 6 and 9 months. However, results may vary from patient to patient.
The use of Restylane Kysse may result in minor injection-related reactions, including swelling and pain. However, these side effects generally resolve themselves within one week post-injection.
OTHER COMMON SIDE EFFECTS INCLUDE:
- Bruising
- Erythema
- Itching
- Tenderness
POSSIBLE ADVERSE EFFECTS INCLUDE:
- Blindness
- Cerebral Ischemia/Haemorrhage
- Skin Necrosis
sculptra:
Sculptra is an injectable soft tissue filler derived from poly-L-lactic acid (PLLA) and is manufactured by Galderma.
This PLLA-based filler is non-toxic, biodegradable, and synthetic, and is intended for the correction and restoration of lipoatrophy, wrinkles, and facial volume.
Use Sculptra to help correct fine to deep wrinkles and folds. Skin depressions in lower-half of the face, particularly nasolabial folds (the deep creases from the nose to the mouth). As well, use this cosmetic filler to improve volume loss around the jawline, cheeks, temple, and pre-jowl fold.
As the skin ages, skin health diminishes due to intrinsic and extrinsic aging. After the age of 20, collagen production in the skin reduces by 1% each year—which means your needs will also change over time. External factors will intensify intrinsic aging, also causing a drop in collagen production. As well, the elastin and hyaluronic acid production rate is also affected, and wrinkles and lines start to appear. Aging skin loses collage, subcutaneous fat and even bony structure, ending up with lost volume.
Sculptra aims to fight these aging signs by stimulating collagen production in the skin. The PLLA compound promotes collagen production. Since the filler works deep within the skin, the desirable effects can be delayed but gradual natural looking skin will be achieved eventually.
The initial result of the treatment gives the area a full look due to the water content of the injection. This fullness will reduce within a few days after the procedure, although the full effect may not be evident for a few weeks.The follow up visit is in one month to evluate for any added filler.
The results can last up to 2 years after the initial session.
Sculptra is generally considered safe but there are some contraindications for certain groups of people, including pregnant or lactating women and anyone with a hypersensitivity to any the Sculptra’s components.
Patients can experience common injection-related side effects:
- Swelling
- Tenderness
- Localized Redness
- Itchiness
- Transient Bleeding
- These side effects generally resolve themselves within 2–6 days after the procedure.
RARE ADVERSE EFFECTS:
- Nodule Formation
- Injection Site Infection
- Hypertrophy
- Skin Sarcoidosis
Fillers from Merz pharmaceuticals, Germany:
Belotero Soft: is a transparent and colorless cross-linked hyaluronic acid gel formulated using Dynamic Cross-Linking (DXL) Technology and Cohesive Polydensified Matrix (CPM) Technology. These patented technologies allow the filler gel to have an ideal balance of stability and fluidity. The hyaluronic acid concentration is 20mg/ml. It also contains lidocaine as a quick-acting anesthetic, making treatment less painful.
Indications: under eye filler, Crow’s Feet
Forehead Lines
Perioral Lines
Belotero Soft treatments can last from 6 to 9 months depending on the area treated and amount of gel used. Since the filler gel is bioresorbable, it will metabolize into the surrounding tissues, making the results non-permanent.
contraindications:
- Pregnant or lactating women
- People with recurrent cases of sore throat
- People with bacterial allergies
- People with hyaluronic acid hypersensitivity
- People who are on immunosuppressive drugs
- skin with active inflammatory conditions, like rashes, cold sores, cysts, or pimples.
- It is not recommended to use this skin filler if you have recently had a chemical peel, laser treatment, or other dermal treatments.
Side effects:
- Itching
- Swelling
- Pain
- Redness
RARE SIDE EFFECTS:
- Indurations
- Infections
- Abscesses
Radiesse:
Radiesse is biocompatible and non – allergenic volumizing dermal filler manufactured by Merz Pharma, which is injected into the skin in order to relieve facial folds like wrinkle lines. It contains microspheres of calcium hydroxylapatite, which are suspended in water based gel.
Radiesse is a great choice for correcting facial asymmetries and for facial contouring, softening the lines of the nasolabial folds,contouring of the jaw line, the cheeks and the chin.
Radiesse is perfect for patients that are looking a fast way to re- contour different areas of their face. Besides its power to replace lost volume, it also stimulates the production of collagen, in order to promote a long lasting improvement
Radiesse gel contains calcium hydroxylapatite, which is naturally found in teeth and bones.
The results can last between 12 and 15 months. At the beginning, for the first few months, it works just like any other dermal filler, after a few months, the microspheres of this product encourage the development of your own natural collagen. The body harmlessly absorbs the microspheres, but the new collagen remains, and as a result it provides a long – lasting rejuvenating effect.
COMMON NEGATIVE EFFECTS
Temporary headache
Minor swelling around the injection area
Minor bruising around the injection area
Mild numbness or tingling in the injection area
Temporary nausea
No improvement after undergoing treatment.
After injection:
1.apply cool compress to areas of injection for approximately 24 hours.
2.avoid the sun, tanning (ultraviolet)lights, sauna and intense facial treatments post procedurally.
3. Massage area gently if palpable nodules become present.
4. Promote facial rest for one week by encouraging patients to limit talking, smiling and laughing.
Swelling and numbness is common after the procedure. Swelling will usually resolve within 7-10 days but it may persist for several weeks. Numbness should resolve within 4-6 weeks
