Facial Fillers

We all strive for the full, youthful face we once had, void of life’s stresses, years of fun-in-the-sun, and normal aging processes. Dr. Enzer offers a number of ways to give your face a more youthful, natural look, from surgical procedures to less invasive treatments, such as facial fillers. Fillers are an affordable alternative to surgery, and a “liquid face lift” can give you the look you desire without the cost, risks, or downtime of surgery.

Treatment areas

Fillers can soften facial creases and wrinkles, and restore youthful fullness to features that have lost volume over time, such as hollow cheeks or thin lips. The image below illustrates common treatment areas that may benefit from fillers. Talk with Dr. Enzer if there is an area not shown that you would like treated.

Types of facial fillers

There are many different types of fillers available, each with its own benefits. Some facial fillers are for specific concerns, such as fine lines versus deep wrinkles. Dr. Enzer chooses to use fillers that are FDA-approved and scientifically proven to have a benefit to the patient. Dr. Enzer also researches each product extensively before introducing it to his patients.

Hyaluronic acid fillers

The most popular filler products are hyaluronic acid fillers. These synthetic fillers give results that you’ll see immediately. They can be used for smoothing out fine lines and wrinkles, and restoring youthful fullness to the face. Many of these products contain a numbing agent which makes the procedure more comfortable and pain-free afterwards.

Hyaluronic acid fillers are considered the safest type of filler because they can be easily dissolved should there be a problem. Fortunately this is rarely needed, as most patients are very pleased with their results. Dr. Enzer has found that the results from most hyaluronic acid fillers typically last at least 7 to 12 months, and some products or treatment areas can last for many years.

Poly-L-lactic acid fillers

Sculptra® is a synthetic filler that helps stimulate collagen production and restore youthful facial volume to sunken areas, such as the cheeks or temple hollows. It is made with poly-L-lactic acid, the same biocompatible and biodegradable ingredient found in resorbable stitches. This filler is unique because it gradually volumizes your features over several months.

For most people, Dr. Enzer recommends three sessions of Sculptra® over six months. The average person can expect the volume effect to last about two years before touch-ups are needed. Sculptra® is best suited for full facial volumization, not for individual wrinkles or scars. To learn more, visit their website at www.sculptra.com.

Calcium-based fillers

Dr. Enzer also offers Radiesse®, a collagen-stimulating filler that works well for deep lines and folds as well as facial voluminization. Radiesse® is made up of calcium hydroxylapatite microspheres which add immediate volume and fullness to the area where it is placed. Dr. Enzer has found that Radiesse® works very well even in areas of high movement, such as the deep folds around the mouth (nasolabial folds). Radiesse® typically lasts about 12 to 18 months. For more information, visit www.radiesse.com.

The most common problems seen after filler procedures are swelling and bruising. Here are Dr. Enzer's recommendations to help minimize any side effects and make your treatment a comfortable and pleasant experience.

Stop any blood-thinning medications or supplements one week before your appointment. This includes Warfarin, Xarelto, Eliquis, Pradaxa, and also aspirin, ibuprofen products, and arthritis medications (NSAIDS). It also includes many herbal supplements such as glucosamine, garlic, ginseng, and others.
Eat a fresh pineapple before your appointment. It must be fresh—not frozen or canned. Fresh pineapple contains bromelain, a natural anti-inflammatory. Discontinue eating the pineapple if you experience mouth irritation!
If you don't like pineapple, take Arnica Montana and/or bromelain supplements the day of your appointment and for 2 to 3 days afterwards. These supplements have natural anti-inflammatory properties that help minimize bruising and swelling. We sell these supplements in our office, but you may also purchase them from a natural foods store.
Apply cold applications to the treatment area every hour for 10 minutes for the first 8 hours after your procedure.
Avoid vigorous exercise for 24 hours after your procedure.
Do not massage or apply pressure to the area for 3 weeks after your procedure, unless instructed to do so by Dr. Enzer. This includes spa facials and wearing swim goggles.

Every medical procedure has risks. The most common problem seen after fillers is bruising and swelling. This can be controlled with frequent cold applications and taking Tylenol. Our main concern with facial fillers is to avoid asymmetry, and over- or under-correction. Some patients may notice bumpiness to the area or bluish discoloration, especially if it is an area with very thin skin, such as under the eyes. We recommend waiting at least three weeks for the filler product to settle in before deciding if you need a touch-up or revision. There are also very rare but serious risks such as infection, an allergic reaction, or even blockage of a blood vessel by the filler. You should notify Dr. Enzer immediately with any of these concerns.

For those interested in a longer-lasting and a more natural solution, we recommend fat transfer. This procedure can be used for lip augmentation, to smooth nasolabial lines, fill cheeks, or to fill other depressions on the face or body. Fat transfer uses one's own fat, thereby eliminating any risk of rejection or allergic reaction. There is minimal pain and discomfort with this procedure, which can be done either in Dr. Enzer's office or in an out-patient facility.
Several years ago, Dr. Enzer devised a technique for full face fat transfer, which, in some cases, replaces the need for more invasive face-lifting. This procedure has become very popular across the country, as it gives patients a more natural correction to facial aging. It has also been recently discovered that the fat we transfer has the highest concentration of stem cells in our bodies. These stem cells, once transferred to the face, become activated to take on the characteristics of their new environment. This results in a much more youthful quality to the skin, in addition to regaining volume lost to aging.
Fat transfer procedures are very dependent on the experience of the cosmetic surgeon, and poor outcomes can be seen, including non-survival of the transferred fat, lumps, irregular grooves, or asymmetry. Dr. Enzer has over 20 years of successful experience with fat transfer, being one of the first to offer this procedure in Southern New England.