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Cosmetic fillers are substances injected into or beneath the dermis to add volume in precise locations such as the lips, facial lines (i.e. nasolabial folds, marionette lines, smoker’s lines), the cheeks, the chin, the jawline and areas with skin depressions from various causes such as acne or surgery. Lip augmentation and facial rejuvenation by treatment of facial lines are the most common uses for cosmetic fillers.

Cosmetic fillers include natural sources such as fat harvested from the patient’s body by liposuction, laboratory-derived temporary materials such as hyaluronic acids, collagen and calcium hydroxyapatite, and permanent synthetic materials such as silicone. Generally speaking, temporary fillers and fat are more convenient and less prone to long term problems than permanent fillers.

The observation that facial features lose volume with age is the basis for soft tissue augmentation. Unlike a facelift which merely pulls the skin away from the center of the face, facial rejuvenation with fillers produces a more natural and youthful appearance without an unnatural stretched appearance and without the need for surgery. Fillers may be combined with traditional facelifting surgery in situations where there truly exists a significant degree of skin laxity.

Information on a variety of popular cosmetic fillers is presented below.


Restylane®

A new method for smoothing wrinkles and enhancing lips that is completely natural. Restylane is a stabilized Hyaluronic Acid in a clear gel that interacts safely with your body's own Hyaluronic Acid to increase volume. Primarily used for wrinkles, lines, facial contouring and lip enhancement, it can last up to 8 months. Unlike Collagen, it requires no skin test and lasts considerably longer than most other fillers.

Juvederm®
Long-lasting gel that, once injected into the skin, literally adds volume to the areas being treated. Similar to one of the body's own natural substances (Hyaluronic Acid), is a completely safe treatment. Juvederm® is an excellent treatment option for deep folds, lip enhancement, facial lines, shaping facial contours, and correcting thin lines around the eyes, mouth and forehead.

Radiesse®
Radiesse® is an injectable product for lip enhancement, depressed scars, deeper frown lines and nasal furrows. This product consists of calcium hydroxyapatite suspended in a gel of carboxymethylcellulose. It is long lasting and it does not require a skin test because it's the same mineral component found in our bones and teeth. It can last up to 1 year.

Autologous Fat Transfer
It is the procedure where excess fat is removed from areas such as the abdomen, flanks, hips or thighs and, after special preparation, injected into areas of the body that need filling. ISCG cosmetic surgeons specialize in the use of the microfat grafting technique. The process requires gently fat removal using low-vacuum liposuction and the use of thin, delicate, non-traumatic cannulas to protect the survival of each harvested living fat cell. The fat cells are then purified and slowly injected thru tiny skin incisions into the tissue of the recipient site utilizing a small syringe and cannula. Tiny droplets are placed throughout the tissues assuring that each transferred fat cell will have an adequate blood supply to achieve the permanent survival of the injected fat cells.


Frequently Asked Questions

View Cosmetic Filler Before and After Photos


Q. What are cosmetic fillers?

A.  They are injections that fill out wrinkled or uneven facial areas, gently smoothing wrinkles and restoring bulk to the curves of the face. Most of them have FDA approval for correction of moderate to severe facial wrinkles and folds, and correction of soft tissue contour deficiencies such as acne scars. There are several replacement fillers available in USA, that include Restylane, Captique, Cosmoderm, Cosmoplast, Hylaform, Hylaform Plus, Sculptra, and Radiesse. [Return to Top]

Q. Which filler is right for me?

A.  Three important factors to consider under selecting a facial filler are: 1) how long the fillers will last, 2) how much it costs, and 3) ease of administration. Drs. Pelosi will determine the best recommendation for your particular needs, including the use of your own fat for cosmetic filling purposes. [Return to Top]

Q. What is Restylane?

A. Restylane is a safe and natural cosmetic dermal filler that restores volume and fullness to the skin to correct moderate to severe facial wrinkles and folds such as the line from your nose to the corners of your mouth (nasolabial folds).
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Q. What is Restylane made of?

A. Restylane is the first cosmetic dermal filler made of non-animal based hyaluronic acid. Hyaluronic acid is a natural substance that already exists in the human body and is used to provide volume and fullness to the skin. The hyaluronic acid in Restylane is a crystal-clear gel called NASHA or Non-Animal Stabilized Hyaluronic Acid. NASHA is biodegradable and fully biocompatible with human hyaluronic acid. [Return to Top]

Q. How is Restylane different than other hyaluronic acid-based products?

A.  Unlike rooster-derived hyaluronic acid-based products, Restylane is free from animal proteins. This quality limits the risk of animal-based disease transmission or allergic reaction. Restylane contains trace amounts of gram-positive bacterial proteins and should not be used by patients with a history of allergies to such material. Additionally, Restylane lasts about six months. [Return to Top]

Q. Is Restylane safe?

A. Yes. Restylane has been used since 1996 worldwide, There is limited risk of animal-based disease transmission or allergic reaction. Restylane is fully biocompatible and allergy testing is not required.

