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Dermal Filler Injections in Birmingham AL

Temporarily Diminish Facial Lines and Restore Youthful Volume

Dermal fillers model

As we age, our faces naturally lose subcutaneous fat. The facial muscles are then working closer to the skin surface, so wrinkles such as smile lines and crow's feet become more apparent. The facial skin also stretches a bit, adding to this loss of facial volume. Other factors that affect the facial skin include sun exposure, heredity and lifestyle.

Dermal Fillers help to temporarily diminish facial lines and restore volume and fullness to the face. Fillers can be helpful to those with early signs of aging or to add value to facial rejuvenation surgery.

The experienced professionals at Hedden & Gunn Plastic Surgery offer a number of dermal fillers at our Birmingham, Alabama cosmetic center that rejuvenate your appearance by diminishing facial lines and adding youthful volume. These injectables include include Juvéderm, Restylane, Radiesse, Sculptra, Belotero Balance and Bellafill.

Dermal fillers are used to:

  • Plump thin lips.
  • Enhance shallow contours.
  • Soften facial creases and wrinkles.
  • Improve the appearance of recessed scars.
  • Reconstruct contour deformities in the face.
  • Decrease or remove the shadow of the lower lids.

Types of Dermal Fillers

For many people, the use of dermal fillers is a simple, office-based "lunchtime procedure" that nicely enhances their appearance. Dermal fillers are very predictable and have relatively minimal risks and side effects. Drs. William Hedden, Stephen Gunn and Joshua Halka in Birmingham-Hoover, Alabama will help you determine the best type and volume of filler for your areas of concern.

Dermal fillers differ in chemical makeup, longevity and softness. For example, softer fillers are used in the lips while sturdier fillers might be desired to enhance cheekbones.

Hyaluronic Acid

Hyaluronic acid is a natural substance found in your body, including skin tissue, and is one of the most popular kinds of injectable fillers. Hyaluronic acid injections can be used to improve the skin's contour and reduce depressions in the skin due to scars, injury or lines. You can see potentially dramatic improvements for:

  • Acne scars.
  • Cheek depressions.
  • Crow's feet at the corner of your eyes.
  • Deep smile lines that run from the side of the nose to corners of the mouth (also known as nasolabial furrows).
  • Frown lines between the eyebrows.
  • Marionette lines at the corners of the mouth.
  • Redefining lip border.
  • Scars including burns, acne and those caused by wounds.
  • Smoker's lines; vertical lines on the mouth.
  • Some facial scars.
  • Worry lines that run across your forehead.

Dermal fillers forumulated with hyaluronic acid at our Birmingham, Alabama practice include Juvéderm, Restylane, Belotero Balance and Hylaform.

Calcium Hydroxylapatite

Calcium hydroxylapatite is a mineral-like compound found naturally in human bones. It's often used to:

  • Treat moderate-to-severe creases such as nasolabial folds, marionette lines and frown lines.
  • Enhance fullness of the cheeks and other facial contours.
  • Improve volume in areas of facial wasting, such as that which can occur in people taking certain medications.

Calcium hydroxylapatite is biosynthetically produced, which means that no animals or animal products are used. This lowers your risk of an allergic reaction and no skin testing is required. This type of dermal filler is known to produce a very natural result, doesn't migrate and side effects are rare. First used in dentistry and reconstructive surgery, calcium hydroxylapatite has a long safety record.

Radiesse is the calcium hydroxylapatite (CaHA) portfolio that provides both immediate, natural-looking results and long-term improvement of a year or more in many patients.


Polyalkylimide is a semi-permanent dermal filler often used to:

  • Treat deeper wrinkles such as nasolabial folds or depressed scars.
  • Plump thin lips.
  • Enhance cheekbones and the jawline.
  • Replace facial volume lost due to age.
  • Treat facial wasting from HIV medications.

Polylactic Acid

Polylactic acid is a synthetic dermal filler that causes the body to produce collagen when injected into the face. This type of dermal filler is known as a stimulator. This non-toxic, biodegradable substance has been used for more than 40 years as suture material.

Polylactic acid is known to work particularly well in the lower half of the face and is used to:

  • Fill the lines caused by laughing.
  • Plump thin lips.
  • Treat deep nasolabial folds.

Polylactic acid is unlike other dermal fillers because it doesn't produce immediate results. Instead, it stimulates your own body's collagen production, so results appear gradually over a period of a few months.

You will likely need about three monthly treatments with polylactic acid to achieve your desired results. Your own collagen is re-stimulated with each treatment. It can take 4 to 6 weeks to see the full effect. While this type of dermal filler is considered semi-permanent, you may still need occasional touch-ups.

Sculptra is a poly-L-lactic acid (PLLA-SCA) facial injection that hlps stimulate your skins natural collagen production and works subtly, gradually over time for a more youthful-looking appearance.

Polymethyl-Methacrylate (PMMA) Microspheres

PMMA is considered a semi-permanent filler and is most often used to treat medium-to-deep wrinkles, folds and furrows, particularly nasolabial folds. It can also be used to fill out pitted scars and to augment thin lips.

