section of the forum is dedicated to discussions addressing injectable fillers including Restylane, Perlane, Juvederm, Radiesse, Sculptra, Silicone, Artefill, or other office-based injectable filler, except for the management of acne scarring (See Acne/Acne Scarring Forum).
So I'm a little confused... 20% of the collagen is absorbed with artefill? I've heard that results improve over the following months of injecting artefill (something about the collagen being absorbed but the microspheres remaining and new collagen being produced?) You've had extensive experience with artefill, how does it work for you? So 1/2 to 1 syringe... I assume for the upper eyelid only? What about for the whole face in someone mid 30's (including very little in the buccal area)? Do you use less filler than most doctors because of knowing the precise points where to inject it? Again, thanks a lot for clearing my doubts
ok, what you are talking about occurs about 2 years out from doing artefill. one's own collagen can continue to improve the area of injection but it does not necessarily happen in everyone. however, there is oftentimes a dip at a month to two months when your tissues do not 1:1 replace the collagen vehicle. so there is a dip then a rise but the rise is typically less than the dip.
yes, 1/2 to 1 in the upper eyelids and possible one more round to touch up any of the dip. the whole face depends on how much loss you have. it could be 2 to 3 or could be 5 to 6. when it exceeds 5 to 6, typically fat transfer is more economical. however, i would caution you again that fat is safe if your weight is relatively stable.
yes, i probably use less filler than most docs because of my experience. however, because i know of so many little areas to place it in terms of aging, i can actually use more. a lot of docs just stick it in the cheek but i blend it over many small areas so if there is enough total deficit i would probably recommend fat as a more universal cost effective solution with the caveat mentioned above. best, sml
Samuel M. Lam, M.D., F.A.C.S.
Diplomate, American Board of Facial Plastic & Reconstructive Surgery
Diplomate, American Board of Otolaryngology Head & Neck Surgery
Diplomate, American Board of Hair Restoration Surgery