• Dermal Fillers
    Turn Back the Clock on some of the Signs of Aging or Enhance your Lips

Dermal Fillers

Dermal fillers are substances that are injected to "fill" any area of your skin that needs it. They are used to fill wrinkles, lines, folds, and scars (eg. acne scars). They are also commonly used to give a fuller appearance to your lips.

One of the main features of the aging face is volume loss. You lose fat, muscle, and even bone as you age. This shows as folds and grooves. Filling these folds is a huge step toward restoring your youthful appearance.*

York Laser and MedSpa has earned a Diamond rating from Allergan, the makers of Juvederm and Botox. This is the highest rating in the region. 

Dr. Philip Kritzinger has been performing cosmetic injections since 2002. He is a Master Injector with gentle hands and a keen eye. He is capable of achieving remarkable results that will have your friends wondering how you manage to look so good year after year! * 

When Dr. Kritzinger hands you the mirror immediately after your treatment, you will likely make the most common comment: "Wow!"

*Results may vary.

FAQ's
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FAQs


Today, there are many different fillers to chose from. We offer three kinds: hyaluronic acid (Juvederm), calcium-based (Radiesse), and Sculptra (Sculptra is so different that it deserves its own page). For facial filling, we most commonly use Juvederm. Radiesse is used most commonly to fill the backs of hands.

Hyaluronic acid (Juvederm, Restylane, Teosyal, Revanesse and others): The most common fillers used today are made of synthetic hyaluronic acid. Hyaluronic acid occurs naturally in the human body. In fact, it is the most ubiquitous substance in nature, being present in almost every multicellular organism on the planet.You may see the term NASHA, which stands for Non-Animal Stabilized Hyaluronic Acid. Early hyaluronic acid products were extracted from rooster combs. The hyaluronic acid products we use today are genetic copies of human hyaluronic acid produced synthetically. The only difference between this manufactured hyaluronic acid and your own is its stability. Human hyaluronic acid is very unstable. In unmodified form, it wouldn't last anywhere near long enough to be used as a filler. So synthetic hyaluronic acid undergoes a process known as cross-linking to thicken and stabilize it. Generally, the more links, the thicker it gets and the longer it lasts.

After trying several hyaluronic acid products over the years, we have settled on the Juvederm family. We offer three products from the Juvederm line: Volbella, Volift, and Voluma. Voluma is the thickest of all these hyaluronic acid products. It gives the longest duration of effect, averaging about 18 months.* Volbella is specifically designed for the under-eye area and lip augmentation.

Any skin can be treated, but the most common areas treated are nasolabial folds (from the nose to the corners of the mouth), labiomental folds (from the corners of the mouth down to the chin), upper cheeks (cheek apples), prejowl sulcus (the indentation that forms in front of jowls), upper lip (smoker's) lines, the glabellum (between the eyebrows), and crowsfeet.

It is also used for lip augmentation and to fill depressed scars.

The backs of hands are injected to disguise prominent veins and tendons.

Almost everyone from 20 (lip augmentation) to 80 (volume loss) could benefit from dermal fillers. Most patients are in their 40s, 50s, and 60s.

Two techiques are used.

For deeper volumizing treatments a cannula is often used. Cannulas look like needles, but they have blunt tips. A cannula is inserted through a single needle poke on each side, most commonly placed beside the mouth. The cannula can then be moved under the skin to fill most of the face (cheeks, nasolabial folds*, labiomental folds*, prejowl sulcus*). Cannulas offer huge advantages over standard needles because only a few needle holes need to be created to treat the entire face. This means less discomfort. As cannulas are advanced they push tissue aside rather than cutting as needles do. This significantly reduces the chances of bruising and damage to blood vessels and nerves.

The other technique is to use standard needles. They are most commonly used to fill lines where injections need to be placed very superficially with great precision.

The amount used depends on the area being treated. In most cases, this is 0.5ml (half a syringe) to 5.0ml (five syringes). Up to 15ml can be used in one session. That might sound like a lot of filler, but 5ml is one teaspoon and 15ml is one tablespoon.

* Nasolabial folds go from the nose down to the corner of the mouth. Labiomental folds go from the corner of the mouth down to the chin. The prejowl sulcus is the indentation that forms in front of jowls.

There is no simple answer to this question, because pain response and tolerance is different from person to person. The degree of discomfort also varies from area to area and the depth of treatment.

When cannulas are used (see previous question), pain is minimal. 

When needles are used, we recommend the use of topical anesthetic creams.

Dental blocks (injections of local anesthetic) can be done when we do lip augmentation. This freezes the nerves that feed the entire area and eliminates pain. But the discomfort of administering the dental block is usually not worth it.

Most procedures take about half an hour. Complex procedures requiring many syringes injected into many areas can take an hour.

Beneficial effects of dermal fillers can be seen immediately following the first treatment.

Dermal fillers do not provide permanent improvement. The duration of benefit depends on the substance used, the area injected, and the person injected. Results vary from person to person and even from treatment to treatment in the same person.

Typically, Juvederm fillers last from 9 to 18 months.

There are very few side effects to dermal fillers.

Bruising can occur.

Mild swelling and redness often occur. It usually resolves in a few hours, but it can persist for up to two weeks.

On rare occasions redness, tenderness, and swelling develops a few weeks after treatment.

Nodules can form. These are inflammatory lumps under the skin that can last for months. They are rare.

There are several treatment options that can improve your skin, depending on the nature of the problem, including peels of varying strengths, micro-needling, laser skin resurfacing, and surgical facelifts. You should also stop smoking, start using cosmeceuticals regularly, and wear sunscreen!

It's only natural to want to know about price. But before you ask this question, you should ask about the skill and experience of the injector. You aren't buying a bag of flour. You are purchasing a complex service. At York Laser and MedSpa, all fillers are done by Dr. Kritzinger. He has been injecting fillers since 2002, and he is the #1 provider of Juvederm in the area.

Now back to price. There is no easy answer to this. It depends on the type of filler used and the number of syringes per session. There are 3 products in the Juvederm line ranging from $600 to over $700 per syringe. In each session, each syringe is a different price. The first syringe is full price. The second syringe is discounted 20%, third 30%, fourth 40%, and fifth and subsequent syringes 50%. This results in an average price across all patients of $580 per syringe. This is a very fair and competitive pricing system.

The only way to give you a good estimate of cost is to see you in consultation so the type of product and number of syringes can be estimated.

We require 48 hours notice for cancellation of your consultation or treatment, in order to fill the appointment time. If sufficient notice is not given, the full value of the treatment to be done may be charged with the minimum amount being $100.


*Results may vary.

 

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