- 1 Noninvasive dermal fillers for a more youthful you
- 2 The Reflections difference — our skilled physicians
- 3 Dermal fillers for lines, creases, and folds on the face and around the eyes
- 4 Dermal fillers for lip augmentation
- 5 What areas of the lip can be enhanced?
- 6 Dermal fillers for the hands
- 7 Dermal fillers for the chest
- 8 Dermal fillers for sunken scars
- 9 Frequently asked questions about dermal fillers
- 9.1 Why choose Reflections for dermal fillers?
- 9.2 Are you a licensed physician?
- 9.3 What are the best fillers for my goals?
- 9.4 What happens during treatment?
- 9.5 How do dermal fillers work?
- 9.6 How much filler will you be injecting, and in what areas?
- 9.7 Do filler injections hurt?
- 9.8 How long will my results last?
- 9.9 Is there downtime after filler injections? What are the most common side effects?
- 9.10 What should I do before treatment?
- 9.11 How do I fix the lines around my mouth?
- 9.12 Will laser treatments affect the longevity of my filler?
- 9.13 How often will I need to return to maintain my results?
- 9.14 What if I don’t like how my treatment looks?
- 9.15 Experience the best of dermal fillers at Reflections
Natural, beautiful, you.
Our conservative approach to dermal fillers works to first correct aging and asymmetry, and then to highlight your natural beauty. We emphasize proportional beauty, enhancing your natural features using techniques that are indetectable but profound.
BEFORE & AFTER PHOTOS
“This was my first experience with Botox/Dermal fillers and I was very nervous…They really took their time and the results were exactly what I was looking for. I would definitely recommend Reflections, especially if you’re going for a natural look.”
–Lisa M. from Andover, NJ on Yelp
Noninvasive dermal fillers for a more youthful you
As we age, our faces begin to deflate as our bodies produce less and less collagen and elastin, the magic stuff that gives our skin its supple, youthful look. This leads to the formation of fine lines, wrinkles and an overall loss of volume in the mid-face, which can, in turn, create all sorts of problems, from deep nasolabial folds between the nose and mouth, to hollowed-looking eyes, or sagging jowls.
Dermal fillers are an ideal way to address the creases, volume loss and hollowing in the skin that occurs naturally with age. Dermal fillers can also be used to enhance the volume and shape of the lips, and restore a more youthful appearance to the neck, chest, and hands.
The Reflections difference — our skilled physicians
Our physicians have performed tens of thousands of treatments and are highly skilled in using every type of dermal filler on the market — it’s what they do all day long. They utilize leading edge injection techniques and the latest innovations like the non-needle cannula, which dramatically reduces the risk of bruising and is far more comfortable than traditional needles. They even teach these advanced techniques to dermatologists and plastic surgeons.
Our doctors’ competence and aesthetic vision is critical to ensuring that the procedure will result in an attractive, natural looking result. You won’t look “done” when you leave our office, you’ll just look terrific. These great results can be yours in just one short visit to Reflections.
Dermal fillers for lines, creases, and folds on the face and around the eyes
There are many dermal fillers available today, each with specific uses in the face. They can be used to:
- Add the lost “apple” volume back to your cheeks, diminishing the creases around the mouth and lifting sagging jowls
- Minimize the appearance of nasolabial folds, i.e., smile lines, running from the bottom of the nose to the corners of the mouth
- Fill in horizontal lines on forehead and the vertical “11’s” between the eyes
- Smooth out the tear troughs running from the inner corners of the eyes down to the mid-cheek
- Add lost volume back to the under eye area, reducing the “hollowed out” look
- Address the “crows feet” around the eyes
Our skilled doctors are experienced with a wide range of fillers and will choose the filler (or fillers — sometimes we use more than one type) that will leave you looking fabulous.
Juvederm Voluma was specifically formulated to add volume back to the cheeks, an area where volume loss due to aging can have a profound effect on the entire face, from lines around the mouth, to sagging jowls to hollows under the eyes. This unique dermal filler uses VYCROSS™ technology to provide added lift and longevity, lasting for up to two years. Voluma is only available in the offices of select expert physicians, like those found at Reflections6.
Restylane is the most well known dermal filler in the United States, renowned for its safety, efficacy and long lasting results. Restylane will immediately soften lines and wrinkles seen with aging, such as the nasolabial folds and tear trough lines. It’s also a great choice for enhancing natural features such as the lips or cheeks. Results last for nine to twelve months, and longer with repeat visits. Some patients find comfort in the fact that Restylane is made from hyaluronic acid, which closely resembles the same naturally occurring substance in the body, and can be dissolved after it’s injected with a substance called hyaluronidase8.
