Alexander Z. Rivkin M.D. is a Yale trained facial cosmetic surgeon and UCLA faculty member who has focused his practice exclusively on providing his patients with the latest in non-invasive, non-ablative cosmetic treatments in Southern California. He understands that no one relishes the thought of “going under the knife,” and believes modern medical technology can provide today's patients with superior alternatives to invasive, painful surgery that requires a long recovery time.

Sunday, December 23, 2007

Questions

I signed up on a forum site to answer questions from people, so I thought I would include some of the more interesting questions here as well.

Here is the first one:

I have been toying with the idea of having the area around my mouth and chin filled to reduce the lines going from my mouth to chin - sort of giving me an appearance of a frown. I also have a little bit of fat loss in that area that adds to this - anyway I guess you could say that after researching various fillers - pros and cons and reading the messages on this boards I am more confused than ever.

I had considered Sculptra but am not sure if this is right for this area and also am concerned about lumps etc..... I am slightly scared of the permenant fillers (Artefill) as I am worried that they are too new to really determine their safety and of course as they are "permenant" any mess ups are there for good. Some of the others, such as Juvederm and such seem to only last a couple of months making the "pain/cost" factor quite high for the length of time it lasts.

Understanding that you can't really recommend anything without seeing a person, can you point me in the right direction of what I should consider and ask when thinking about doing this?

There is so much "stuff" out there that I am really confused as to the differences in these products. Perhaps there are others on the board who are confused who would welcome some info on how to approach this.

Thanks!

hi,
this is a really good question - there are many options for fillers these days. This is good because you can really select a treatment that suits your anatomy, your mindset and your budget. however, it does tend to get confusing, trying to figure out just what would be best for you.
if i had to guess, i would start off with juvederm in your nasolabial folds. it is a very soft and natural looking filler and it lasts about 6 to 8 months. the stuff on the net you hear about it lasting 2 months or so is mostly rare cases of poor injection technique or just unusual people.
i think sculptra would be quite expensive, although it would last longer. you'd have to come in 2 to 3 times at close to $1000 a pop and it would last about 2 years or so. not bad, but most of my patients don't want the hassle and expense.
radiesse is very good, but i get more bruising and swelling than juvederm, and it lasts about 10 to 12 months. its about $200 more per syringe.
also, either radiesse or juvederm stimulate collagen, so even after the filler has been broken down, the lines come back a bit more shallow each time.
hope that helps,
cheers

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