Tag Archives: facial fillers

Here’s What to Look for in a Qualified Aesthetic Dermatologist

Frequently on the Aesthetic Dermatology and Skin Cancer: Jeffrey H. Binstock, M.D. website we caution readers to be careful when selecting the provider who will use fillers and other injectables on your face.

But how do you judge competency and experience?

Certainly, you can ask friends, but generally their experience is anecdotal—limited to just one or two people who treated them in the past. Or, perhaps they have a friend who has a friend.

The fact is that the best results from treatment depend on many factors, including the exact purpose for using a filler, its known limitations, any interaction between the filler and your skin, and, of course, proper placement of the filler under your skin.

Here’s what to look for during your initial consultation with the person doing the injecting.

First, meet with the provider who will do perform the treatment. Describe what you want done and that you know there are lots of fillers that could be used. Which one is best for you, and why? The FDA has posted a list of fillers with descriptions here.

The person doing the injecting must be thoroughly familiar with all filler option—one size does not fit all.

Second, training and experience count. Ask where the person doing the injection went to school. They should have a degree from an accredited medical school, preferably with a post-doctoral degree. For example, in addition to receiving his degree in medicine and years of experience in aesthetic dermatology, Dr. Binstock’s training includes a prestigious Fellowship at UCSF. Today, he is Clinical Professor of Dermatolgy [Volunteer] at the University California San Francisco.

Then, ask about for how long the person doing the injecting has been providing this service in an aesthetic dermatology practice.  Theoretical knowledge can be learned from books, but practical knowledge is best acquired through experience treating many patients over many years. How many people does he or she treat with fillers each week?

Finally, cost. We all look for the best price, that’s normal. But if the cost is too good to be true, be cautious. Ask about the source of the fillers. Sometimes, cheaper prices are charged because drugs being injected come from outside the U.S. and are not approved for use by the U.S. Food and Drug Administration (FDA).

Seek a board-certified aesthetic dermatologist who is experienced in facial rejuvenation. For consultation, contact Aesthetic Dermatology and Skin Cancer: Jeffrey H. Binstock, M.D. Dr. Binstock, Dr. Layton, and Stephanie Cullinane, PC-A, will answer your questions. Call our San Francisco office at (415) 956-8686, or in Mill Valley call (415) 383-5475.

Treating Age-Related Volume Loss in the Cheeks

Juvéderm Voluma® XC is a facial filler that uses a unique formulation of hyaluronic acid. It is designed to correct “age-related midface volume deficit.” In other words, it plumps up the cheeks! “XC” means there is a small amount of lidocaine in the product, which numbs the area during treatment.

Voluma XC differs from other hyaluronic acid fillers in several ways. First, it feels soft and natural in the skin. Second, Voluma XC may be less painful than other fillers because it is injected deeper into the skin where there are fewer nerves. Third, injecting deeper may also cause less bruising because it is injected under blood vessels. Fourth, the results typically last 9 to 12 months—some report up to 2 years. The duration of response is related to the area of the cheek treated and the dose. Follow-up treatments extend the duration of response.

Response to Initial Treatment

Immediately after treatment, 96% of 115 people treated with Voluma XC reported being “delighted” or “happy” with the results. Satisfaction was maintained by day 21.

Response to Initial Plus Follow-up Treatments

The volume of Voluma XC injected and the number of treatments extend the duration of satisfaction.

Table 1. Responders were those who achieved at least a 1-point improvement on the Mid-Face Volume Deficit Scale.

Table 1. Responders were those who achieved at least a 1-point improvement on the Mid-Face Volume Deficit Scale.

In a study of 235 adults initially treated with Juvéderm Voluma XC plus touch-up treatment available 30 days later, responders were those who achieved at least a 1-point improvement on the Mid-Face Volume Deficit Scale (Table 1). Six months after treatment, 76% to 83% of patients responded depending on the area of the cheek evaluated (Figure 1). Higher responder rates, up to 24 months, were achieved as the volume of Voluma XC injected and the number of treatments increased.

The Bottom Line

Figure 1. Month-6 response rates were 76% for zygomaticomalar, 83% for anteromedial cheek, and 77% for submalar regions.

Figure 1. Month-6 response rates were 76% for zygomaticomalar, 83% for anteromedial cheek, and 77% for submalar regions.

The development of newer hyaluronic acid fillers has created many products with subtle but important differences. Voluma XC requires special training and experience to use it correctly. If the person injecting your face doesn’t appreciate how Voluma XC differs from other fillers and lacks experience injecting Voluma WC, you will not get the full benefit for the money spent.

Further, if your doctor doesn’t have an artistic eye and an understanding of how Voluma XC can bring harmony to the anatomical changes that accompany aging, you could leave the office looking really fake.

Don’t look really fake. For consultation and more information about our approach to using facial fillers, including Juvéderm Voluma XC, to achieve the best look for you, contact Aesthetic Dermatology and Skin Cancer: Jeffrey H. Binstock, M.D. Drs. Binstock and Layton will answer your questions. Call our San Francisco office at (415) 956-8686, or in Mill Valley call (415) 383-5475.