Juvederm Ultra™ and Juvederm Ultra Plus™ consist of a smooth gel that when injected instantly restores skin’s volume and smooths away facial wrinkles and folds such as the nasolabial folds. The hyaluronic acid in Juvederm supplements the body’s natural supply of this substance. Juvederm comes in two formulations, Juvederm Ultra and Juvederm Ultra Plus. Ultra Plus is more robust, giving us the ability to better treat deeper folds and wrinkles, and may last a bit longer. Juvederm can last up to one year after the first treatment, and longer after repeated treatments7.
Radiesse is a leading edge dermal filler used for the correction of facial lines, wrinkles and folds, as well as for facial contouring and enhancing volume in the cheeks. Radiesse works by stimulating the body to produce collagen, a building block of youthful skin. Safe and effective, it lasts longer than the hyaluronic acid fillers on the market today. Radiesse is FDA-approved for cosmetic use and is well known for immediate satisfaction and long term results of 12 months5.
Belotero Balance® is an injectable dermal filler specially formulated to inject superficially into the skin, making it ideal for fine lines around the mouth and eyes, and the tear troughs that run from the inner corners of the eyes down to the middle of the cheeks. The results are immediate and last from nine to 12 months1.
Sculptra™ is a synthetic material that is injected below the surface of the skin to create a fuller, smoother, more youthful looking appearance. It provides a gradual and significant increase in skin thickness, improving the appearance of wrinkles, folds and sunken areas in the face. It is provided in a series of three monthly treatments and lasts for years11.
Bellafill™ is a dermal filler FDA-Approved to smooth out scarring indentations caused by acne. This collagen-based filler provides a natural, soft result that lasts for 5 years2,3,4.
Dermal fillers for lip augmentation
Everyone wants full, sexy, kissable lips, and now you can have them! If aging, heredity or dental problems have left you with thin or flattened lips, we can remodel them to a youthful, sexy shape. Our philosophy at Reflections is to give a more aesthetically pleasing appearance to the lips, ensuring that they look perfectly natural — not overdone!
Restylane and Juvederm are two of the most popular dermal fillers available today to restore and enhance lips volume and shape. These fillers offer very short recovery time and in the hands of the highly skilled physicians at Reflections, you’ll get natural looking, long lasting results.
We pre-mix our fillers with a touch of lidocaine to make the procedure comfortable. During the treatment, the physician will regularly hand you a mirror to get feedback regarding the appearance and size of your lips. Amazingly, the entire process takes about 15 minutes.
What areas of the lip can be enhanced?
We will determine the best approach to enhancing your lips based on your treatment goals, your anatomy, and your age.
The vermilion border, the junction between the white and red part of the lips, is an important area to treat with dermal fillers. By injecting this region, we can define the lip border better, similar to wearing lip liner. This can also help with lines that cross through this area. To increase the volume we inject the body of the lip (red area). This can create a pouty look and avert the lip outwards so that more of red shows. As a general rule we would like the bottom lip to be one and a half times the size of the upper lip (or 40/60, upper to lower lip), though we can create other proportions, if the patient requests (a lip ratio of 1:1 is more popular in Latin America, and can create a beautiful, natural lip profile for many patients).
The oral commissures are located in the corners of the mouth. This area usually increases in size with age. Filling this area turns the corners of the lips horizontally, or even upwards creating a more positive and happy appearance.
Shape and curve
The philtrum consists of the two lines in the center of the upper lip that connects to the nose. By enhancing this double-ridge, it is possible to give the upper lip more shape and curve, enhancing the sensuality of the lips.
The cupid’s bow or the V-shaped area in the center of the upper lip can also be enhanced with dermal fillers. Done in conjunction with the philtrum, it can achieve a pleasant overall shape to the upper lip.
Dermal fillers for the hands
Are your hands making you look older than you are? Many women take great care of their faces from an early age but neglect their poor hands, which are subjected to sun damage, harsh chemicals, and inclement weather. All of this can add up to volume loss, making the tendons on the backs of the hands stand out (and making them look like they belong on a much older woman).
We’ve done this treatment countless times — we even did it on NBC’s Today show!
