Which Facial Filler is Right for Me?

Leanne Cross, MD

Leanne Cross, MD

Asking which facial filler is right for you is a trick question individual needs or goals differ, and frequently, different areas of the face will respond better to different fillers. Consulting with an experienced injector with an artistic, comprehensive outlook, will give you the best options. That having been said, however, there are inherent differences between fillers that may influence your decision making.

How do they work?
Some facial fillers simply take up space. Once they are gone, it is essentially like they were never there. The hyaluronic acid fillers like Restylane, Perlane, Juvederm, Belotero, and some others, fall into this category. Other fillers cause some of their effect by stimulating collagen growth. Once the filler is gone, there may be a little more collagen in the area than if the filler was never injected. Fillers that stimulate collagen include Radiesse, Artefill, Sculptra, and silicone. The first two have a temporary background gel that is replaced with collagen later, so the volume remains fairly constant, whereas the last two have little volume of their own initially and the volume appears later as the collagen growth occurs.

What is the consistency?
The thicker the filler, the better it will be at lifting deeper lines and hollows. At the same time, thicker fillers are harder to blend smoothly into surrounding tissues, so they are better for more defined deeper folds, and tend to be used deeper in the tissues. Perlane and Radiesse are good examples of thicker fillers. Sculptra, on the other hand, goes in with the consistency of water so it can be used in areas where soft contour changes are needed without defined edges.

40 year old patient before and after facial rejuvenation with dermal fillers by Leanne Cross, MD

40 year old patient before and after facial rejuvenation with dermal fillers by Leanne Cross, MD

How long does it last?
This can vary to some degree from person to person and on where the product is placed. Typically, Restylane will last approximately 6 months, Juvederm, 12 months, Radiesse, up to 18 months, Sculptra, at least two years, and Artefill is essentially permanent. Each dermal filler has its place, depending on a myriad of factors.

How much filler do I get?
Restylane and Belotero are 1ml per syringe; Juvederm and Artefill are 0.8ml per syringe. Radiesse’s syringes are the largest, containing 1.5ml of product; a 0.8ml size is available for touch-ups. Sculptra differs in that it is manufactured as a vial of powder and it remains up to the injector to reconstitute the product with variable amounts of sterile water for use. Make sure you are purchasing Sculptra by the VIAL, rather than, by the syringe.

How much does it cost?
Prices can vary considerably from one establishment to another, but in general, the more filler you get and the longer it lasts, the more expensive it will be. Frequently, the cost will be higher depending on the injector’s experience. However, exercise caution in bargain hunting where your face is concerned.

What are the side effects?
There are certain expected side effects from the injection process itself; swelling and bruising are always possible and some areas of the face are more prone to bruising than others. Radiesse is known to initially cause more swelling than the other products, but if indicated, is worth the downtime. Just make sure you don’t have a hot date or important speaking engagement later the same night. The same rule applies for injections in or near the lips. Plan for some downtime as this area tends to bruise and swell.

Combining products:
Frequently the best results are achieved by the skillful combination of different products at different layers and for different purposes. The face ages globally, so it must be addressed with a comprehensive approach. The eyes tend to focus on the wrinkles and overlook the more subtle volume and contour changes associated with aging. Addressing only one aspect of the aging face, wrinkles, will lead to an unbalanced result.

Find an injector who is knowledgeable and experienced, understanding, and artistic. You should feel comfortable with your injector and develop a long-standing relationship. You should be able to openly communicate your concerns and feel that your wishes are being heard, but also be open to the advice of the experienced professional who can take a step back and consider the whole picture.

Call 813-874-2332 for an appointment or visit www.lecadatampa.com. Lecada Medical Artistry is conveniently located at 3710 West Azeele St., Tampa, 33606.

Pout V. Trout – A Fine Line

Leanne Cross, MD

Leanne Cross, MD

Lip augmentation is one of the most misunderstood cosmetic procedures today. There are a large number of really scary lips out there and it has given many people the mistaken impression that if you have anything done to your lips, you will end up with “trout mouth”. The truth of the matter is that there are also a large number of really well done lips out there as well that those folks weren’t born with, but they look natural and beautiful, so you would never suspect that the owner wasn’t born with them.

What leads people to consider lip augmentation:

1. I have always wanted bigger, poutier lips.

2. I used to have really great lips but they seem to be getting smaller as I get older.

3. My mouth area just looks old and saggy.

The mouth is the anchor for the lower face. A youthful, attractive mouth will greatly enhance the appearance of the entire face, but striving for something that is not realistic or balanced, will take away more than it will add. People with naturally smaller lips are at greater risk for “trout mouth” because attempting to add too much volume will push the lips forward and distort the corners, rather than making the lips softer and more rounded. It is often better to sacrifice some size for better shape.

Lecada - LipsPeople with “smoker’s lines” (even if they aren’t smokers), run a greater risk for “chimp mouth”, because adding volume above the upper lip in an attempt to stretch out these lines, can, distort the mouth if that area begins to project forward beyond the top of the upper lip, or stretches the lips too far to the sides. Sometimes repeated procedures will cause changes to happen gradually enough that the patient may not be aware that they are beginning to look unnatural, or more often, the lip lines are so disturbing that they are so happy for those to be improved that they don’t notice the unnatural side effects.As we age, the mouth area begins to flatten and turn inward as the lips themselves lose volume. Balancing the little structural support around the mouth with some subtle definition of the lip edges, with a small increase in softness and volume to the lips themselves, is the best way to enhance the area since this keeps the mouth proportionate and with a natural shape.

