hi i'm dr johnny thanks for joining me
today we're talking about
dermal fillers what are your options i'm
going to go through them
talk about the different types talk
about what are the options most people
choose why they choose them
what should you choose what makes sense
for you
it depends on what we're trying to
achieve angles
you want a full face rejuvenation you
want short term
you want long term what's your provider
really good at doing
what type of fillers are they used to
doing that will determine it we have
permanent products
i have a video i did recently on bella
fill a lot of people ask hey how come
things don't last longer
i'm going to succinctly as i can take
you through the types of dermal fillers
that are commonly used i'll touch on
some that are
available in just a few countries maybe
but we're going to stick with
what's commonly available in most
countries
why people choose them and what's right
for you starting
in three seconds
so there's so many choices out there
part of what we do with this channel
is take the confusion out of it or at
least educate so you can figure out what
you might want to do
i'm going to in a very quick fashion for
each one
run through some of the possibilities
and what may
make you choose one versus another and
everyone's psychology is a little bit
different
some people want things in their body
they know is going to go away
other people want things that are
permanent they want implant type of
products
and other people want something in
between and just because you want a
certain look or you
want something that lasts a long time
but is ultra safe and never has a
problem it might not exist
so we'll talk about it remember if you
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me to answer as you can imagine because
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information but the comments are
important so when you see like our
ulthera video where people are
commenting
about the problems they've had the
successes they've had
these are real world answers and
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educate
which is why we're here so subscribe and
like it onto fillers
so let's start with the most common type
of fillers first of all
way back when when i started we had
collagen didn't last
hard to find it is embedded in
bellophill
which i have a whole other video if
you're interested in permanent or long
term
but and i will talk about it in this
video quickly but
the most common done around the globe
are hyaluronic acid fillers
and there's so many most people know the
juvederm family
the restylane family we have bellatero
there's versa so there's different ones
that have different properties and
characteristics but
hyaluronic acid i did a video on
hyaluronic acid
skin care that's how many of us know it
that's not cross length
so that if you were to inject that
product it's often micro needled in
it'll last three to five days at most in
the body and it's gone
fillers hyaluronic acid fillers are
crosslinked it's why i'm skeptical and i
have a whole video on the hyaluron pen
or high pen
because a lot of people are putting in
superficially
non-cross-linked hyaluronic acid which
is gone pretty quickly
when you do go to the crosslink product
now it's place
superficial and there's been a lot of
problems people who have
clinics real clinics see real problems
they're going to tell you they're
dissolving a lot of hypen problems
because
you have to put these type of fillers a
little deeper
so they don't have a tingle or blue
looking effect and the high pen has a
variable depth
depending on the skin type and many
factors but that's hyaluronic acid
the benefits they contour they're
dissolvable
so if you don't like it you get rid of
them the downside is
there's five actually six different
types of hyaluronic dazes which is what
we use
hyaluronidase or highland x-type
products to dissolve
the products naturally our body has them
at different
different levels so some people will
wear them off quick
they last way longer than the studies
show so
i can make a study that shows all all of
them pretty much the last six months
or two years because it's how the
studies designed what we look for
we're looking for often a facial
assessment scale in the study
whereas if you watch my video of my prf
under eye when i
did my under eyes five years ago i had
them done with hyaluronic acid
each year would come a little to the
surface i dissolve a bit i was pretty
happy with it
finally dissolved it all went to i'm
putting doing prf i'm in the midst of
that
watch that video so that's not a filler
that's your blood product
but the hyaluronic acid part of the
problem is it draws
water in it lasts a long time so
sometimes we do need to dissolve them
you get migration which is why we
dissolve lip filler you can watch
my videos on that but the hyaluronic
acid
families and when we talk about them
there's over 200 hyaluronic acid fillers
in europe
so when you guys from around the globe
are asking me questions about them
a lot of times i can't answer because
people don't know what's been put in
their body if you're looking for price
point
or you've paid a quite a cheap price for
your filler
a lot of times you don't know the depth
its place but you might not know
what it is it might not be what you
think it happens more than you
than not there's cases of people
injecting
products with toxins
that actually had permanent filler in
them and all these little bumps occurred
where they were given the toxin so the
botox or dysport when
in fact there was pmma in there so you
know we see it all and we see
all what people call botched or all the
problems so
when people think they're getting a
filler if it was a price point sometimes
they're not getting what they think it's
very common how would you know
think about yourself you go to a clinic
you
i'm buying wrestling i go to a clinical
buying wrestling i got a great deal it's
300
i know that's the cost of the product it
probably isn't it
i don't know it could be in the same
vial looks the same
i think i'm getting restylane in my face
it could be bio-alchemic
a long-term to permanent product from
europe that i can get very inexpensively
so you understand the breadth of the
problem but there's hyaluronic acid
products some of the benefits
and the downsides number two we get into
if we're still going on fillers we go to
kind of biostimulator filler
would be say radius which is hydroxyl
calcium hydroxyl appetite which has
carboxymethyl cellulose
in 70 percent of the syringe 30 is that
calcium component
there's typically 1.5 cc syringes
although you can get different sizes
so people like it because hyaluronic
acid comes in a 1ml
typically now they're getting more
they're getting one and a half times
maybe for the same price but understand
three quarters or 70 percent of that
syringe
is a filler that's going to go away in
two to three months not a bad thing
not a negative but you're going to get
that power effect
you might get that disappointment in two
to three months but you're getting
that biostimulator or calcium that
