FROM WWW.HEALTHNEWSDIGEST.COM

WELCOMING THE NEXT GENERATION OF PAINFREE FILLERS

By Wendy Lewis

This week marked a major breakthrough for women (and men) in search of ageless looks. First Juvederm® XC from Allergan announced its FDA approval, followed shortly by Restylane® and Perlane® with Lidocaine from Medicis. These fillers are the next three hyaluronic acid gel derived filler choices available to Americans, after Prevelle® Silk from Mentor and Hydrelle®, which is now marketed by Coapt Systems.

Some may balk at this news because their doctors are already using lidocaine with their injections, however, this indeed marks a dramatic advancement in the next generation of age-reversing injectable substances. It also signals that doctors and the pharma giants that make these products are more interested in making us comfortable while getting our lips enhanced or folds filled. Now that the two market leaders have entered the lidocaine enhanced filler space, this clearly sets the new gold standard for every filler product that gets launched.

Essentially many of us will be able to tolerate Juvederm XC or Restylane with Lidocaine without the need for additional messy topical anesthetic creams or local anesthetic injections which can be as uncomfortable as the filler injections alone. These breakthrough products contain 0.3% lidocaine that effectively numbs the treatment area within a few seconds, so the only painful injection is the first time the needle enters your tissues. Reduced stinging and burning also reduces your squirming and contributes to an overall manageable and one might even say “pleasant” experience for you and your doctor. Furthermore, the treatment will take much less time, since the anesthetic is already loaded into the syringe. Topical creams used to take 30-40 minutes to kick in, local injections added more time and more swelling, and many doctors were fiddling with mixing lidocaine into fillers before they used them.  So these new products are a real win-win.

These product launches are also a giant leap for women who want multiple areas treated in one session will now comfortably be able to tolerate two, three, four or more syringes to enhance sagging cheeks, deep creases around the mouth, fill in hollows under the eyes and reshape the lips with ease. For all the filler virgins out there who have been afraid to take the plunge and have their first treatment because of the stinging of the needles, now is the perfect time to reconsider. Hyaluronic acid gels have been studied around the world for over 15 years and have been proven to be safe and effective for filling facial lines, folds and wrinkles, as well as lips, scars, and other areas as an off-label use.

Take advantage of special offers and find a qualified physician injector by visiting: www.juvederm.com, www.restylaneusa.com

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*Photo reprinted with permission

By Guest Bag Lady Dr. Bonnie Marting, DNP, ARNP

Evolence® is a filler worth exploring. Since its FDA approval over a year ago, Evolence® has proven to be not only an elegant soft-tissue filler, but a surprisingly adaptable and smoothing entity that immediately transforms its target into precisely what these products are meant to do: create a beautiful wrinkle or fold correction without a hint of appearing corrected. This makes working with Evolence® a pleasure.

All fillers can be used to correct lines and defects. An interesting characteristic of Evolence® is that it flows extremely easily, and the defect appears to take more of this product than say, a hyaluronic acid such as Juvéderm® or Restylane®. What is interesting is that most of my patients who have previously received other fillers really loved the look and feel of Evolence®. There is little to no inflammation afterward, and the product is robust enough to gently lift even more difficult areas such as the corners of the mouth.

Although not intended for use in the lips, Evolence® can be used almost everywhere else. Since the collagen fiber is so similar to human collagen fiber, the correction appears to be maintained for a long period of time, as if the patient was just treated.

As one of my patients remarked, “I think it is amazing! You see it right away, and it really doesn’t look like anything happened, except the corners of my mouth are no longer turning down! It was so fast and comfortable…I may never ask for anything else.”

Another commented, “I was so afraid to do anything for so long. I’m only 37 so I thought it was too early. When I finally got up the nerve to try Botox and loved it, I thought I might be ready for something else. I can’t believe how young and refreshed it makes me look! I no longer have smile lines! Even my dad, who was totally against cosmetic treatment, was ecstatic!”

When patients come to me for help they will often ask, “What do I need?” I will invariably ask what bothers them or what are they concerned with, as their looks don’t bother me the way they might bother them. Then we start exploring the areas, one at a time. What I have learned is that most of my patients, especially the cosmetically naïve ones, really don’t know what is out there.

If you are new to the world of fillers, I suggest considering each of the following:

1. Why are you going in the first place? Do you look tired? Are your lips thinning? Is your face starting to droop? Ask about specific treatments and products that will address your issues.
2. Why these products? When you and your clinician decide on what product or products to use, ask why he or she chose them. Ask for before and after pictures.
3. Ask how often he or she performs these treatments. Many different types of clinicians perform injectable treatments today. Make sure it accounts for at least 50% of their practice – avoid someone “practicing” on you.
4. Think about using Arnica gel (a gel or ointment that contains some derivatives of thymol, which may have anti-inflammatory properties) prior to and after treatment. Bruising with Evolence® is rather rare, but always a possibility (more likely if you absolutely cannot afford a bruise at the time!). Some topical Arnica can sometimes reduce the chance of a bruise, or decrease clearing time. Eating pineapple (active ingredient: bromelain) can greatly reduce bruising.
5. Price vs. Quality. The lowest (or the highest in many cases) prices may not necessarily be what you are looking for. Ask your friends or medical professionals who they would trust. These are the best referrals.

Be sure to leave a consultation appointment with what you came for. Ask until you have all your questions answered, and feel comfortable proceeding with a procedure, or tabling it for a later date.

www.yearserased.com

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Are your skinny lips a 2? Or are they a plump perfect 5? The Merz Aesthetic Scales can show you how your pucker rates on a scale of 1 to 5.

Carefully designed by a group of leading physicians as an innovative tool to help cosmetic doctors communicate with their patients about the various areas of the face, these scales are becoming a state-of-the-art measurement for the effects of aging on skin. The Merz Aesthetic Scales provide a common language for both patients and physicians to assess how well they are aging (or not, as the case may be). 

There are 6 scales to date:

• A Validated Brow Positioning Grading Scale
• A Validated Grading Scale for Forehead Lines
• A Validated Lip Fullness Grading Scale
• A Validated Grading Scale for Marionette Lines
• A Validated Hand Grading Scale
• A Validated Grading Scale for Crow’s Feet 

So for example, let’s say when your doctor shows you the Merz Lip Fullness Scale, you think you are starting out at a petite 1 and you secretly desire to be a megawatt 4. In that case your doctor may tell you that to get there will require 4 syringes of hyaluronic acid filler or 100ccs of fat taken from your thighs. You may rethink your request down to a 3 or 2, which may be more reasonable and realistic for you. Whatever the outcome you agree on, instead of just telling your doctor you want “fuller lips”, the Merz Aesthetic Scales will alow you to point to what you want so that your doctor can advise you properly. It’s a great concept.  The same rules can be applied to forehead lines, wrinkled hands, droopy brows, corners of the mouth, and crow’s feet.  

The end result is that for the first time patients and doctors are speaking the same language, comparing apples to apples, so there can be less confusion, misunderstanding, and disappointment when it comes to having injectable treatments like fillers and neurotoxins. Go Merz!

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