Injectable Fillers

As we age, our faces begin to show the effects of sun exposure, gravity, and years of facial muscle movement, such as smiling and frowning. The underlying tissues that give our skin a youthful and plumped up appearance begin to break down. This leaves creases in predicable areas such as “laugh lines,” “smile lines,” “crow’s feet,” and “marionette lines.” Wrinkles are classified into two categories, dynamic and static wrinkles.

Dynamic wrinkles are caused by contractions of the small delicate muscles of facial expression each time we smile, laugh or frown. Over a lifetime normal use, these muscle contractions may lead to more permanent lines and creases. Dynamic wrinkles typically form across the forehead, between the eyebrows (frown lines), and on the sides of the eyes (“crow’s feet”). These are treated best with BOTOX® injections.

The second are static wrinkles, which are caused by folds that form from the sagging of facial tissues. These wrinkles are caused by the life-long effects of gravity and result in “laugh-lines” and “marionette lines.” These wrinkles are best treated with soft tissue fillers such as Restylane, Hylaform, and Captique. If significant sagging of facial tissues is present resulting in jowling, loss of the jaw line, and laxity of the neck, then a facial rejuvenation procedure may be considered.

Your face is unique. It shows the distinctive, individual life
you have led.

Therefore Dr. Zemmel will evaluate and treat each patient as an individual. Several soft tissue fillers are available and Dr. Zemmel uses each one differently depending on the circumstances.

What To Expect From Treatment

The most important fact to remember about injectable fillers is that the results are not permanent. Injected material is eventually metabolized by the body and excreted as harmless byproducts. Hylaform, Captique, and Restylane typically last 4 to 6 months. You should not expect the same long-lasting results that may be gained from cosmetic surgery.

In some individuals, the results may last only a few months and in others, the results may be maintained for 8 to 12 months. Research has shown to a number of factors influence the “staying power” of the filler. These include:

However, the precise reason for the variation of results among patients has yet to be identified. Although it’s true that some individuals’ bodies are more receptive to one substance than another, others may find that neither substance produces long-lasting results. Sometimes one substance may work better than the other for a specific problem.

Risks Of Injection

When injectables are administered by a qualified Plastic Surgeon, complications are infrequent and usually minor in nature. However, individuals vary greatly in their anatomy, their physical response to the injection, and their healing abilities. The outcome of treatment with injectables is never completely predictable.

Most patients experience a small amount of bruising and swelling which usually goes away in a few days. Infection, scarring and lumpiness can occur but are extremely rare.

Planning For Treatment

Facial rejuvenation is very individualized. That’s why it’s important to discuss your hopes and expectations with Dr. Zemmel who has experience with many different types of surgical and non-surgical procedures for the face.

In your initial consultation, Dr. Zemmel will evaluate every detail of your face:

He will help you select a treatment option based on your goals and concerns, your anatomy and your lifestyle.

Dr. Zemmel will ask you about your medical history, drug allergies, and check for conditions that could cause problems, such as active skin infections or non-healed sores from injuries.

Insurance usually doesn’t cover cosmetic procedures. However, if your injectable treatment is being performed to treat a scar or indentation from an accident or injury, you may be reimbursed for a portion of the cost. Check with your insurance carrier to be sure.

Treatment Will Be Performed In The Office

Dr. Zemmel administers injectable fillers in the office. If you are undergoing additional surgical procedures, it can be done concurrently in the operating room.


You will be give topical anesthetic cream, which will dull the sensation to that area. Dr. Zemmel will then give you one or two small injections of Novocain (lidocaine) to completely anesthetize the area. Once completely numb you will not feel any of the injections.

Treatment And Types Of Soft Tissue Fillers

Dr. Zemmel most commonly uses:

Each filler has its own technique of injection, its own lifespan, and its own properties.

When injected beneath the skin, all fillers plump up creased and sunken areas of the face. They can also add fullness to the lips and cheeks. Injectable fillers may be used alone or in conjunction with BOTOX®, a resurfacing procedure, such as a laser treatment, or a recontouring procedure, such as a facelift.

As mentioned above, you will be completely numb before injection. Dr. Zemmel will then inject the filler using the “threading” technique, which layers the material in a uniform pattern just under the skin. Dr. Zemmel will then gently massage the skin and filler to smooth out the area. This is important in preventing small lumps.

You will be given a mirror throughout the procedure so you may guide Dr. Zemmel to the areas the concern you most.

Since part of the injection is salt water that will be absorbed by the body within a few days, Dr. Zemmel will slightly overfill the area. He will ask you to hold a hand mirror during the procedure to help you decide when you’ve had enough.

The anesthetic lasts 2 to 3 hours, and after you may notice some minor discomfort, stinging or throbbing in the treated area. Occasionally some bruising or swelling will occur, but it is usually minor. Any redness that appears in the injected site usually disappears within 24 hours.

No bandaging is needed and you are free to eat, drink, and wear makeup with sunblock protection shortly thereafter. Most people return to their normal activities immediately after the procedure. There may be some temporary swelling and redness in the treated area, which should dissipate within a few days. If these symptoms persist, contact Dr. Zemmel.

Your New Look

If you’re like most of Dr. Zemmel’s patients, you’ll be very satisfied with the results of your injectable treatments. You may be surprised at the pleasing results that can be gained from this procedure.

Finally, keep in mind that Dr. Zemmel can offer you the full gamut of the most advanced treatments ranging from cosmetic surgery, refinishing techniques, laser therapy, injectables and the use of other fillers. You and Dr. Zemmel may determine that a single procedure or a combination of procedures is the best choice for you.