Restylane and Fat and fillers III

Posted on April 30, 2010

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So…I recommend hyaluronic acid [Juvederm, Restylane or for quick fixes;Prevelle silk] for the superficial wrinkles of the lip area, mid forehead area, and the slight hollow of the naso-labial fold where there is a wrinkle and possible depression from the nose to the corner of the mouth, and very carefully at a level deep near the bone at the hollow of the lower lid tear-trough.

Dr. Richard Clark of Sacramento, California

Dr. Richard Clark of Sacramento, California

In the area below the lower lid I would recommend that it be done by an MD [only a Plastic Surgeon, ENT or dermatologist …well-trained  and experienced in this subtle area].  My nurse does injections of the other areas and augments the lip better than I …well, at least “almost better.”  I have also recently augmented a narrow chin for a patient who will eventually have a chin implant but wants a temporary improvement now before her wedding which is coming up too soon for her to have an operation.

In regard to fat injection, I want to add that it is great for augmentation of many areas from the lip to the buttock…if done according to the principle of narrow injection tunnels to allow each fat cell to get a good blood supply. It can be a solution to long-lasting filler to the lower lid tear-trough rather  than repeat injections of Restylane. Too important considerations with fat:  1] avoid over filling…tell your doctor you would rather have to return for a touch up than to have a lip that is forever too big! 2] It is a surgery which requires an operating room and a recovery and that is why I have some patients opt for midface/cheek augmentation with Radiesse.

So, to summarize: Temporary treatment of Wrinkles and minor superficial hollow and flat lips= Juviderm or Restylane  or [Prevelle] ; Temporary treatment of Deeper Depressions of Cheek = Radiessepermanent treatment of Deeper Depressions of face and elsewhere and lip or butt augmentation = Fat injection. (I may blog on lip augmentation in future, because better than fat injection in the lip is a dermal/fat graft, but that is another story.)

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