Find out what collagen, Radiesse, Restylane® and other fillers can do for you! Contact our office near Portland, Oregon.
Peter Goodkin M.D.
9775 SE Sunnyside Road #500
Clackamas, Oregon 97015
P / 503-654-7546
F / 503-786-3542
A member of the ACMMSCO©™
Restylane®, Perlane®, Juvederm®, Radiesse®, and Evolence®at Our Portland, Oregon Area Office
Finer facial wrinkles and creases begin to appear as a result of sun damage (photoaging) when the underlying collagen and elastin fibers begin to break down and wear out. With time, and yes, age, facial volume is also lost. Smiling, squinting, and facial expressiveness bring about what are called dynamic lines, folds, creases, and wrinkles. This is part of the natural aging process. At the Clackamas offices of dermatologic surgeon Dr. Peter Goodkin, Restylane®, Radiesse®, and collagen are used for patients from the Portland area and throughout Oregon to overcome these problems.
Restylane®, Perlane®, Juvederm®, Prevelle®, Radiesse®, and Evolence®
Surface imperfections are best managed with creams, lotions, chemical peels, lasers and resurfacing procedures. Lines and folds accentuated by smiling, squinting or frowning are often best softened with Botox Cosmetic® which temporarily weakens the muscles that cause the problem.
When we lose facial volume, it’s like the face becomes deflated. Folds get deeper and everything sags. This actually changes the shape of the face.
Replacing volume, pumping up those folds, and restoring the shape of the face is the goal of our injectable fillers. The first FDA approved injectable cosmetic filler was bovine collagen. Numerous new fillers have been approved in the last ten years and we now have many of them FDA approved and available for use in the United States.
Our most commonly used fillers are based on hyaluronic acid (Restylane®, Perlane®, Juvederm®, Prevelle Silk®), calcium hydroxyl apatite (Radiesse®), and poly-L-lactic acid (Sculptra Aesthetic®). Hyaluronic acid is the lubricant we all have in our joints. Calcium hydroxyl apatite is a normal precursor in bone formation. Poly-L-Lactic acid is a synthetic with no allergies reported. The production of the original cow and human collagen fillers has ceased. It is now so rare to see allergy with the newer fillers that skin test volume syringes are not even offered.
Many of the hyaluronic acid products, as well as porcine collagen, calcium hydroxyl apatite and Poly-L-lactic acid last considerably longer in the skin, compared to human collagen.
Restylane®, Perlane®, Juvederm®, Radiesse®, Prevelle Silk® and Evolence® are available at Our Portland, Oregon area practice.
- How do fillers work?
- What are the best areas for treatment?
- What problems can be seen?
- What does it feel like?
- How long do the fillers last?
- How long do I have to hide, if at all?
How do fillers work?
All of the cosmetic fillers are injected into or deep to the skin, to fill wrinkles and folds and to restore volume where volume has been lost. Once in your skin, it either pumps up the wrinkles and folds or revolumizes (reinflates) cheeks and temples, which secondarily decreases the depth of wrinkles and folds. Adding volume has the benefit of adjusting the face to a more youthful shape.
What are the best areas for treatment?
The nasolabial folds, marionette lines and drool lines are the most common areas treated. Nasolabial folds can either be filled directly, deep to the fold, or by adding volume back to the cheeks.
The nasolabial folds, marionette lines and drool lines fill well with Restylane®, Perlane®, Juvederm® and Radiesse®
When volumizing the cheeks, Radiesse® or Sculptra Cosmetic® often work best.
Lips are often treated with different fillers at different layers of the skin. Collagen may still work best for the fine, etched in wrinkles around the mouth (“lipstick lines”). Collagen or hyaluronic acid is great to improve the definition at the red border of the lip, and lip volume is usually treated with hyaluronic acid (Restylane®, Perlane®, Juvederm®).
Frequently a combination of different fillers will give the best results.
What problems can be seen?
Redness and swelling can occur from 1-3 days. A bruise is always possible at the injection site. Bruising and redness can be covered with make-up. It’s possible to have bumps, ones that you can feel, or even ones that you can see. Most bumps are temporary. Many can be massaged out by the doctor. Since there is an injection, it is possible to develop infection. This is extremely rare. Talking about rare problems, it is even possible for the filler to block a blood vessel, cutting off the blood supply to a small section of skin. This could lead to an open sore and a scar. If this were common, fillers wouldn’t be used as cosmetic procedures.
What does it feel like?
