Dermal Fillers Newburgh, NY (Injectable Fillers)

Patients are given a list of medications and supplements to avoid 1 week prior to their treatment to minimize bruising. If you were prescribed Aspirin for cardiac reasons, do not discontinue without consulting with your doctor. Homeopathic remedies started 2 days before your injection such as over the counter oral Arnica (or Yunnan a Chinese herb available at Dr. Rubinstein’s office) help to minimize bruising. A topical anesthesia is applied 30 minutes prior to your treatment to numb the area and make the injections comfortable. A fine needle or micro cannula is then used to carefully fill in the treatment areas and improve facial contours. The actual treatment takes about 20 minutes and patients can return to normal activities the day after treatment.

Some mild bruising, swelling, and tenderness may occur following the procedure, but this should subside within a few days. Icing 10 min on and 10 min off for a few hours post treatment is recommended. Continuing the Yunnan herb for 48 hours post treatment can help minimize significant bruising. For noticeable bruising Dr. Rubinstein has special make up concealer. In addition, a complimentary laser treatment 1 to 2 days post injections can helps to break up the bruise and speed up clearance. Topical and oral Arnica in addition to the Yunnan will further aid in bruise clearance once you finish the Yunnan. It can take 2 to 4 weeks to see your final results with the HA fillers and 6 months with Sculptra. Before and after photos are taken to assess your results. Sometimes touch up or boost injections are beneficial. Dr. Rubinstein doesn’t believe in saving syringes, a common practice, for touch up treatments as this can lead to infections.

Because there are so many specialized fillers on the market these days, choosing the right formula for you can seem overwhelming. Fortunately, Dr. Rubinstein is an expert on the different fillers and will be able to recommend the right one for you, based on your goals for the procedure.

Dr. Rubinstein charges by the syringe for the HA fillers and by the vial (kit) for Sculptra. The longer lasting HA fillers tend to be more expensive. The more syringes used in a single treatment session the greater the discount per syringe. When using HA fillers for a liquid facelift, a discounted package price makes these treatments affordable. Sculptra is the most economical of the fillers because you are purchasing an entire kit which can be used for each treatment vs. paying for each individual syringe with the HA fillers. Results also don’t have to be maintained as often. Make sure you are getting your money’s worth and that your doctor isn’t sharing your Sculptra vial with more than one patient. Not all HA syringes are the same. There are small and large sizes so make sure you know what you are getting. If your doctor is saving your HA syringe for multiple treatment sessions you are increasing your risk of adverse events including infection.

In New York, there are no restrictions on who can inject fillers and Botox. It isn’t unusual to see dentists, primary care doctors, gynecologists, and even pediatricians advertising often discounted filler injections to supplement their practice income. For those that want the best treatment results, Dr. Rubinstein advises to seek out “Core Cosmetic Physicians”- dermatologists and plastic surgeons with experience in facial esthetics. Make sure your injector is documenting your pre and post treatment results with photography and making detailed notes and drawings in your medical chart in the event that you have an adverse event and need to consult a Core Physician for product removal or corrective treatment.

For patients who want more dramatic results from fillers, a Liquid Lift can be a great choice. Also known as a Liquid Facelift, the procedure involves several filler injections to restore lost volume in the face. Dr. Rubinstein likes to give the analogy of a table and table cloth to describe facial anatomy and the aging process. As we age, the table (fat, bone) shrinks and the table cloth (skin) is left with less support and is more susceptible to the downward pull of gravity and sags. Rather than simply pulling on the excess tablecloth, which can leave one with an over tightened look, Dr. Rubinstein prefers to re support the table by using fat or injectable fillers. This makes the face more gravity proof and actually slows down the aging process. Older patients benefit from treating both the table and the table cloth (i.e. face lift) but less surgery is needed once volume is restored creating a much more natural and youthful appearance. Patients often do not want surgical volume restoration with fat injections and opt for injectable fillers. Dr. Rubinstein will most commonly use Restylane Lyft or Juvederm Voluma in those who want instant results lasting one to two years respectively and Sculptra where patients want gradual, longest lasting results, often greater than 2 years, using their own collagen stimulation, without the downtime of fat injections.

Dermal fillers are very safe, and rarely involve major side effects when treatments are performed by Core Physicians with knowledge and understanding of facial anatomy and facial esthetic experience. Some patients experience some bruising, swelling and tenderness following the procedure, but this is temporary. If you tend to form keloids fillers that stimulate collagen can result in nodule formation. Some physicians advise their patients to avoid dental work up to two weeks post injection to minimize risk of infection. Dr. Rubinstein hasn’t found this to be necessary unless the dental work is for an active infection vs. routine cleaning. Infections can be avoiding by properly prepping the skin before injections and not saving and re using opened syringes. Dr. Rubinstein tends to select HA fillers in patients who have autoimmune skin conditions such as Lupus or Scleroderma or are on chemotherapy. Rare complications from fillers include skin necrosis and even blindness if filler is injected into an artery. An experienced injector will be able to detect early signs and symptoms of intra-arterial injection and inject hyaluronidase (an anti HA) to melt away the filler. Experience, skill, and use of micro cannulas help minimize these rare risks.

It’s possible, but unlikely. Most fillers today don’t require allergy testing, and Dr. Rubinstein will advise you of any potential allergy risks prior to the procedure. If you’re concerned about an allergy you have, however, be sure to bring it up during the consultation.

The longevity of your results will depend on the filler used, your lifestyle, and the treatment area. High activity areas, like the lips, tend to wear off more quickly than other areas. Fillers can last from 4 months to 2 years, depending on the formula. Tanning, smoking and daily vigorous exercise will diminish the duration of your results.

We have all seen some scary and unnatural results whether its family, friends, or in the media. I am often amazed by the unnatural appearance of some of my plastic surgery colleagues when I see them at medical meetings. These are the same people performing treatments. Beauty is in the eye of the beholder. Make sure you review pre and post treatment photos from your injector before having treatments. Injecting fillers is both a learned skill and an art. Results can and should be natural enhancing your facial features. Dr. Rubinstein will turn away patients who he thinks have body dysmorphic issues. Besides looking younger and more rested, no one should be able to tell you’ve had cosmetic treatments—unless you choose to tell them!

It requires a great deal of skill, finesse and artistry to produce excellent results with injectable fillers. These treatment should be performed by experienced Core Physicians.

Injectable filler treatments do involve a small amount of discomfort, but most patients find it very tolerable, especially since a topical anesthesia is typically applied prior to the procedure.

Absolutely. Fillers complement other treatments, such as skin resurfacing or Botox injections well, providing more comprehensive anti-aging results. These are often performed on the same day.

Generally the use of facial fillers is limited to adults over the age of 21, for safety reasons.

Although many of the fillers have not been FDA cleared and tested in adults over the age 65, Dr. Rubinstein has found them to be very effective especially in combination with surgery. With fillers that stimulate collage such as with Sculptra, Dr. Rubinstein has found them to be less effective after age 70 and prefers the HA fillers. There are many exceptions to this rule however as he has many patients well into their 70’s with long lasting Sculptra results. Dr. Rubinstein will help guide you as to which treatment option is best for your needs.

Depending on the filler, a fine needle or micro cannula (hollow tube) will be used to administer the filler gel.

If you live in the state of New York, Laser & Cosmetic Surgery Specialists offers Dermal Fillers among its services. For a full list of services, please visit our Locations page.