Stop wasting your nights on a mattress that doesn't get you. Experience the most comfortable mattress in the world. The sleep number smartbed at the touch of a button. You can personalize your comfort.
Choose firmer or softer, adjust cooler to warmer. And right now, save up to $2,500 during our massive labor day event. Hurry into your local sleep number so today, because we have your number. Have you been wanting to feel younger?
Or look more rejuvenated and refreshed? Do you look at the vast aesthetic and wellness industry and wonder where to begin? What's available to you and what works? You're listening to Aesthetic Express, where board certified nurse practitioner, Dr.
Kyle Far brings you expert education about everything aesthetic, beauty, and wellness related. And now your host, nurse practitioner, Dr. Kyle Far. Thank you, everybody.
I appreciate you taking the time to listen to Aesthetic Express. My name is Dr. Kyle Far. I am a board certified nurse practitioner who practices in aesthetic and wellness medicine.
And like always, I'm your host of Aesthetic Express. And I'm really grateful that you're deciding to take some time out of your day and spend it with us today. Today's kind of a fun topic. I want to talk today about Dermal Fillers.
This is another very common procedure that we do at Detroit Aesthetics Company, which I'm the owner of in Plymouth Michigan, right outside of Metro Detroit. Dermal Fillers are becoming very, very popular in the anti-aging arsenal of treatments that we have available. Dermal Fillers also sometimes get a little bit of a bad rap. And I think a lot of that's just because there's some Dermal Fillers that's done out there that's just not done correctly.
So like we've talked about in previous episodes, we're going to kind of recall on some of the information from the episode where we talked about how to face ages, keeping all of that in mind and kind of refreshed. I might mention a few things from that. But then also really keeping in mind that you're going to a provider who's well-versed and trained in these types of procedures, especially with Dermal Fillers. It's an area that I really spend a lot of time on myself personally, making sure that I'm always perfecting my craft, learning new things, going to different seminars and workshops to learn all of the new tricks and tips that have been developed when it comes to Fillers.
There's always new products coming out on the market as well. So really making sure that I'm learning about those products. I'm comfortable with them and sharing them with you. So I wanted to take some time today and discuss the different Dermal Fillers that are out there.
The United States, we have a really good selection available. If you go over to Europe, there's probably double or maybe almost triple that available. The FDA, obviously in the United States, maybe makes it a little more difficult for things to get into the market. But if you have clients who've come in from overseas and they'll say, hey, do you have such and such treatment?
I'll be like, nah, unfortunately we don't make that here in the US, but here's something similar to that product. So that's how I've gotten to learn a little bit about what else is available out there globally. You kind of research a little bit and then find what's closest here. But real commonly when we're talking about Dermal Fillers, people come in and they're looking for the, getting their filler fix.
We think a lot of lips, people get lip augmentations. It does nice, voluptuous lips. There's a certain celebrity, that's a reality TV celebrity, with the initials of KJ, who's has her lipstick lined and has really made her lips pretty famous. Everybody wants those lips.
One of the things to remember, when you come in for Dermal Fillers, it's really hard to come in with a picture and be like, this is what I want. We can't synthetically make something. We're also working with what the patient has. So it's really talking to the patient, educating them and saying, here's what I see that you have right now anatomically, here's what you were born with, and here's what we can do with that.
But a lot of the times when we're talking about fillers, one of the things I really like to do the most and can make some really drastic changes is again, think about when we talked about in the podcast episode about how the face ages. When we're young or younger, our face kind of has this or portrays this heart shape. We have a narrow chain and really broad, well-defined cheekbones. It's real easy for girls to contour those faces and they'll suck in the cheeks and contour them to make them look even more defined.
Then, though, as we age, we start to... We maybe hollow out a little bit, and things kind of flip upside down, per se. Our chin or our lower face actually widens, and the upper face narrows, and kind of hollows out. So a lot of the times we will use Dermal Fillers to fill in those areas.
We will maybe augment around the temples the cheekbones, the medial cheek. This is where the cheek meets the outermost corner of the lips. We call that sometimes the nasolabial folds. That's another area.
