Volume Restoration is a non-surgical procedure that is achieved through the injection of substances that add volume back into the skin. These include dermal fillers and fat transfer. Dermal fillers are biocompatible products that are injected into the deepest part of the skin to soften wrinkles and sometimes even support the structure of the skin.
Fat transfer involves removing fat cells from the lower part of the body (usually the abdomen) and injecting them into the face to replace lost volume.
These volume restoration techniques can be used to address a number of issues, such as nasolabial folds, marionette lines, tear troughs, hollowing of the cheeks, and even scars. They can also be used for lip augmentation to make the lips fuller.
Dermal fillers are not permanent, and they last for varying periods of time (see below). Fat transfer generally lasts longer. Typically, about half or slightly less than half of the volume of fat transfer is permanent. Some patients start by trying dermal fillers, and when they feel confident that they like the result, they have a fat transfer procedure for a more permanent outcome.
At Cascade Facial Surgery, Dr. Jonathan Grant treats every patient as a unique individual. He will evaluate your skin and may suggest a combination of dermal fillers to provide the results you want. He is an expert injector who can deliver a natural-looking result that is not overdone.
For those with signs of aging related to muscle activity rather than volume loss, we may recommend Botox®. If necessary, Dr. Grant will discuss this with you during your consultation. Read his blog post with questions and answers about dermal fillers.
Who is a candidate for Volume Restoration?
Candidates for volume restoration are those with signs of aging such as:
- Nasolabial folds (“smile lines” that run from the nose to the mouth)
- Marionette lines (wrinkles that run from the mouth to the chin)
- Dark rings under the eyes (tear troughs)
- Flattened cheekbones due to gravity
- Other lines and wrinkles on the face, neck, or hands
Adults of any age who would like fuller lips may be candidates for volume restoration in that area.
Different Types of Fillers
Juvéderm® is a smooth gel filler composed of a naturally occurring substance found in our bodies called hyaluronic acid that helps to add structure and fullness to your skin. Juvéderm® is injected under the skin to instantly restore your skin’s volume and smooth away facial wrinkles and folds, like nasolabial folds, marionette lines, and the vertical lines that form around the lips. Juvéderm® injections usually last 6 to 8 months.
Juvéderm® Voluma is also a smooth gel, but it is unique in that it has been formulated to give greater improvements in restoring deeper soft tissue volume loss with more longevity. Voluma’s consistency makes it ideally suited for deeper tissue injection, and it is presently FDA-approved for volume loss across the cheeks. Voluma can last up to 2 years in some cases.
Restylane® and Restylane® Lyft restore volume to the skin to correct facial wrinkles and folds, such as nasolabial folds. Restylane® is the only FDA-approved filler for lip injections and can also add fullness and definition to your lips, giving you a little extra pucker for that perfect kiss. Both products are composed of a naturally occurring substance found in our bodies called hyaluronic acid. The micro-particles in Restylane® Lyft are larger than those in Restylane®, thereby helping to fill deeper creases. The first treatment of Restylane® lasts about 6 months, but a second treatment can last up to 1-1/2 years.
Radiesse® is a volumizing facial filler that replenishes lost volume and helps to stimulate collagen production for a long-lasting outcome. With this treatment, you will see immediate results, as Radiesse® provides structural support to diminish deep facial wrinkles and folds. Radiesse® typically lasts 6-9 months, but can last up to a full year.
Fat Transfer involves using liposuction in the abdomen to remove fat cells from your own body. These are then treated in a centrifuge and injected into the face to replace lost volume. The amount of fat that is removed from the abdomen will have little effect on that area of the body, so it is not a fat-reduction technique for the abdomen. A small incision is made in the abdomen, and a cannula (tube) is inserted. The cannula is attached to a suction device which removes the fat cells. The incision is small enough that sutures are not usually visible and may not be required. Some of the fat (approximately 50%) can be absorbed by the body, necessitating an additional procedure, but the results are longer lasting than dermal fillers.
Understanding the Volume Restoration Procedure
Dr. Grant will examine you during your consultation and discuss what you dislike about your skin. Then, he can devise a treatment plan for you using dermal fillers or fat transfer.
A topical anesthetic is used for volume restoration with dermal fillers. Fat transfer can be done with local anesthetic or IV sedation. For fat transfer, local anesthetic is used at the liposuction site, as well as the injection sites. Most dermal fillers also contain Lidocaine to further numb the skin for your comfort.
The fillers are injected using a fine needle, and the dermal filler procedure takes only a few minutes depending on the number of areas that need to be treated. Fat transfer takes longer, as the fat must first be harvested from the abdomen and then treated before it can be injected.
Recovering From Volume Restoration
Downtime after volume restoration is minimal. Some patients experience mild symptoms of swelling and bruising at the injection sites. These usually resolve quickly and can be covered with mineral-based makeup.
In some cases, we may direct you to massage the injection sites.
If you have fat transfer, recovery is also relatively easy. The incision in the abdomen is small enough to require only a Band-Aid, although you may experience some mild pain, swelling, and bruising there. If you need pain medication for a day or two, non-prescription formulas are usually sufficient.