A truth or myth: A Wrinkle … is a wrinkle is a wrinkle? [Part 2]

August 2nd, 2013 by Dr. Robert J. Troell, M.D., F.A.C.S.
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Dermal filler procedures (Restylane, Perlane, Juvaderm, Radiesse, Artifll) are indicated for improving the appearance of wrinkles and lines as well as volume replacement of facial areas of aging’s fat resorption or to produce enhancement or augmentation.

When repair of volume loss or for enhancing or augmenting areas, radiesse and artefill are a better choice of dermal filler compared to hyaluronic acid fillers. Radiesse is hydroxyappetite, a white firmer material that is injected below the skin into the deeper tissues. The advantage of radiesse over hyaluronic acid fillers is that it lasts longer, approximately 10-12 months. Artefill has an excellent safety profile, has a natural feel, long-lasting filler composed of 80% absorbable collagen, however, 20% of the filler is composed of microsomes of silastic that are permanent.

The Vampire Facelift uses a dermal filler to augment volume deficiencies and platelet rich plasma (PRP) to enhance the skin’s collagen and elastin fibers (see Laguna Beach Life magazine, June 2013 issue). Dr. Troell has modified the Vampire Facelift and refers to this procedure as the “Ageless lift” using a combination of a microdermabrasion, micro-needling of the skin, a dermal filler placement (as needed) followed by the dermal skin injection of platelet rich plasma to rejuvenate your skin.

Facial fat grafting allows permanent volume replacement. It is performed by taking your own fat and placing it in areas of volume loss. New developments in fat harvesting, fat processing and fat grafting have yielded the highest fat survival rates, as much as 80% in Dr. Troell’s hands. The addition of one’s own adipose derived stem cells and PRP can also improve the survival of this grafted fat to make a reliable, permanent volume replacement of augmentation procedure. Face, hand, breast, buttock, lower extremity and cellulite indentations have all been treated using one’s own fat.

Although volume enhancement by dermal filler or fat injections can improve the following, often a mid-facelift or standard facelift is preferred to re-suspend dropping soft tissue, softening the folds appearance:

♦ the folds extending from the nose lateral to the corners of the mouth (nasolabial fold)
♦ the folds from the corners of the mouth to the lateral chin area (mesolabial fold)

Related posts:

A truth or myth: A Wrinkle … is a wrinkle is a wrinkle? [Part 1]
A truth or myth: A Wrinkle … is a wrinkle is a wrinkle? [Part 3]

Facial Plastic Surgery American College of Surgeons American academy of cosmetic surgery American society of liposuction surgery American academy of otolaryngology head and neck surgery