Real commonly though, we use hyaluronic acid fillers for that. Sometimes if we're looking at the circumference of the face or the outer face, we kind of have our mid face, which is where our nose and the nasal labial folds and the lips are at. But for outer face, sometimes we're looking for volume replacement. I might recommend a treatment like Sculptra or Polyoleptic Acid, a product that's out there.
But we can kind of use a combination or kind of even a little bit of everything, a lot of the times. But it's common, like we said, we're also using fillers though in some other kind of unique places. I have people coming in and they feel that their hands look older. If you know their hands are maybe thin and they see the veins in their hands, and they feel that their hands really age them with what they do.
So we can put dermal fillers in the hands. We could use a product. We could use some stuff off label in the hands. There's only one product right now in the market that's FDA cleared for their hands.
It's called Radias, which is a different kind of dermal filler. It's not a hyaluronic acid base filler, which is the most common ones. It goes gel ones like you'll hear about. We're going to talk about the different kinds here a little bit.
But we're also putting filler sometimes. You're seeing these non-surgical nose drops where we can augment the nose and kind of even out the shape or maybe pull up the tip of the nose a little bit. There's ways to use dermal fillers. If you're, you've worn earrings for a long time and your earlobes get saggy, we can do earlobe rejuvenation with dermal fillers in the earlobes and kind of perk those up.
It sounds crazy. I've done a handful of times this earlobe augmentation. I remember the first time I told one of my colleagues that they were like, what did you do? And I had to pull up a YouTube video to kind of demonstrate.
And then they're like, oh my gosh, that's crazy. I've seen people like that. Hey, they didn't know it's out there. But when it comes to dermal fillers, there's two major game players in the market.
We're talking about the different ones out there. You're going to hear me talk a lot about wrestling, because primarily that's what I use in my office. It's my kind of filler of choice. And then there's Juba Derm, which is made by a company called Allergen.
They also make Botox and Gildermah, who makes wrestling and Dysport. They also are the owner of the product called Sculptra. But look at fillers. There's so many things we can do.
Wrestling has a really cool add-out right now that you might see a new beauty or a lure of those magazines. And it really shows kind of on the face where we can make this the moment. You say yes. Stand where the Incas once walked in Machu Picchu.
Come face to face with elephants on safari. Share a home cooked meal with locals who welcome you like family. Save up to $1,500 per couple on guided tours worldwide, backed by Colette's Century of Expertise, booked by September 30 using offer code Hello27. Co Colette, my Traveler's Sport Travelers.
Visit www.colette.com or contact your Travel Advisor. And use Dermal Fillers and how they can be beneficial for you. We might use Dermal Fillers to kind of fill in lines. So you might have what we call expression lines.
So when you smile, like you guys can see me, when you smile, you have these little lines that show up kind of around the mouth. And that's from their not dimples, but their lines that show up around the mouth, just from volume loss. We might want to potentially add volume to the cheeks. Maybe you want to smooth out some deep folds, like either in the nasolabial folds, or you have some marionette lines, you know, lines on the lower portion of the mouth kind of underneath the lower lip.
You might want to plump out thin lips. Maybe you have thin lips as we age. Our lips actually get more narrow. I think they found between like the age of 21 and 30 or 40.
The lips actually got wider and more narrow by about four millimeters, which is pretty drastic. You might want to treat laugh lines. You know, so we have the laugh lines, marionette lines, similar area. Fine lines and wrinkles.
I'll see patients who come into the office and they have these little fine wrinkles, especially around the mouth. And they'll say, I've never smoked it in my life when I have these little lines. It might be a percitor. They might just be, again, like we talked about in the episode about facial aging.
They might call a wrinkler. But they'll say, the reason I hate them is I go to put my lip gloss on and my lip gloss bleeds into those lines. And it just doesn't look as good. It doesn't, I can't get a real nice firm border on my lips because of these lines and it bleeds.
So we might use filler there. We can use filler kind of as a skin booster. As we age, we lose hyaluronic acid in the skin. And it goes away so we can use thinner products off label to kind of boost the skin and kind of make it a little more plump.
