What You Need to Know Before Getting Cosmetic Fillers

Serving Denver, Broomfield, Westminster, Boulder, Arvada, and surrounding areas

As the popularity of dermal fillers grows, and more and more clinicians enter the field to provide these services, it is important to take a careful look at who is providing the services before committing to a procedure.

In most states, only an MD can inject dermal fillers, however, in Colorado, both nurses and Physician’s Assistants can also legally perform injections, as long as they are directly supervised by a physician. While some med-spas have inadequately supervised nurses or aestheticians doing the injections, this is not advisable (see Rule 800, Colorado Board of Medical Examiners[1]). Moreover, especially with dermal fillers, you want to achieve the most natural looking results, and that requires skill, experience, and a trained medical eye on the part of the physician.

At Sonata Aesthetics, Dr. Janowski uses three types of dermal fillers. Each is designed to add volume to different areas of the face. In your full consultation, he will work with you to give you his expert opinion about which filler will work best for your particular goals and concerns.

By far, our most popular filler is Juvederm. Juvederm is manufactured by Allergan. In order to ensure that your provider is using Juvederm that is American made and distributed by Allergan USA, make sure your provider is listed as a buyer on Allergan’s website.

Juvederm is a smooth, hyaluronic acid filler appropriate for most areas of the face. Hyaluronic acid is a naturally occurring substance in the body. It can be used to soften folds around the mouth, enhance the lips, lift the corners of the mouth, volumize the under-eye area, and reduce lines and wrinkles almost anywhere on the face.  It comes in two forms:  Ultra and Ultra Plus.  The Ultra Plus formulation is a bit firmer than the Ultra formulation, and will last a bit longer.  Both forms come mixed together with lidocaine for greater comfort during injection. The results of Juvederm last 6-9 month, or even up to 1 year, depending on your particular body chemistry, and where you had the injections.

Only MD’s can purchase dermal fillers, and all dermal fillers come pre-packaged and sealed in prepared syringes. Most syringes are formulated with lidocaine in them. Lidocaine is a local anesthetic, and makes the injections more tolerable, literally numbing the areas as the injection is being performed. (If you have a known lidocaine allergy, please let us know and we can order filler that has not been formulated with lidocaine.)

Our second most popular dermal filler is Radiesse, manufactured by Merz Aesthetics. Radiesse is an ideal filler for facial contouring. Radiesse is a calcium-based filler, appropriate for areas where more volume is needed, or lines are deeper.  It works best in the mid-face area to enhance cheek volume, in the jawline, and in strong nasolabial folds.  Radiesse tends to last longer than other fillers, and has greater collagen-stimulating properties as well.  The filler comes in a generous 1.5cc syringe, so more area can be filled compared with other products.  Lidocaine is mixed with Radiesse prior to injection for increased comfort. The results of Radiesse can last between 9 months and 1 year, again depending on your body chemistry and the location of the injections.

One of the newest dermal fillers is Belotero. Belotero is a new hyaluronic acid filler which has special indications for lip lines (“smoker’s lines”) and fine lines on the cheeks and other areas.  Unlike other fillers, it can be injected very close to the skin surface, allowing for correction of very fine superficial lines.  It lasts between 6 and 12 months, depending on the area. Belotero is also manufactured by Merz aesthetics.

Dermal fillers have very few side-effects, and most people the receive the injections go right back to their daily tasks. You may experience some bruising and swelling around the injection sites. 90% of people report very little to no bruising and swelling, however, those people who tend to bruise easily may experience some bruising and swelling. Additionally, if you are on blood thinners, regularly use Ibuprofen, Aspirin, or alcohol, or have very delicate skin, you may see additional bruising and swelling. Immediately following the injections, we will provide you with ice packs and topical Arnica cream to help reduce inflammation. It is also important to stay well-hydrated before and after the injections.

Many people ask if getting dermal fillers hurts. Most people report little to no pain. Dr. Janowski will numb the treatment area with a topical cream, and for lip injection, with a local pain block (like you receive at the dentist).

Dr. Janowski is also specially trained in the use of micro-canulas for injecting filler. Micro-canulas as thin, flexible, and blunt needles that allow for more precise placement of the product, and less injury to the skin. Most people describe the process as extremely tolerable.

The effects of dermal fillers are immediate, however, because of some sub-dermal swelling, you won’t notice your best results until a week to two weeks following treatment. The product may also feel a little lumpy or bumpy under your skin, but that will soften with a few days. We tell patients to expect their best results two weeks after treatment. We ask patients to return two weeks after treatment for a quick follow-up visit to ensure they received the best results.

Additionally, hyaluronic based fillers – like Juvederm and Belotero can be dissolved by a skilled doctor, so if you don’t feel your results are perfect, they can be corrected.

Allergan and Merz, the manufacturers of dermal fillers, report more than a 90% satisfaction rate with dermal filler, and our patients report feeling fresher, younger-looking, and extremely pleased with their results.

[1]Rule 800, Colorado Board of Medical Examiners, Section VI. A.: The Board finds that the delegation of medical services in the area of Medical Aesthetic services involves a broad range of changing technologies and practices, and it is an area in which insufficient personal and responsible delegation and supervision of medical services has led to public safety concerns in Colorado and nationwide….Representatives of the Colorado Officer of Barber and Cosmetology Licensure have appeared before the Board on more than one occasion to address public safety concerns stemming from improper or inadequate physician delegation of medical aesthetic services, poor outcomes and the difficultly in identifying whether appropriate equipment is used in this field under appropriate supervision. Section B. Medical Aesthetics Services are medical services in the cosmetic or aesthetics field that constitute the practice of medicine. Such Medical-Aesthetic services include, but are not limited to: (1) the use of a laser, radio-frequency device, intense-pulse light, or other technique that results in the revision, destruction, incision, or other structural alteration of human tissue and/or for hair removal; and (b) the performance of injections of Botox, Collagen, Restalyne, or any other substance injected for a primarily cosmetic purpose.

*Results may vary from patient to patient