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Copyright 2010 David B. Reath, MD, PLLC
Celebrating over 20 years as East Tennessee's Plastic Surgeon
Awarded one of America's Top Plastic Surgeons by the Consumer's Research Council of America.
2009 Top Doc Selected by Cityview Magazine's "Top Doc".
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Never before have there been so many non-surgical solutions for facial aging.
Hyaluronic acid dermal fillers are the fastest growing non-invasive facial procedures in Knoxville. Juvederm, Restylane, and Prevelle are all injectable wrinkle fillers made from hyaluronic acid. Fillers differ in formulation. Some are more plumping and some last longer than others. There is also a significant difference in cost.
Many more wrinkle fillers are awaiting approval by the FDA so it will become increasing difficult to keep them all straight. It is very important to understand that just because a filler is new, doesn't mean that it's better. The key is to find the right Knoxville office with a great injector who has access to the latest fillers and makes recommendations based on your goals and budget.
Breaking News!
(2/3/2010) We have our first supply of the FDA-cleared Juvederm XC, the newest hyaluronic acid injectable filler formulated with lidocaine for greater comfort. A new split-face control study demonstrated that 93% of the patients treated with Juvederm XC had less pain than when treated with the non-lidocaine formulation of Juvederm. Here is a recent Turth-O-Meter Tuesday video about Juvederm XC.
We did our own side-by-side study and here is what our patient had to say:
I recently got to try Juvederm XC and I must say that I am a believer in this product!
Jill first applied a topical anesthetic around the nasolabial folds
(creases that run from my nose to the corners of my mouth). She then
proceeded with a very small injection of the Juvederm XC, waited 2 or 3 seconds for the numbing agent to take effect, and then completed the
injection. Other than the initial needle stick (which is really quite
minimal), the whole process was painless. Compared to previous
procedures I was actually able to sit back and relax.
At the last minute, we decided to add some filler to the lower corners
of my mouth, where we had NOT applied a topical. Using the same process - a small injection, wait a few seconds, and then complete the injection - it was still a very comfortable process. I really believe that I could have done without the topical altogether, which will save me 20-30 minutes of "numbing time" on my next visit.
Post-treatment was also a much improved experience. I typically review a lot of paperwork during the work day, so I am constantly looking down. The XC formulation really made a difference, as I was so much more comfortable compared to previous treatments without XC.
My recommendation -- If you decide to use a filler, be sure to ask for
Juvederm XC!
Shopping for Injectable Fillers
There are many physicians's offices that are now injecting fillers. Why come to us?
Experience combined with artistry- You will benefit from an injectable plan designed personally for you by Dr. Reath. The injectable consultation with him is free and patients find it very helpful. Working under the direct supervision of Dr. Reath, our nurse injector, Jill Maze, RN, trains with the most renowned experts in Cosmetic Injectables. It requires a unique blend of artistry and science, as well as the need to stay current. Consequently, she periodically travels the U.S. to observe the leaders in her field. Patients routinely comment on her caring manner and her fabulous results.
Did you Know? The majority of people in the United States have more facial wrinkles on the left side than the right side, so it is likely you'll need more fillers on the left side of your face. Any guesses as to why?
It has to do with driving. If you spend a lot of time driving a car, the left side of your face is exposed more frequently to damaging UVA rays than the right. Many of us don't think to put on sunscreen when we are out running errands even if we would never go without it at the beach. Since UVA rays travel through glass, and most sunscreens protect you only from UVB rays, it is important to choose a product which blocks out the UVA's . Or better yet, visit our store. All of the sunscreens in our store protect you from both UVA and UVB rays.
About Hyaluronic Acid Based Fillers-
Hyaluronic acid is a natural complex sugar found in all living animals that retains water and adds volume to the skin’s surface. It binds with collagen to provide structure, elasticity and volume to the skin and contribute to its overall appearance. As the skin ages, the cells lose the ability to produce hyaluronic acid. As a result, the skin begins to lose volume, often resulting in thinning lips, facial wrinkles and folds. Dermal fillers comprised of cross-linked hyaluronic acid are used to temporarily replace the lost hyaluronic acid and to restore skin volume with a smooth natural appearance.
Before and After Pearl Fractional Laser and Juvederm:
This is a 64-year-old woman who was concerned about facial aging and wanted to explore nonsurgical options for facial rejuvenation. Here she is before and after her Pearl Fractional Laser treatment with Juvederm in her lips and nasolabial folds. What an incredible difference!
Before and After Juvederm: This is a 39 year old patient who was concerned about her lips and nasolabial folds. She received one syringe of Juvederm Ultra Plus to her lips and one syringe of Juvederm Ultra to the nasolabial folds. The patient had a great result and restored fullness in her lips.
Before and After Juvederm: This is a 40-year-old man before and after his Juvederm treatment.
