What is it?

Tissue fillers are substances that restore volume and shape to the skin. A number of different products have been developed as tissue fillers. These substances can help replenish volume to areas that are in need such as acne pox marks or minor skin irregularities. They can be used to provide bulk and shape to the lips or the brow. They have also been used to fill the deep lines that are produced as a result of aging. One of the more popular fillers has been collagen. This substance is made from animal tissue and gets absorbed in about 3 months. Restylane is a newer product that has the advantage of lasting more than 6 months.

What does it accomplish?     

The purpose of injecting a tissue filler is to reduce or eliminate the deep, persistent lines that are that are on your face, to contour or shape parts of the face, and to fill in small irregularities in the face. Common locations for injection of tissue fillers have been the frown line and the nasolabial folds. Tissue fillers have also been used to fill deep scars and depressions produced by acne or other conditions that affect the surface of the skin such as cheek irregularities produced by acne.

What happens during the first consultation?

In the first consultation you will get a chance to discuss your concerns with our patient care coordinators and Dr. Marefat. We will tell you what you need to know about your procedure and will help you determine what is best for you. You will receive information booklets, review before and after photographs, and receive pricing on the procedures.

How is it done?  

The procedure is done by injection of the tissue filler (collagen, Restylane, alloderm, ect.) directly into the deep layer of the skin that has facial line. The area to be injected can be anesthetized so that you do not feel the sting of the injection. Usually 1 or 2 cc is enough to produce the desired effect.

What can I expect after the injection?

After the injection the area may remain numb as a result of the local anesthetic for 1-2 hours. Occasionally, there may be a small amount of bruising in the injection site. This may be due to a small blood vessel being injured during the injection. The swelling from the injection will be completely gone in 1-2 days. Within 2-3 days you will start to see the beneficial effects of this medicine. The facial lines become softer and less conspicuous. Fillers such as Restylane may undergo periodic swelling and subsiding for several weeks. This is due to the natural absorbent quality of Restylane. Water may accumulate inside the filler depending on your hydration state.

Procedure: Tissue Filler injection continued

When are the sutures removed?  

There are no sutures with Tissue fillers

How many visits do I have after surgery?

We like to see our patients frequently after surgery. You are seen by the doctor or nurse within 2 weeks of injection. Then the normal routine is 3 months after injection. Of course if there is a need, you are seen as many times as necessary. We encourage our patients to come for their follow-up Botox injection every 3-4 months.

When can I cover my bruises with make-up?

You should be able to put makeup on your bruises immediately. The bruising is less likely to occur if you refrain from taking aspirin containing medications two weeks before your injection.

Am I a good candidate?

The ideal candidate for tissue filler injection is person who has significant frown lines or laugh lines when their face is not animated. You are also a candidate if you have thin lips or insufficient brow fullness. There is no definite age category when the injection should be done. Most patients that seek this procedure are over 30 years old. The ideal candidate for plastic surgery is a self-motivated patient who has realistic expectations about the results.   Generally the younger you are the better a candidate you are for surgery. But the physiologic age of person is more important than the chronological age. That is to say you may be 60 years old, but your skin and general health could be better than most who are 50 years old.

What does the surgery cost?

The cost of injection varies but here are some guidelines that will help you determine roughly what you could expect. Remember that these are only rough estimates . These estimations include the cost of the filler, the injection, and any follow-up visit. The fee may be subject to change without notice. The best way for you get an accurate cost analysis is to see a doctor.

Tissue Filler injection     $400-$600

Which Tissue filler should I use?

This depends on what you want to achieve. Today we have many choices for fillers. Some fillers are made from your own body's tissue such as fat or dermal grafts. The advantage of using your own body's tissue is that it is never rejected. In addition, some of these grafts are longer lasting.   The disadvantage of using fat or dermis is that it entails harvesting the graft from some part of your body. The recovery time may also be more than using a substance such as collagen or Restylane. The advantage of using filling agents that do not belong to your own body is that you do not have to harvest them. They are made by animal or non-animal chemical substances and are ready for injection. However some people are allergic to these substances and their body may react to them in an adverse way. Furthermore most of these products are not long lasting. Restylane, which has been recently approved for use in the United States, is one of the longer lasting tissue fillers. It may last up to 6 months after injection.   You should choose the tissue filler that can best address your problem with the minimum of adverse side effects. In order to make this decision it is best that you discuss this with your plastic surgeon.

How do I pay for surgery?   

You can pay for surgery by certified check, credit card, or cash. Payments for cosmetic surgery are expected prior to the procedure. If you are scheduling several weeks in advance of surgery you can pay by personal check.

Procedure: Tissue Fillers continued

Are there scars?

No.

Does it hurt?

There is minimal temporary discomfort as the injection is being given. Dr.Marefat usually numbs the area to be injected with local anesthetic so that you do not have too much pain.

Will I be awake during the procedure?

Yes. You do not need any sedation for this procedure.

Where is the procedure performed (i.e. office suite or hospital)?

The procedure is performed in the office.

Are medical photographs taken?  

Yes. Photographs are mandatory for all cosmetic and reconstructive cases. Photographs are the only way for us to compare your before and after results. Photographs in plastic surgery serve the same role that x-rays serve for orthopedic surgery.

Date Revised: 1/23/07

At Metropolitan Plastic Surgery PC, Dr.Marefat offers the highest standard of care in Cosmetic Plastic Surgery with accessilbe locations in Northern Virginia ,Washington D.C., and Maryland. Dr.Marefat combines artistic skill with the lastest techiques of Plastic Surgery to achieve superior results in cosmetic procedures such as Liposuction, Tummy Tuck or Abdominoplasty, Breast augmentation or Breast Implant placement, Mastopexy or Breast Lift, Blepharoplasty or Eyelid Surgery, Facelift, Rhinoplasty or Nose Surgery, Botox Injection, Lip Augmentation,Tissue Fillers,Laser Surgery, and many other cosmetic procedures. This site is a valuable source of informationn about Dr.Marefat's practice, his approach to Plastic Surgery and his locations in Woodbridge Virginia, Alexandria Virginia, and Washington DC.

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