Radiesse can solve this problem. It’s gently injected into the area between the over-prominent tendons and then massaged into place, giving the hands a fuller and smoother appearance — no more “granny hands!”5. We can also help get rid of fine lines and freckles from sun exposure with a laser treatment if your hands require it.
Dermal fillers for the chest
After the face and hands, the delicate skin on the chest gets the most UV exposure, whether from wearing low-cut blouses or the angle at which it greets the sun when in a swimsuit.
Visible signs of sun damage — sunspots and craggy lines in the skin — start to appear around age 30-35 and without intervention become severe by age 50. The sooner we treat these areas, the better the cosmetic outcome.
Belotero Balance, with its ultrafine structure, is perfect for filling in the lines and little crevices on the chest. It can also be combined with laser treatments to take care of pigment and texture issues1.
Dermal fillers for sunken scars
Sunken scars due to accidents, acne scars, and everything in between can be made less apparent with a little help from dermal fillers. A small amount of filler is placed under the depressed area of skin, stimulating the formation of collagen, which adds volume to the area and lifts it to the same height as the surrounding skin. Often this is done directly after a technique called Subcision. Subcision uses a blunt-tipped instrument to gently break up the tethered scar tissue that holds those deep scars to the fascia below. Breaking up this old scar tissue releases the skin. Then dermal fillers can add support from below. To make a scar look even better, we have laser treatments that can resurface the skin and reduce the appearance of redness.
Bellafil has been FDA-Approved to provide correction for sunken acne scars and the results can last for 5 years or longer2,3,4. However, other dermal fillers are also a safe option for this treatment, and may offer different results that may be more suited to your needs, depending upon the types of scarring you have and results that most matter to you. Your experienced physician injector will help you select a filler that provides you with the best results, and suits your lifestyle and health needs.
Frequently asked questions about dermal fillers
Why choose Reflections for dermal fillers?
Choosing the right facility and physicians to perform your dermal filler treatment can make the difference between looking naturally great and looking “done” (or worse). It’s important to find a medical practice where only physicians perform injections (in New Jersey it is illegal for any non-physician to inject dermal fillers, including advanced-trained nurses), and one that uses many different dermal fillers, as each is better for different areas of the face and certain cosmetic concerns (some practices use one filler everywhere, with less than stellar results).
Are you a licensed physician?
Licensing and certifications for dermal fillers and other cosmetic treatments can be really confusing, so we’ll break down the details in a separate blog, but the answer is yes, our physician injectors are licensed to perform dermal filler injections, and they each have several years of experience doing so. Currently, only physicians inject fillers at our practices, because we want to ensure our patients have the safest experience possible, and achieve the best results possible.
At Reflections, only experienced physicians inject fillers, and we use every major FDA-Approved filler on the market. We are also preceptors for the largest manufacturers, which means we teach advanced filler techniques to other physicians like dermatologists and plastic surgeons.
It’s also important to look for a practice like ours that performs these treatments all day long — you don’t want a doctor who dabbles in dermal fillers to be warming up on you! We honestly aren’t trying to toot our own horn here, but it’s important to do a little research and find a facility with the skill and the tools to treat you right. You can double-check the experience of your provider by asking to see their awards from the manufacturers of each dermal filler. Galderma (makers of Restylane, Sculptra, and Dysport), Allergan (makers of Juvederm, Kybella, and Botox), and Merz (makers of Xeomin and Radiesse) all award physicians based on skill and experience.
What are the best fillers for my goals?
The best filler for your goals will likely be different from the best filler for your friend’s goals, even if you both want to treat the same area. The reason for this is that each person is unique, the changes occurring under your skin are different, and in order to make your results as natural-appearing as absolutely possible, we will need to use different types of filler for different treatment areas and different patients. This is why our practice stocks every single kind of FDA-Approved Dermal Filler, and we regularly use each of them, so that we are always able to grab just the right thing for you. We provide complimentary in-person consultations with our physician injectors, to ensure patients get the assessment and guidance they need in order to make an informed decision about their filler treatment.
What happens during treatment?
Using an ultra-fine needle or a smooth-tipped cannula, dermal fillers are injected into the skin. The physician will massage the treatment area then continue injecting the filler along the length of the wrinkle or fold until the maximum correction has been achieved. We blend lidocaine into all of our dermal fillers to reduce bruising and make for the most comfortable treatment experience possible.
