Injectable Fillers

Injectable fillers are a suite of products that reverse the signs of aging, replace lost volume, and smooth wrinkles.

The difference between fillers and other cosmetic injectables, like Botox, is that fillers are injected into the dermis layer of your skin, whereas Botox is inserted into the underlying muscle. Once inside the skin tissue, the filler expands, adding the necessary support to the skin’s weakened inner structure. As the dermis is refreshed and revitalized from the inside out, the skin smooths out overlying wrinkles and regains its lost elasticity. But choosing which filler is just right for your complexion and desired results may seem a bit daunting. With our family of fillers, Dr. Daniel Markmann and his expert team have just the product to remedy any signs of aging on your countenance. The first step to a younger refreshed you is to schedule a personal consultation at our offices. During your consultation, Dr. Markmann and his friendly staff can identify your signs of aging and create a personalized treatment plan. To reach us directly, please call (410) 465-3600. 

How Our Skin Ages

Unlike other organs, our skin also undergoes different processes of aging that can make us appear older than our years. Whether from the sun’s harmful UV rays, free radicals in the air, or pollution, our skin has to combat many different forces to retain its youthful appearance. To help keep our radiant glow, our skin utilizes collagen – the fibrous, flexible protein that makes up 70-80% of our skin’s internal structure.^[1] Collagen is produced by our skin’s fibroblast cells. When we’re young, collagen is responsible for our skin’s youthful elasticity and moisture.^[2] It is what helps our skin remain resiliently radiant. But, as we age, our fibroblast cells slow down, hindering the production of new collagen fibers. So, the existing collagen fibers weaken and gradually loosen, causing the enveloping skin to crease and wrinkle. With 30% of our natural collagen supply lost by the age of 50,^[3] it can sometimes feel like a race against the clock to restore your complexion and reverse the hands of time. Luckily for you, Dr. Markmann and his team at Metamorphosis have just the fillers necessary to give you a rejuvenated, refreshed appearance. 

Types of Derma Fillers

At Metamorphosis, we have a wide array of derma fillers to choose from. We don’t believe in the “one-filler-fits-all” approach. Rather, we believe all of our patients are unique and should be treated with the right approach for them. You might find that these fillers complement each other nicely and elect to add multiple to your treatment plan. Or you might find that your ideal filler is the perfect addition to another one of our other services. However you elect to utilize these fillers, we will be happy to answer any questions or concerns you may have about them during your consultation. Here, Dr. Markmann or a staff member will walk you through our suite of fillers and help you determine which one is right for you. At Metamorphosis, we offer:

Fat Transfer

Extracting the donor fat cells through liposuction techniques, we take unwanted fatty tissue from other areas of your body to fill out features around your face. Once the fat is extracted, we purify and rinse it before reinjecting it gradually into the target area of the skin. We then massage the skin to ensure an even contour. Fat transfer is a popular approach for people who wish for a natural approach to anti-aging. The fat cells that are relocalized to your face will interact and adapt to the area, reacting to exercise and diet just like any other type of fat cells. So, results may change if weight is lost or gained after your treatment.

Collagen

When collagen is injected directly into the dermis layer of your skin, these new, healthy fibers replace the old, weakened ones. This process restores the skin’s inner structure, moisture, and elasticity. As the new collagen fibers take shape, your overlying wrinkles, fine lines, and loose skin are shed from your complexion, leaving you with a healthier, more moisturized complexion. 

Calcium Hydroxyapatite

Calcium Hydroxyapatite (CaHA) is a biodegradable filler that replaces volume in facial features and naturally stimulates collagen production. The injectable gel spreads evenly throughout the target skin tissue. As the filler absorbs into the dermis, the CaHA microspheres induce neocollagenesis by activating the fibroblast cells.^[4] Over the next couple of months, your skin’s structure becomes refreshed and rejuvenated with the cascade of newly produced collagen, gradually achieving a younger visage. 

Hyaluronic Acid

Hyaluronic acid is a naturally occurring substance that is vital to our skin’s health and function. In fact, 50% of human’s supply of hyaluronic acid is found in our dermis.^[5] When injected into our dermis, the gel expands, restoring volume and reversing signs of aging in your face. The hyaluronic acid gel binds with the molecules in your skin to bolster the skin’s hydration and volume as well as provide inner structural support.^[6] 

Poly-L-lactic Acid

Used for more than 40 years in the medical community, Poly-L-lactic acid is a biodegradable compound that, when injected into the deep dermis, stimulates the fibroblast cells and causes increased collagen production.^[7] This filler also adds volume underneath the skin, contouring your facials features to a more youthful appearance. Results from Poly-L-lactic acid fillers are long-lasting. 