When a more permanent solution to facial wrinkles is desired, PMMA is often used instead of collagen replacement therapy or hyaluronic therapy. PMMA has been used for many years in permanent surgical implants. Because of this, your surgeon will likely under-fill on the first treatment, adding more later if needed.

One of the downsides of PMMA is that a number of injections are needed to create volume and it can take up to three months to realize the full effects. It may also be visible under the skin. To avoid any unwanted results, it's key that your plastic surgeon is familiar with the proper technique, which involves injection at the dermal subcutaneous junction using threading or tunneling methods.

Bellafill is the polymethyl methacrylate (PMMA) microspheres dermal filler that stimulates collagen growth long term to help maintain your youthful appearance for up to 5 years.

Fat Injections

Some patients may wish to consider fat injections, which use fat harvested from the patient's own body to add facial fullness, fill creases or build up shallow contours.

Dermal Filler Candidates

You may be a good candidate for dermal fillers if you:

For some patients, surgery such as a facelift, brow lift or eyelid surgery may be the best approach. Minimally-invasive rejuvenation treatments, such as soft tissue fillers, cannot achieve the same results, but may help delay the time when consideration of a facelift becomes appropriate. It is important to remember that dermal fillers are temporary treatments for facial aging and that ongoing treatments will be needed for long-term results.

Your Dermal Filler Consultation

During your dermal fillers consultation be prepared to discuss:

Your surgeon may also:

Your plastic surgeon will carefully explain:

Dermal Filler Risks and Safety

Severe complications from dermal fillers are uncommon. Potential risks vary depending on the specific filler used and the relative permanence of the filler substance. Your plastic surgeon and/or staff will explain any risks in detail.

Potential risks of dermal fillers include:

Dermal filler risks will be fully discussed prior to your consent. You will be asked to sign consent forms to ensure that you fully understand the procedure, as well as the risks and potential complications. It is important that you address all your questions directly with your provider.

Although good results are expected from your procedure, there is no guarantee that you will be satisfied with your results. Because significant complications can occur from dermal filler injections, it is important to be in the care of a physician who understands the risks and is trained and prepared to deal with any complications that may occur.

In some situations, it may not be possible to achieve optimal results with a single procedure. As most fillers do dissipate over time, you will need to consider repeating the injection process at intervals to maintain your correction.

Dermal Filler Procedure

Facial Assessment and Mapping

If you choose to utilize packaged soft tissue fillers, the plastic surgeon or specially-trained nurse will evaluate your facial appearance and skin tone, and examine the areas of your face to be augmented. Strategic points on your face may be marked as the appropriate injection sites for the filler. Photographs may be taken of the areas to be treated.

Cleansing and Anesthetizing

The injection sites will be cleansed with an antibacterial agent. Pain at the injection site may be addressed using a very cold instrument to chill the skin, anesthetic ointment to numb the skin or injection of local anesthesia. While not painless, the injections are usually easily tolerated.

Dermal Filler Injections

Injection usually takes only a few moments per site. The process of injecting, massaging and evaluating the result is performed, and additional filler added as needed. Depending on the number of areas to be treated, the whole process may be as short as 15 minutes or as long as an hour.

Cleanup and Recovery

Once the results are deemed satisfactory, any markings will be cleaned off. You may be offered an ice pack to reduce swelling and alleviate discomfort. Although the area may feel a bit tender for a day or two, it is usually not painful enough to require any medication.

Dermal Filler Recovery and Results

Recovery time varies for each patient and for each type of filler injected. You can resume most activities right away, but it is generally recommended that you avoid intense physical activity for the first 24 to 48 hours to minimize swelling and bruising. Be sure to discuss your specific recovery plan with your physician prior to scheduling your injections.

Your initial appearance after treatment with any dermal filler may include:

Most conditions can be alleviated with topical icing and massage and will improve within a matter of hours or just a few days. Some reactions may require more aggressive treatment with medications or injections.

Although not common, visual disturbances may occur. When accompanied by pain or weakness on one side of your body, it is extremely important that you contact your surgeon and receive care immediately.

When your own fat is the injected filler, the healing process is longer and may take a few weeks.

Procedure Information © American Society of Plastic Surgeons

Hedden and Gunn Plastic Surgery

Dermal Fillers help to temporarily restore skin volume and smooth wrinkles to give your face a younger look.

Birmingham, AL Office & Surgery Suites

Hedden & Gunn Plastic Surgery
140 Village Street
Birmingham, AL 35242
205-980-1744 or 800-HeddenMD
American Society of Plastic Surgeons * American Society for Aesthetic Plastic Surgery *
* Dr. William Hedden, Dr. Stephen Gunn
Hedden and Gunn Plastic Surgery

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Questions About Injectable Treatments?

Contact our Birmingham, AL cosmetic surgeons today to rejuvenate your look with Dermal Fillers including Restylane, Juvéderm and Sculptra.

To schedule your consultation at the earliest possible date, please call 205-980-1744.

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