There's actually topical forms of hyaluronic acid too, where it's not a filler, but it's topical ones. We carry one that I absolutely love in my office by a company called Skin Better Science. It's a product called Lines. Pretty easy to know what it's for when it's called Lines.
But it's an injectable grade hyaluronic acid that's able to kind of get into the skin and plump up and perk up that skin. But kind of going back through, people come in a lot of times, again, this is, I've said this before, I hand in the mirror and I say, well, what do you see? What bothers you in the look in the mirror? A lot of the times people, they look at the jowls.
And they're like, well, I want this lower face gone, or they'll say that they don't like their nasolabial folds, the lines that kind of come from the nose down to the corner of the mouth. They'll say they really feel like they age them. And they'll think, well, I just want those filled. You know, going to an expert injector, one of the things that they might tell you is it's really important, especially those of us who are highly trained and do this a lot.
We look at the whole face and we really want to look at the source of where this volume losses from. Sometimes I'll be talking to patients and I'll say, we don't want to put filler there. You know, we don't want to necessarily put filler right in the nasolabial folds right now because sometimes putting filler there, what it can do is it can actually make that lower face start to look very wide. Boxy and almost can sometimes give a masking when looked to the face, which is what women, you know, don't want typically.
They want to look more feminine. They want to get that heart shape back. So what we want to do is we want to do is we want to address volume loss kind of in the upper face, maybe in the cheek area or in the malar region. Tiertros even sometimes may.
And when I take some rest on the lift, and this is an off label use, there's no product here in the US that's FDA cleared for tier trophus, but I'm very trained in this and I feel very confident and comfortable doing this and I do it in a very safe way as well, which I'll talk about here in a second. We man, when we fill in that tier troph area, it really kind of pulls up that frontal cheek, the apple of the cheek there and a lot of the times really soften that nasolabial fold and all of a sudden the client doesn't really feel like they need that, the filler and the nasolabial fold anymore. Sometimes they'll come in too and they'll say their eyebrows feel heavier. Maybe they've lost some of the arch in their brow.
A lot of the times when you fill the temple in, it's kind of like putting the pull back in the tent and as soon as that skin kind of perks up and goes to that natural contour, the brow lifts up a little bit, the eyes look a little more awake and alert and they really feel like it's really helped kind of bring back some of that youthful look that they were desiring. But it's crazy. People come in and there's so many fillers out there. You see so many commercials and advertisements and this one's the best and that one's the best.
The big game ones on the market are Restylane and Juvederm. Restylane obviously is my filler of choice and they kind of have two different kinds when we look at it. Restylane has their two newer products, which I'll talk about here in a second, Refine and Define and then they have kind of the original three amigos that were out there. We have Restylane, L, L just means that there's lidocaine in it.
How much all of the dermal fillers with the exception for one and there's a very new one on the market that just came out and I'm not very well versed on it because I don't use it that just hit the market but they have lidocaine in them for comfort for the client. It'll also kind of numb the area. A lot of the time based on the area that I'm doing I might put some topical numbing medication on for a few minutes especially for doing the lips which can be a sensitive area. But when going back to Restylane we have the original three, Restylane L, Restylane Lift which is for mid-face kind of augmentation, deep folds and then Restylane Silk.
Restylane Silk actually just got a new FDA clearance for lip augmentation using a micro cannula which I'll talk about here in a second but those are what we call NASHA technology, not NASHA like the space program but NASHA, N-A-S-H-A, NASHA stands for non-animal synthetic hyaluronic acid. Hyaluronic acid meaning what we have in hyaluronic acid is a very abundant substance in our body. It's very important to consider that. The body doesn't necessarily think that putting hyaluronic acid in it is crazy.
You have hyaluronic acid lubricating your joints inside your eyes, it's a major component in your skin so we are filled with hyaluronic acid already. That's what those are. Those fillers are really based on the idea of how thick they are in particle size. If you were to really break it down into a simple form you could consider that they all kind of start out as the same product, the same kind of substance.