After your treatment, you might have some redness or swelling. This will normally last les than seven days. Sunbathing and cold outdoor activities should be avoided until any redness or swelling disappears. You should not be treated with Restylane if you are pregnant, breastfeeding, or under 18. [Return to Top]

Q. Where can Restylane be used?

A. In the U.S. the FDA had approved Restylane for facial wrinkles and folds like the ones from the nose to the corners of the mouth. Restylane has been used in more then 3 million treatments in over 60 countries to correct a variety of wrinkles. Drs. Pelosi will consult with you prior to your injection regarding common treatment areas. [Return to Top]

Q. How long does Restylane last?

A. Restylane is proven to deliver long-lasting results. Studies have shown that Restylane effects generally last for 6 months. Restylane’s stabilization technology helps maintain the cosmetic effect until the injected material is nearly gone.
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Q. How often should I have Restylane treatments done?

A. Treatments are typically scheduled twice a year. Having a follow-up treatment before the product has fully dissipated may enhance the lasting effect.
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Q. What should a patient do prior to treatment?

A. Restylane requires no pretesting, but you should take a few precautions before being treated. Avoid using aspirin, non-steroidal anti-inflammatory medications, St John’s Wort, or high doses of Vitamin E supplements prior to treatment, because these may increase bruising or bleeding at the injection site. Also, if you have previously suffered from facial cold sores discuss this with the doctor. Drs. Pelosi may consider prescribing a medication to minimize recurrence. [Return to Top]

Q. How is Restylane different from Botox Cosmetic?

A. Restylane is natural, cosmetic filler that plumps up the skin to smooth away facial wrinkles. In contrast, Botox Cosmetic is a drug that relaxes the muscles underlying wrinkles. Many patients have been very pleased after receiving treatment with both products in different areas of the face. [Return to Top]

Q. How is Restylane different from bovine collagen?

A. Bovine collagen is derived from animals (cows) and requires an allergy test with up to a 3 week waiting period. Restylane can be administered immediately-no waiting is required. [Return to Top]

Q. Do the injections hurt?

A. Restylane is injected directly into the skin in tiny amounts by an ultrafine needle, resulting in minimal discomfort. The procedure is simple and convenient, and results are practically instantaneous. Some patients may experience discomfort around the injection site. To optimize your comfort during the short procedure, Drs. Pelosi may anesthetize the treatment area. [Return to Top]

Q. How much do Restylane treatments cost?

A. Restylane is a customized procedure based on your specific needs, so the cost will vary from patient to patient. You may require more than one syringe of Restylane in your initial treatment to achieve optimal results. In general, the cost of Restylane is comparable to the cost of similar procedures. Because Restylane lasts about 6 months, it proves to be very economical over the long term process. [Return to Top]

Q. What are the safety considerations?

A. Restylane restores volume and fullness to the skin to correct moderate to severe facial wrinkles and folds. After your treatment, you might have some redness or swelling. This will normally last less than seven days. Sunbathing and cold outdoor activities should be avoided until any redness or swelling disappears. If you are pregnant, breastfeeding, or under 18, you shouldn’t use Restylane. [Return to Top]

Q. What is lip augmentation?

A. As time passes by, your tissues sag and your lips will lose their substance, they retract giving a sad tired appearance, lipstick runs…..you look at yourself into the mirror, and realize that you have to do something about it.

Lip Augmentation gives you fuller lips, it can be done to one or both lips. The procedure is very popular because the results are seen immediately, they can be subtle or drastic, according to the wishes of the patient.

It can be performed in a very short amount of time using a topical anesthetic cream, local anesthesia, or nerve blocks. The lips can be augmented with the patients own tissue (microfat grafting), biologic tissue fillers or soft synthetic implants. [Return to Top]

Q. What is involved in the lip augmentation procedure?

A. In the case of microfat grafting, the fat is harvested from different areas of the body, processed, and then injected to the lips. With biological tissue fillers such as Restylane or Captique, a pre-packaged syringe is used to inject the material into the lips. With soft synthetic implants (Gore-Tex, Advanta, Alloderm) a tiny incision is made into the corner of the lip, and the implant is threaded into position.

Fat injections are used when the patient wants to use their own tissues. It takes longer to be completed then tissue fillers or synthetic implants. There will be some initial shrinkage of the fat during the first 3 months, thereafter the result is usually permanent. Swelling and bruising may last 2 weeks. [Return to Top]

Q. What are the drawbacks of lip augmentation?

A. Lip Augmentation using fillers has become popular due to the impressive cosmetic results. Complications may include cold sore outbreak, extrusion of synthetic implants, infection, and re-absorption of the filler.

Very few cosmetic surgeons are skilled enough in the technique of lip augmentation-especially when fat is used for the lip augmentation.

A poorly performed lip augmentation may have devastating psychological repercussions on the patient. The correction of a bad lip augmentation can be very challenging and the results unpredictable.
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