If you are considering lip augmentation, be sure to find a provider with a proven track record for creating beautiful, natural looking lips. Make sure that all the options and Techniques are explained clearly as there are many different products available and many different injection techniques. Just as no two people’s lips are exactly the same, your injector should be able to individually tailor your treatment for optimum results that suit your individual needs and desires.

Call 813-874-2332 for an appointment or visit www.lecadatampa.com. Lecada Medical Artistry is conveniently located at 3710 West Azeele St., Tampa, 33606.

Taking the “tox” out of Botox

Leanne Cross, MD

Leanne Cross, MD

Who would have thought so many people would be excited about an injectable product, whose name contains more than half of the word “toxin”? Yet Botox is the single most popular non-surgical cosmetic treatment performed in the US today. Why is this? And is it actually dangerous or toxic?

Let’s first learn more than you ever cared to know about Botox. 200 years ago, it was discovered that improperly handled meats could be responsible for a flaccid paralysis known in the early 1800’s as “sausage poisoning”, and later, cleverly called “botulism” after the Latin word for sausage. It wasn’t until 1895 that the bacteria producing it was isolated, 1928 when the toxin was first purified, and 1949 when it was discovered how it worked. By the late 1960’s someone finally said, “Hmmmm, this stuff could be useful”, and in 1973, monkeys wound up on the receiving end of this idea. Finally in 1980, humans were officially injected for muscle-related eye problems, and cosmetic uses were first being documented in 1989. The first formal study for glabellar frown lines was published in 1992, but It wasn’t until 2002 that the FDA approved the first use of Botox in the U.S. for the “angry 11’s.”

Since Botox functions by blocking the signal from the end of the nerve to its target tissue (muscle, sweat gland), new, innovative uses are being explored. Aside from an ever widening array of cosmetic techniques, numerous other medical uses of Botox are currently employed or under investigation, including everything from treatment of anal fissures to injections for migraines, TMJ, and excessive sweating, to name only a few.

Despite its ominous name, Botox has proven to be very safe. Realistically speaking, you are taking much greater risk by stepping into a crosswalk than by having cosmetic Botox injections.

On the other hand, poorly injected Botox can lead to the highly toxic syndrome of “Spock eyebrows”, “frozen face” or “cro-magnon brow”, and beautifully injected Botox has been shown to be highly addictive and has proven to be a “gateway drug” for the non-surgical cosmetic industry.

Movies have painted a picture of Botox causing a frozen, unnatural expression. While it makes for good comedy, this does not have to be the case. You unknowingly run into people every day with well done Botox. They’re the ones who look like they don’t need it.

For many years, injectors have attempted to lift the eyebrows by paralyzing the central part of the forehead while leaving the edges untreated, so that when the outer part of the forehead attempted to compensate for the immobilized center, it would lift the outer ends of the eyebrows. Unfortunately, this gave rise to angry eyebrows reminiscent of Jack Nicholson in “The Shining”. There are improved injection techniques now which can lift the brows in a natural and attractive fashion.

When treating horizontal forehead lines or “Crow’s feet” around the eyes, it is no longer considered necessary to eliminate all trace of movement. There is a delicate balance between frozen and wrinkled, in which lines are minimized but some movement is retained in areas that create positive expressions.

On the other hand, a stronger treatment for the frown lines between the brows is desirable. Let’s face it, unless you have small children or incompetent employees, you don’t really need to scowl as much as most people do. In fact, ongoing research is showing that cosmetic Botox has the potential side effect of improving depression, aside from the improvement in appearance. The inability to scowl seems to trick the brain into perceiving things as being less scowl-worthy.

Talk to your injector about your desired results. Would you prefer to remain natural-looking but rested, or are you are aiming to beat those lines into submission? A talented injector can give you the look you desire without creating an artificial appearance.

Call 813-874-2332 for an appointment or visit www.lecadatampa.com. Lecada Medical Artistry is conveniently located at 3710 West Azeele St., Tampa, 33606.

Dr. Tim Doerner

Our motto is to treat our patients like they are our family

Dr. Tim Doerner and Nicole Grunsfeld

Dr. Tim Doerner and Nicole Grunsfeld - Photo: Lisa Sibley

PV: Why did you choose your line of work?
Tim:When I was very young my best friend’s dad was a dentist and it interested me. It’s a great way to help people and be your own boss.

PV: What is your role in your business?
Tim: I am a sole practitioner, meaning I am the only doctor working with a wonderful staff to provide excellent dental care for our patients.

PV: What sets you apart from your competition?
Tim: Being a general dentist, I provide a wide variety of services. We do everything from implant surgery to Invisalign to Botox. The conservative caring attitude we have, gives the patients options when they need dental treatment

PV: What would you be doing now if this weren’t your business, taking money out of the equation?
Tim: If I was not practicing dentistry I would probably be traveling.

PV: What do you do for fun?
Tim: Go on cruises, traveling, boating, and motorcycling.

PV: Who or what is most important to you?
Tim: My fiancée Nicole, my children Aaron and Alexa, also my mom who just turned 94 are most important personally. My excellent staff and longtime patients are most important professionally.

PV: A little secret about you that would shock people that don’t know you.
Tim: People are always surprised when I tell them I own an ice cream /cookie store. We have to keep the sweet tooth happy too, don’t forget to brush. We also treat the Phillies baseball players.

PV: What are your personal and professional mottos?
Tim: Our motto is to treat our patients like they are our family. Also work hard, play hard…

PV: When you were five, what was your dream job?
Tim: When I was five I loved baseball I played in college and would have loved to be a major league pitcher but dentistry has been an excellent alternative.


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