Then it's all about how big the particle size is of the actual product itself. We judge these based on what we call a G-prime or how thick they are, how dense they are, even how elastic they are. Restylane lift being the one that really can provide the most lift to support the tissue and then restylane L. Restylane silk would be, I don't like to say the, it's like I said, you would say it's the thinnest of a one.
But then it's also going to determine where we're going to use that. Restylane L, primarily we might use for lip augmentation. We can use it in these olebial folds or for the moderate to severe tissue loss in the face or restylane lift. Off-label we use it primarily for cheek augmentation is where I like to use it.
I really like to use it deep in the tear trough area to help push that tissue up and correct the tear trough deficit. I think it looks beautiful in that area. It's a fantastic use for it there. We have some ways that we can also use it off-label in the temporal region as well.
A quick note here that I'm the stuff I can talk about when I'm doing these areas, I do everything I can as safe as possible. With any kind of dermal filler, one of the biggest risks that you'll hear about associated with it is tissue necrosis or tissue death. And the reason that happens is dermal fillers, if they're injected directly into a blood vessel, they can cut off blood flow to that area. If we lose blood flow to something, unfortunately that tissue then becomes what we would do is say ischemic, ischemic meaning it's the loss of oxygen to that area and the tissue would die.
I'm going to talk about how we manage that, knock on what I have not had a vascular event in the years that I've been injecting, but I'm also going to say that I always keep the medication on hand to take care of it should one occur. But the way that one of the best ways that I alleviate that is when I'm injecting into the face, deep into the face, the temporal region underneath the tear trough. I use what's called a cannula. So a cannula or a blunt cannula, it looks like a needle, but it's not.
If I were to take that cannula and poke it against my skin, it wouldn't poke me. It wouldn't hurt. It's not sharp on the end, it's blunt. So the idea here is that as this is moving through the tissue one, it's not cutting through the tissue the way a needle point would, but it's kind of taking the path of least resistance to get through.
So the idea is that if it were to meet a blood vessel, it would kind of bounce right off of it or maybe kind of nudge the blood vessel out of its way so that cannula can continue on its way. So it's a little, it's an extra cost to use those. It's not a cost that I pass on to the patient. I don't sit the patient down and say, do you want this done with a cannula?
Or without a cannula? With a cannula, you're going to have to pay for it. It's a cost that I absorb because I feel that it's the safest thing to do and that's important for my patients. There are places we don't use cannulas.
If I'm going to do lip augmentation a lot of the times or if we're doing anti-aging treatments on the hands, I can see the blood vessels in those areas around the lips. I know where they're at, but when I'm doing a lot of the facial work, I think it's just smart to use these cannulas. It takes training, took some extra courses, it took some extra time, kind of had to get used to them. You're using a flexible kind of cannula now because they do move a little bit.
So you kind of have to learn how to use them and manipulate them, but man, I love them now and I'm confident with them and it's good knowing that I'm providing my clients with the safest treatment possible. The newest products on the market may have some of my two favorites. I keep a stockpile of this. I'm telling you what, if a zombie apocalypse comes, I am stocking up on a distport and probably wrestling refined defined along with food for myself, my family, my dogs, but I'm going to make sure I bring some of this with me too very jokingly.
But wrestling refined and defined, these have this. It's called expression technology if we were to just say it, but the Alderma spells it very chic, they spell it X, P-R-E-S-H-A-N meaning the X is there because it's cross linked. So these molecules are cross linked and bound together and that's really the difference between these two products is how much they're cross linked. I'm going to explain that here in a second.
Press comes from expression, you know, where they're meant for expression lines on the face. There's really cool videos that I have on our website, Detroit medspot.com, along with Facebook that shows they've treated patients and they're having them say like, say, she's seashells by the seashore and singing songs, I can't even say that. And then they were showing what the expression lines look untreated and then they treated the patient, allowed the product to integrate into the tissue for two to three weeks, whatever that time frame was, and then retook the video. And man, you really see that they have a, it really kind of corrects those expression lines.
And then HA and the name stands for hyalurine acid. And then from what I was reading online, they just kind of tacked that and on the end so everything sounded good. But there, it's, you have defying which is meant, wrestling defined is meant more for your moderate or severe deep folds. It is less elastic but more thicker.