PMMA

When microspheres of polymethylmethacrylate (PMMA) are injected subdermally, the overlying deep creases in the skin smooth out. Having been used to erase wrinkles and restore volume since 1990,^[8] PMMA injections are a staple in the cosmetic industry. PMMA is a more solid filler that is meant to tackle deep, heavier wrinkles and used for reconstructive purposes when enough tissue is absent. 

Personal Consultation

During your consultation, we will begin with a brief physical examination and a new patient intake interview. Next, Dr. Markmann will ask about your aesthetic ideals. How do you want to see yourself in the mirror? How do you want to feel about your appearance? How do you feel about your appearance right now? All of these questions lend insight into your wants and expectations of our care. It is our duty to best fill those desires. So, the better we understand your desired, aesthetic appearance, the closer we can get to achieving it. 

Once he has an overall sense of your longed-for results, Dr. Markmann will construct a personalized treatment plan. This treatment plan will address all of your areas of concern. He will then walk you through our family of filler, pointing out which ones he feels are suited best for your needs. Then, we will schedule a time and date for your filler sessions. Before you leave our care, we will give you a list of preparatory instructions that you should follow between now and your treatment date. These instructions may have personalized steps along with more general pre-procedural steps.

Procedure

On the day of your procedure, we will begin by cleansing the target area(s). Next, we apply a topical anesthetic or local anesthesia to assuage any discomfort. Then, we have you lie back and angle your face upwards. Dr. Markmann or a trained staff member will fill a syringe with the appropriate amount of the elected dermal filler and gently injects it into your target area(s). Next, we massage the area, ensuring that the solution has spread evenly throughout the skin. Then, we will repeat this process until all of your desired areas have been treated. Finally, you will be free to leave our care and return to your day. Fillers don’t require any downtime or necessary recovery steps. If you experience any discomfort or swelling, please let us know. 

Cost

The cost of your filler treatment will vary depending on the number of fillers we use and the number of places treated. During your consultation, we will discuss pricing structure and financing options. If you would like to learn more about our financing options, please visit our financing page or give us a call at (410) 465-3600. If you are traveling to see Dr. Markmann, please visit our Traveling For Surgery page to learn about our recommended steps.

References

1. Oikarinen A. (1994). Aging of the skin connective tissue: how to measure the biochemical and mechanical properties of aging dermis. Photodermatology, photoimmunology & photomedicine, 10(2), 47–52. https://pubmed.ncbi.nlm.nih.gov/8043384/
2. Markey A. C. (2000). Botulinum A exotoxin in cosmetic dermatology. Clinical and experimental dermatology, 25(3), 173–175. https://doi.org/10.1046/j.1365-2230.2000.00606.x
3. Shuster S, Black MM, McVitie E. The influence of age and sex on skin thickness, skin collagen and density. Br J Dermatol. 1975;93:639-643.
4. Loghem, J. V., Yutskovskaya, Y. A., & Philip Werschler, W. (2015). Calcium hydroxylapatite: over a decade of clinical experience. The Journal of clinical and aesthetic dermatology, 8(1), 38–49. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295857/
5. Kablik, J., Monheit, G. D., Yu, L., Chang, G., & Gershkovich, J. (2009). Comparative physical properties of hyaluronic acid dermal fillers. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 35 Suppl 1, 302–312. https://doi.org/10.1111/j.1524-4725.2008.01046.x
6. Ballin, A. C., Cazzaniga, A., & Brandt, F. S. (2013). Long-term efficacy, safety and durability of Juvéderm® XC. Clinical, cosmetic and investigational dermatology, 6, 183–189. https://doi.org/10.2147/CCID.S33568
7. Vleggaar D. (2006). Soft-tissue augmentation and the role of poly-L-lactic acid. Plastic and reconstructive surgery, 118(3 Suppl), 46S–54S. https://doi.org/10.1097/01.prs.0000234846.00139.74
8. Lemperle, G. (2020). Polymethylmethacrylate Microsphere Injections in the Face. Minimally Invasive Aesthetic Procedures, 581–588. https://doi.org/10.1007/978-3-319-78265-2_81