Real Plastic Surgery Questions that have been Answered by Dr. Windle
Real Plastic Surgery Questions that have been Answered by Dr. Windle. All of the questions in this section have been asked by patients or prospective patients on various sites including www.drwindle.com, RealSelf, Zwivel, and smartbeautyguide.com. Dr. Windle has personally provided all of the answers.
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How long do Juvederm fillers last in your cheeks and lips?
There are several different Juvederm fillers and the company who makes them, Allergan says that they last up to 12 months. In my experience, they generally last between 6 and 10 months. Because so many patients are seeking value these days, I prefer to use a filler that will last a much longer time. For this reason, I use Bellafill the 5 year plus filler. I have used it in the cheeks, lips and lower eyelids with great success and extremely high patient satisfaction. There are many examples of Bellafill before and after photos here.
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What is the best tear trough filler option and how much does one need to use? Is Restylane a good option?
Tear troughs be corrected with just about any filler including fat, one of the hyaluronic acids (Restylane, Juvederm, Belotero etc.) or a long-term filler like Bellafill. My patients generally chose Bellafill since it is long lasting and therefore they do not have the repeated expense on refilling and the repeated down time of getting a filler done like bruising and swelling.
The complication rate for all filler is about 0.12% according to the FDA’s filler surveillance data. Therefore, who you chose to have the procedure done and what filler to use are the decisions you have to make. It is always difficult to tell how much you will require until you are seen for the procedure but in general more is required when the hyaluronics are used because they need to be placed in the deeper tissues to avoid a common problem with them when placed too superficially called the Tyndall effect.
Remember that a syringe of filler is like a pencil in that you can put a pencil in an artists hands or in a 5 year old’s hand and you will get two different results!
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5 weeks ago I had Restylane put in my tear troughs. Now I have lumps in tear trough? Should I be worried?
This is a very common concern. Lumps after any filler injection are very common, especially if a needle rather than a cannula is used to perform the injection. Injectors who use a needle tend to inject dollops of filler rather than “air brush” it place as when a cannula is used. What I mean by that is that with a cannula, multiple small threads of filler can be placed and this gives you a much more precise placement of the filler. That said, fillers like Restylane will remain soft but what you are likely feeling is the result of trauma from the needle. This should settle in time and is really of no consequence. If you like your result, you might consider a long term filler like Bellafill in a year when the Restylane has gone. This filler last 5 years and phenomenal results can achieved.
This video on filler safety helps explain some of the issues that can be seen after a filler injection.
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I am worried my lower eyelids have been overfilled one week after filler to correct my tear troughs.
Many patients do not understand that a treatment with a fill, especially when a needle is used to place the dermal filler, rather than a cannula, that there can be a lot of trauma to the tissue, especially when the filler is placed under the eye to treat lower eyelid bags and tear troughs.
Lumps, bumps, swelling and bruising are very normal consequences of an injection of filler in the lower eyelid and they can all result in the appearance of too much filler at a week after an injection. These injection sequelae normally last at least 3 to 4 weeks and can last even longer in some circumstances.
This page has a video on filler complications that might be of use to you.