So if you're going to think of wrestling refined and defined, I want you to think of a net. And if I had defined, my net would be very tightly wound to together. It's going to be very tightly tied, almost like a bug net or a sieve almost that you might use like in the kitchen where restoline, that would be restoline defined. Restoline refined is very elastic, it's very stretchy.
If I take a little bit of that gold gel, I jokingly call it because it's worth a ton of money and you put a little bit between your fingers and you kind of move it back and forth, it's very stringy and stretchy. It's more like a loose net. So maybe like, kind of think of almost like a net, like, man, I can't think, something that you might throw a bunch of soccer balls in like a soccer ball net or something but it's a very loosely woven net. That's kind of the difference between those.
And then restoline refined, this is meant to your moderate to severe wrinkles, the fine lines of wrinkles. That's what the FDA clearance is for. I also use a lot of these two fillers in the lips. I love them in the lips and it's important to understand these products and I have to look at clients too and look at how their lips move and how they look.
If somebody has very fine lips, I'm not going to ever put a product in there like restoline defined necessarily because if I put a very stiffer product in very thin fine lips, their lips are going to not move, they're not going to have the fluidity that they need for when they're going to talk. So it wouldn't look natural or it might start to look duck-like, which is everybody's fear. I'm going to use something like restoline refined or restoline silk in those. Same thing with I've talked to injectors out there and they said, oh, I put restoline lift in the lips and I put jouveter and voluma in certain lips and I'm like, man, those lips they may not move very smooth and they may look kind of unnatural.
So it's always important that you go to injectors out there who understand where the product should be used, where they're best met for. When you look at a lot of the available materials out there and the marketing materials, because of the way that these products are cleared for the FDA, they're only legally allowed to market them in certain areas. Again, a lot of what we do is off-label use and I always try to mention that. Off-label is not meant to scare you.
We're really not doing anything dangerous, especially I can speak for myself and a lot of the other very skilled injectors that I know we've been trained and mentored on how to use these products in other areas of the body, but that's what's important is we understand anatomically what is present in these parts of the body and we know how to safely inject them. We also know and we should have on hand the product that's available should we have an adverse event to happen. The product is called Hylenex. What Hylenex does is it actually breaks down the filler.
There's a really cool YouTube video out there where somebody takes some HA filler and it's on a piece of glass or a mirror and then they put Hylenex over it. In really over a short period of time and it breaks down that gel. So that's what we would do. I always make sure I keep a stockpile of it on hand just in the event that we need it, but it's important.
When you go to an injector ask them to have this on hand, they should have that available to them. It's just it's kind of a no brainer in my book. I always make sure I have it. It's one of those things that just spend money on and you pray you never need it, but you always have it.
I think it's a must. Again, we're talking about fillers. It's just keeping in mind what they're for. They're for volume loss.
It's not something that they say, I want to get rid of these lines between my eyes or the 11s. That's not a filler thing, typically. What we want to do is that's what we're going to use the neurotoxin to paralyze that muscle. A good rule of thumb is we kind of say with the exception of a temple.
Nose down is german filler. Nose up is neurotoxin. That's where we use these areas. These products have been around for quite a long time.
I mean, man, in Sweden, where everything typically comes from Europe, Reston has been around since 1996. It was FDA cleared for first use here in 2003. A majority of these products typically have FDA clearance for up to a year. There was a study done with Reston that suggested that patients who were originally treated with, I believe it was Reston L, they were treated to appropriate correctness based on the provider's judgment.
Then if they were retreated with a follow-up treatment, I shouldn't say retreated, but a follow-up treatment, which is probably typically lasted about four to nine months after that. That the Reston L stayed with them with appropriate correction for closer to 18 months. It's important when you're considering how long these things last and you're getting that data. That depends.
It's almost like subjective. You really have to examine the clinical study design methodology that would use how much filler was used. Was it one syringe or was it? There's other syringes out there on the market from other companies and you read their FDA studies.