How do dermal fillers work?
here are basically 7 types of fillers, and each type works a little differently: Hyaluronic Acid (Juvederm, Voluma, Volbella, Vollure, Defyne, Reyne, Silk, Lyft, Belotero, Restylane) Calcium Hydroxylapatite (CaHA) (Radiesse) Poly-L-Lactic Acid (Sculptra) Collagen with polymethyl methacrylate (PMMA) beads (Bellafil)
Collagen Fat Transfer Illegal Substances (including silicone) Hyaluronic acid fillers are by far the most common. They provide soft, natural results as the molecules of filler attract and bind water molecules in the skin, stimulating the production of collagen. The volume beneath the skin increases, restoring a smoother, more youthful appearance. The body metabolizes and absorbs the injected hyaluronic acid over time.
Hyaluronic Acid fillers have an antidote of sorts, called hyaluronidase, which is very helpful in our practice when patients come to see us upset about how their results from another practice turned out.
Calcium Hydroxylapatite (CaHA) (brand name: Radiesse) and Poly-L-Lactic Acid (brand name: Sculptra) are solutions injected under the skin to stimulate collagen. They can be used to create stiff volume, which is useful for contouring bony areas of the face, or to smooth, firm, and tighten the skin, which can reduce wrinkles and cellulite. They have also even been used in butt augmentation. Collagen is a more permanent filler, and we tend to avoid is because our bodies are not permanent things – they change over time, and so it can be very difficult to create a result with these that will not look unnatural as the body around it changes with time. There are, however, situations where we do make use of these products. Fat transfer is a method of transferring your own fat, usually taken from your abdomen or love handles, to create a very natural and long-lasting result. Finally, illegal substances such as silicone are often to blame for the worst filler results – the disfigured and seriously ill patients you sometimes see on the news. It’s important to be an educated consumer because there are people out there who don’t know what they’re doing (or at least we hope that’s the case). Our physicians provide free in-person consultations where we educate the patient about what’s possible, what’s safe, and what their options are. Please feel free to schedule an appointment, at the very least you’ll walk away with the knowledge you need to stay safe.
How much filler will you be injecting, and in what areas?
The number of syringes of filler you’ll need will vary quite a bit by patient. We’re going to make a video and write a blog for you guys about this, because it’s probably the question we get asked the most in our DM’s these days, and it’s too complex to cover in detail here. The short answer is: we need to see you for a consultation in order to be able to answer that.
Here are some ballparks you might find helpful:
- Lips generally take only 1 syringe of filler, but sometimes 2-3 are needed to achieve bigger changes
- Cheeks generally need 1-2 syringes for a noticeable difference, but most patients over 45 will be happiest with 2-5 syringes
- Under eyes tend to need 1-2 syringes, but if the cheeks are involved, that number goes up
- Smile lines (nasolabial folds) can generally be improved with 1 syringe, but if the cheeks are very heavy you will need to fix those in order to get the best result
Do filler injections hurt?
We use numbing injections that can be customized to your preference to ensure the treatment is as comfortable (and numb) as you would like. Most fillers either come mixed with lidocaine, or we mix them with lidocaine prior to injection. Lidocaine is a numbing agent that’s very similar to what a dentist gives you prior to filling a cavity. Since a dentist injects that medicine directly into your nerve bundles, you feel nothing of a cavity being filled. This is called a nerve block, and we’re happy to do that for you if you really don’t want to feel anything. However, by putting the lidocaine in with the filler, we’re able to avoid those additional injections for numbing, and this lower dose of lidocaine wears off much faster, so you’re not fully numb for several hours after. This is the numbing most patients prefer, but again, we can customize this to your preference.
How long will my results last?
Although it varies by patient and depends on the particular dermal filler used, results from dermal filler injections are immediate and typically last for six to 24 months, depending upon the filler used and the area treated. Most patients report that the area treated continues to look improved even after the filler has been fully resorbed.
Is there downtime after filler injections? What are the most common side effects?
Immediately following the injections, you may experience:
- Minor redness generally lasts no longer than 1 hour, and for most patients, this dissipates before they leave the office (15 minutes)
- Swelling generally increases for the first 24 hours, before resolving within 48-72 hours. Certain areas swell much more, like the lips, and other areas don’t tend to swell at all, such as the temples.
- Tiny scabs may also form at the injection sites, though this doesn’t happen for most patients. It’s more common when a cannula is used. Don’t pick the scars, but you can apply makeup over them. They generally don’t last beyond day 2.