stimulates your own long-term collagen
very different product not dissolvable
there's places you wouldn't put it for
me the lip
the under eye would be places it's very
nice
in the hands the cheeks jaw lines are
great because it has a high g
prime you better think of calcium like a
phone
it's strong it has punch
okay so so it's an element of course
calcium is
so you can form things you can get nice
contours
that's the benefit of it and it helps
stimulate your own collagen so
that's that would be a calcium type of
filler
let's go to the next biostimulator you
know i love
sculptra plla that is
in different countries you find it in
different mediums so it could be
the plla molecule could be found
in embedded in hyaluronic acid
in this country many countries what
sculptor comes
as a powder like product and then we mix
typically a water type of product with
it either water sodium chloride
different things
but a liquid and then we inject it now
many people ask in this question in this
channel what about
pdo polydioxanone or the threads
pcl polycaprolactone or the thread type
that's in kind of like sculptor mixed in
a
water you mix it up you'll see i if you
watch my video on
powdered or liquid pdo threads i think i
called it you can watch it
but that's also a bio stimulator but
it's not plla
it would be the pdo or the pcl would be
the active ingredient
see how this gets confusing sculptor is
one of
probably the most predictable
best collagen builder that i know of in
a vial
and the benefit of it is water is the
carrier so when you're going to get your
hyaluronic acid filler
i can contour you i can make lips i can
make a jawline with it i can give you
chin projection
but imagine if i could blanket your face
with a collagen stimulator and i could
treat your whole face because you tell
me who wants half a face treated
i'll tell you the young people because
their skin looks good they're looking
for projection
great hyaluronic acid if they draw water
in their
under eye not a big deal a darker person
skin type four
and above or a younger person with good
skin
a lot of times you might not see the
water the h a
filler hyaluronic acid fillers drawing
in
however if you take something like what
i do is plasma sculpt
concentrations of plla and your blood
product platelet-rich fiber
watch my videos on that i treat the
whole face
and at the same time i can treat the lip
and hair growth above the brow
things like that because no one comes
very few people except the under 30
category and even them
will come to the clinic and say i just
want part of my face treated
it makes no sense if you're over the age
of 40 or 50
you want the whole face treated why have
a young looking lip or
a young looking cheek or
a chin projection when the rest of the
face has lost collagen there's vertical
lip lines smoker's lines
there's loose skin around the edge of
the mouth nobody
wants that they're doing it because
hyaluronic acid fillers
are the most common they're dissolvable
they're quick to do they're available
but combining it with or going to a
biostimulator for most people
after the age of 40 for me and my
practice is paramount
everyone this is not the saber needs to
do that i'm giving you opinion
it's my channel it's our channel that's
why we're that's why you're coming here
but educating you on biostimulators
versus the fillers let's go to something
long-term and permanent and
for a complete discussion on bellaphyl
which is pmma
polymethylmethacrylic acid you can go to
my video on that
but it's long-term there's five year
data on it
now that's what the company can say
because that's where the study went to
just like the nasal fold study showing
something lasts
18 months it's studied but the filler
here might last two to five years seven
years it could still be there
easily hyaluronic acid filler so
the company can only say five years but
pmma does not dissolve
it's long lasting it's the longest
lasting it's in there permanently
some people want they come into the
clinic they'll say i don't want anything
to do with something that doesn't last
long term because it's cost effective to
have something that lasts long term now
there are side effects specific to
something that's in there full time
and you can't remove it if you don't
like it and some may say the face might
change
which is why i don't use that type of
product under the eye because there's so
many changes
skin fat and bone around the eye and the
eyes in the window where
people are very particular about what
they see it's why i use prf or
platelet-rich vibrant before any filler
under the eye because it's your own
body's product you see how we all have
our own
art of doing this not one way is right
i'm not right it's not my way it's what
i do
for my patients it's what they like it's
why they come to me
you have your own provider and have the
reasons why you go to them and you like
them as well
i'm giving you the information so for a
filler like pmma
understand that it's very long term it's
the longest lasting
i will note there's a safety factor with
long term the more you get injected if
you have to come in every year for your
injections
you take the risk of necrosis blindness
the bad things i have videos on those
if you want to see fillers gone wrong or
what can go wrong with fillers or pdo
threads
you can watch those videos but
understand a temple take a temple
who wants to come and get that filled
every year with a hyaluronic acid it's
why most people don't
fill the temple but now if you had a
permanent solution
like fat from your body a long-term
solution like
sculptra or a permanent solution like
bella fill
especially if fat didn't work bella
fills a great option because you do
i'd say two sessions maybe five to eight
vials
you're probably done for your life in
your temple you probably don't have to
do it again
for my patients once they've had bella
fell i might then add some sculpture to
lift the edge of the eye give that towel
around the head lift
every few years but pretty much they're
done at the temple
and the temple is an area that a lot of
people don't bring it up
when they go in to get their fillers
because people are scared to do it
and rightly so if you're using a micro
cannula and a hyaluronic acid in the
filler
hyaluronic acid filler in the temple and
you're doing it every year
just by the fact that you're having a
needle put in your temple with a filler
once a year once every two years versus
once in your
life there's a safety balance factor
that you and your provider need to make
for me
it's kind of a no-brainer but my
patients obviously think like me and
that's why they come to me
and everyone will have their type of
patient and patient profile
so those are the main type of fillers
now i didn't talk about bio alchemid
i didn't talk about silicon they don't
apply to a lot of people
there's some other classes of fillers
maybe i missed if there are
put it in the comments i don't want to
make these too long but i do want to
educate you on all
that's commonly out there join me here
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