I mean, no wonder they lasted close to 18 months or two years. The patient had sometimes six, seven or eight syringes of filler put in them during their treatment. Keep in mind, you're investing in yourself. You're making yourself feel good.
It's everybody's body chemistry and the way their body handles things is different. I always like to give a time frame for patients. Maybe six to 12 months. I know that seems like a long possible length, but it's the reality and it's the honest truth.
But dermal fillers, man, definitely get a consultation coming and talking. It's not like you have to do it all at once. I always tell my clients, hey, here's what I see. Here's what I think we could do.
What do you want to do today? What financial do you want to do? I always make sure that we start in an area on the face that's going to look good and we take things in step by step ways sometimes. Other times though, we say, hey, let's go for it.
I really find clients the other week. She's like, I'm turning 60 in two weeks and I'm just going to do it. By the end of the treatment, we put eight syringes of product interface. No, she did not look overdone like those clients or those people that you may see on some of those real housewives of the various city.
So and so and you're like, I don't ever want to look like them. I always tell my clients, I promise I'd never make you look like that. I mean, geez, you're my walking billboard when you're out there. I don't want you looking crazy or overdone.
It's a very, I want you to look natural. I always kind of say, you know, everyone's going to notice, but nobody's going to know. That's the goal when we're working with these fillers. So obviously maybe expect some bruising after the treatments are done side effects.
You know, potentially might be some bruising, might be a little sore in the area. I know when I've had filler put under my eyes and in my cheek, it was maybe a little tender for a couple days, but it wasn't bad. Little bruising sometimes, which you can cover up if you choose to with some makeup or you can use arnica, which can maybe help with that. But other than that, you know, ice may be a little swelling, especially in the lips.
I tell people go home and ice ice baby, you know, put use that ice, that bag of peas, especially when we do certain parts of the body with fillers on the face. I tell people we can't love them or hate them for at least two, sometimes even three weeks because we kind of have to let the body kind of adjust to that swelling in that product being there, especially if you've never had dermal filler before. Your body might be like, hey, what the heck is this? Never had this here before.
So you kind of have to let the body adjust. So I say, we're not going to touch them up. We're not going to do anything. Can't love them or hate them for two weeks.
I have seen clients where the right side swelled a little more than the left and they thought they were unbalanced, but when we left them alone for two, two and a half weeks, they came back in for follow up and it was perfect. It looked absolutely beautiful. But I always like to post a lot of pictures on my Instagram account to Troit Medspa. You can follow us on Instagram, shoot us a message, give any questions, see some examples there of dermal filler.
But go out there and get a consultation. If you have any questions for us, you have topics you'd like to hear us discuss on the podcast, shoot me a message over at Detroit Medspa.com or on Instagram or on Facebook. We use that Detroit Medspa tag on all of those. Make sure you subscribe to our podcast.
We can be found on iTunes, SoundCloud, Tumblr, Spreaker, Stitcher, and Fingers crossed. Hopefully we'll be able to pop up there on iHeartRadio. But I don't want to take up any more of your time today. Thank you so much for spending time with me.
I really appreciate it. I hope I talked a little something about these fillers or got you thinking about them. Maybe it might be something you want to do. Like Harry Winston always says, people are going to stare.
So you got to make it worth their while. Make sure that you take care of yourself and have a fantastic day. Bye bye for now. Thank you for listening to Aesthetic Express with nurse practitioner Dr.
Kyle Far. If we don't discuss a topic you're interested in today, be sure to subscribe to our podcast on iTunes. So when we do, we don't miss it. For more information on treatments, visit Detroit Medspa.com.
The creators, participants, producers, and distributors of this podcast is claiming any liability with the material presented. The information presented here should not take the place of personalized medical advice. The information in this podcast is not meant to diagnose, treat, or serve as consultation for any condition. It is solely intended to educate the consumer and professional.
Based on the personal experience and research of the participants, discussion of specific aesthetic and medical and wellness treatments is done only in an individual consultation setting with Detroit Aesthetics Company and nurse practitioner Dr. Kyle Far. Contact Detroit Aesthetics Company to schedule a consultation.