- Bruises are thankfully not that common in our patients (we take some measures to reduce our bruise rate because we know it’s what our patients worry about the most). If you do end up with a bruise, please call and let us know. We can do a laser treatment that will break the bruise up, and this makes the bruise dissipate in just a couple of days (vs. having to cover it with makeup for a week or longer).
These symptoms typically disappear within two to three days. Allergic reactions are extremely rare. There is no need for bandaging and most patients are able to resume normal activities immediately following the treatment., even if they’re going back to work and don’t want their coworkers to know.
What should I do before treatment?
Avoid aspirin, ibuprofen, Vitamin E, fish oil, and other blood thinners for at least a week before treatment.
How do I fix the lines around my mouth?
Many physicians will treat the nasolabial folds directly instead of addressing the root of the problem. At Reflections, we find that many times these folds of skin from the bottom of your nose to the corners of your mouth are caused by an overall loss of volume in the cheeks, which droop down and create problems. By addressing this volume loss in the cheeks, we re-contour the face, lifting the skin and making the folds disappear. The best fillers for replacing volume in the apples of cheeks, to create this kind of lift, are Juvederm Voluma and Restylane Lyft. This is usually a better solution than adding filler to the folds themselves, as doing so can make the area around the mouth look unnatural.
Will laser treatments affect the longevity of my filler?
Laser treatments will not shorten how long the results of your dermal filler treatment will last. Many patients get terrific results combining the two.
How often will I need to return to maintain my results?
Some fillers last forever, but most do not. Most fillers create results that last 6 months to 24 months, meaning you’ll want to schedule maintenance appointments to ensure your results remain excellent over time. There are a couple of things you can do to improve the longevity of your results, in fact, we made a video about it. Check it out here: https://www.reflectionscenter.com/maximize-botox-and-fillers-results/
What if I don’t like how my treatment looks?
Fillers made from hyaluronic acid can be dissolved using a substance called hyaluronidase. The following fillers are hyaluronic acid fillers which can respond to hyaluronidase: Belotero, Restylane, Restylane Silk, Restylane Lyft (previously Perlane), Juvederm, and Juvederm Voluma. Sculptra, Radiesse, and Bellafill are not hyaluronic acid and are not able to be dissolved.
Experience the best of dermal fillers at Reflections
Our experienced physicians have the skill and resources to create the best possible dermal filler treatment plan for you. We promise natural, long-lasting results that you’ll love!
1. Lorenc, Z. Paul M.D.; Fagien, Steven M.D.; Flynn, Timothy C. M.D.; Waldorf, Heidi A. M.D.; Clinical Application and Assessment of Belotero: A Roundtable Discussion; Plastic & Reconstructive Surgery: October 2013 – Volume 132 – Issue 4S-2 – p 69S–76S doi: 10.1097/PRS.0b013e31829a0bfc
2. Gottfried Lemperle, et. al., ArteFill® Permanent Injectable for Soft Tissue Augmentation: I. Mechanism of Action and Injection Techniques., Aesthetic Plast Surg. 2010 Jun;34(3):264–72.
3. Jacob CI, Dover JS, Kaminer MS. Acne scarring: A classification system and review of treatment options. J Am Acad Dermatol; July 2001; 109-117.
4. Cohen et al. Artecoll: A Long-Lasting Injectable Wrinkle Filler Material: Report of a Controlled, Randomized, Multicenter Clinical Trial of 251 Subjects. Plast. Reconstr. Surg. 114: 964,2004.
5. Radiesse Injectable Implant – P050052/S049 – FDA Clearance issued June 4, 2015
6. Juvederm Voluma FDA Clearance: http://www.fda.gov/ucm/groups/fdagov-public/@fdagov-afda-adcom/documents/document/ucm349428.pdf
7. Juvederm FDA Clearance http://www.accessdata.fda.gov/cdrh_docs/pdf5/p050047a.pdf
8. Restylane FDA Clearance http://www.accessdata.fda.gov/cdrh_docs/pdf4/p040024s051a.pdf
9. Restylane Lyft FDA Clearance http://www.accessdata.fda.gov/cdrh_docs/pdf4/P040024S073a.pdf
10. Restylane Silk FDA Clearance http://www.accessdata.fda.gov/cdrh_docs/pdf4/P040024S072c.pdf
11. Sculptra FDA Clearance http://www.accessdata.fda.gov/cdrh_docs/pdf3/p030050a.pdf