Most treatments only take a few minutes. The sensation is usually just the pricks of the small needle that’s used. Most of the time we apply a topical anesthetic, usually about 45 minutes before the session and this is all most people need. Anesthetic is also mixed with many of the fillers. Some sensitive areas are best numbed with dental-type nerve blocks, making the treatment almost pain free.
How long do the fillers last?
Permanent fillers can cause permanent problems so we stick to the reasonable duration implants. This varies with the filler. Most people believe that the human collagen fillers last the shortest time, probably 3-6 months, depending on the area injected. Most of the hyaluronic acid fillers, the porcine collagen, calcium hydroxyl apatite and poly-L-lactic acid, last closer to 6-12 months, or even longer. Some of this depends on the technique of the injection as well as the area in which it is used. Once a full correction is achieved, touch up sessions are best performed before all of the implant has been reabsorbed, often at about 6-12 month intervals.
Our Portland-area patients have been very pleased with these products. What’s good about them is that you can use them whenever you wish to restore a more youthful appearance.
How long do I have to hide, if at all?
Swelling and redness can last 1-3 days in most areas. Application of ice intermittently for a short period after the treatment will help reduce any swelling. Swelling in the lips can last longer in some people. Bruising can occur with any injection procedure. Avoiding aspirin, ibuprofen and other blood thinners before the session can minimize this risk. Bruising and redness can be camouflaged with make-up. Even though many people report little or no redness or swelling and go about their business right away, with your first session it’s best to plan for 2-3 days.
Sometimes a combination of different fillers will work best. Restylane®, Perlane®, Juvederm®, Radiesse®, Prevelle Silk® and Evolence® are available at our Portland-area, Clackamas practice.
Radiesse®
Radiesse™ is made of tiny microspheres of calcium hydroxyl apatite (30%) mixed with a common hydrogel (70%) that is used in many cosmetic products. Calcium hydroxyl apatite is similar to bone and teeth, and it's naturally compatible with your body. However, Radiesse™ is man-made.
Will I need a skin test to determine whether I'll have a reaction to Radiesse™?
How long will the Radiesse™ treatment last?
What facial areas can be treated with Radiesse™?
Does Radiesse™ become hard or noticeable to touch?
Are there any lingering effects of Radiesse™ treatment?
When can I return to my normal activities after a Radiesse™ treatment?
Are there any activity restrictions after I undergo a Radiesse™ treatment?
Do I need a skin test to determine whether I'll have a reaction to Radiesse™?
Because Radiesse™ is made of biocompatible calcium hydroxyl apatite and a safe, tested hydrogel, no skin test for reactions is needed. There have been no reported reactions from the use of Radiesse™.
How long will the Radiesse™ treatment last?
Most people who have been treated with Radiesse™ can expect correction that lasts about 12 months or more!
What facial areas can be treated with Radiesse™?
The facial areas that are most commonly treated with Radiesse™ are:
- smile lines or nasolabial folds (smoothing and contouring)
- wrinkles at the corner of the mouth
- acne scars
- facial defects or recessions
- frown lines
- the cheeks (restoring volume in and around them)
- modest enhancement or correcting asymmetrical features.
Does Radiesse™ become hard or noticeable to touch?
Radiesse™ stays soft and takes on the characteristics of the tissue surrounding the site where it's injected. Soft new tissue will eventually replace the Radiesse™, with most replacement occurring within three months. Patients have reported that Radiesse™ stayed very natural-looking and -feeling.
Do Radiesse™ treatments hurt?
To reduce or eliminate the pain associated with this type of treatment, Dr. Goodkin uses a mild local anesthetic. The numbing effect of the anesthetic wears off over a period of 15 minutes to one or two hours, depending on the type of anesthetic used. There is no pain reported afterwards.
Are there any lingering effects of Radiesse™ treatment?
There is minor inflammation or swelling from the treatment as a result of the expansion of facial tissue. This is normally resolved well within 24 hours but has been reported to last as long as 48 hours for some patients. Bruising is not uncommon and may last a few days. Application of ice intermittently for a short period after the treatment will help reduce any swelling.
When can I return to my normal activities after a Radiesse™ treatment?
Most patients resume normal activities only a few hours after receiving treatment.
Are there any activity restrictions after I undergo a Radiesse™ treatment?
For 48 hours following your treatment, you should avoid activities that strain your facial features as much as possible. For example, avoid activities such as shouting, eating tough foods, using a straw, chewing gum, etc. Otherwise, your normal activities are no problem.
To arrange your private consultation with dermasurgeon Dr. Goodkin to discuss dermal fillers such as collagen, Restylane®, or Radiesse ™, contact our offices near Portland, Oregon.