Before and After Radiesse and Juvederm: This is a very active 60-year-old woman who told us she wanted to look as young as she feels. She was particularly interested in nonsurgical rejuvenation. Here is a great example of the dramatic improvements that can be made using injectable fillers. Our Nurse Injector used the semi-permanent filler Radiesse in her nasolabial folds and Juvederm Ultra Plus in her lips and mouth area.
Juvederm- You are probably hearing a lot about Juvederm, made by Allergan, the company that brought us BOTOX® . It has been all over the media. Virginia Madsen, and her mom, are speaking out about their great results with it, along with Botox.
We have been using Juvederm with great success since it originally came on the market. This year, the FDA confirmed our experience with the product....it lasts longer than other hyaluronic acid fillers. And in many cases, based on new clinical data, it is lasting up to a year with a single treatment. Even better, Juvederm, in conjunction with Botox®, makes both products last longer.
It is available in two different formulations. Regular Juvederm is perfect to treat moderate wrinkles in the mid-dermis as well as to outline and fill in the lips. The other, Juverderm Ultra Plus, is a more plumping formula which can be used in lips as well. It works better to contour the face and add volume to larger areas such as the cheeks.
It is the next generation of hyaluronic acid products. The hyaluronic acid in Juvederm is manufactured in a smooth gel versus a gel particle suspension in Restylane. This different formulation is providing a smoother, longer lasting correction than current hyaluronic acid products on the market.
Juvederm $600 per syringe Juvederm Ultra Plus $650
Prevelle Silk- Prevelle Silk is a new hyaluronic acid filler from Mentor Corporation, the company we use for our breast implants. It is different from Juvederm and Restylane because it contains lidocaine. Some patients find that's all the pain blocking they need depending on the area they are having treated. It's formulation is perfect for treating really fine lines. We are having great results using Prevelle Silk under the eyes. Because of its thinner formulation, Prevelle does not last as long as Juvederm. Still, if you are on a budget or considering fillers for the first time, Prevelle is an excellent choice.
$300 per syringe
Before and After Prevelle Silk: This is a 37-year-old who asked us for help with the dark circles under her eyes. Nurse Injector Jill Maze injected Prevelle Silk in her tear troughs with this fabulous result. Just a small amount makes a big difference!
Before and After Prevelle Silk: This is a very active 60-year-old who wants her face to look as young as she feels inside. She particularly mentions the hollows under her eyes which she feels make her look older and tired. Jill Maze injected Prevelle Silk in her tear troughs. Isn't it amazing what a difference a little Prevelle can make?!
Restylane- Another popular dermal filler is Restylane. It can be used to treat mild to moderate lines and wrinkles and is designed to be injected in the mid-dermis. It won Allure magazine's coveted Best of Beauty Breakthrough award in 2006. We can still use Restylane by special request, but find most of our patients prefer Juvederm because it lasts much longer.
$600 per syringe
Introducing Jill Maze, RN
Jill Maze is a welcome addition to our practice. Her patients attest to both her caring bedside manner and her skilled professionalism. Working under the direct supervision of Dr. Reath, Jill’s extensive training, and gentle touch is a winning combination. She is an active member of the American Society of Plastic Surgical Nurses.
Since the FDA’s approval of Juvederm and other fillers, Jill has been focused on training with the southeast’s most renowned experts in Cosmetic Injectables in both Atlanta and Boca Raton, Florida. This year she traveled to Las Vegas to be in the first class in the country to attend the Advanced Injector Competence Training Course designed by the American Society of Aesthetic Plastic Surgeons. In addition, she received specialized instruction on techniques for using Botox® for areas other than the upper face. She is also trained and experienced with the recently FDA-approved semi-permanent filler Radiesse.
This area requires a unique blend of artistry and science as well as the need to stay current, so Jill will continue to travel the U.S. to observe the leaders in her field. When she is not traveling and taking care of patients Jill likes to spend time with her husband and two teen-aged daughters camping in the great outdoors.
About Evolence-
We recently received word from Johnson and Johnson that Evolence, a Hyaluronic Acid wrinkle filler, is being discontinued effective immediately. Our office evaluated Evolence last November when it came on the market and decided not to use it in our practice even though it was being marketed heavily here in Knoxville. Evolence is not the first filler we have passed on. Recently we evaluated and decided not to carry Artefill, Sculptra and Elevess because we did not feel they brought value to our patients.
On his RealSelf.com blog today, Tom Seery noted that Evolence "failed to gain traction" against alternative hyaluronic fillers like Juvederm. On RealSelf.com patients complained about Evolence's results more than any comparable wrinkle treatment, with only 35% saying Evolence was "worth it."
The important thing to remember is that just because a product is new does not mean it is better. The key is to find the right Knoxville office with a great injector who has access to the latest products and is willing to look past the marketing hype. As Dr. Reath points out, "you can't go wrong with the gold standard- Juvederm".
If you have questions about Botox, Restylane, Evolence, Juvederm or Radiesse, email Nurse Injector Jill Maze at JillM@dbreath.com
BOTOX® is a registered trademark of Allergan, Inc., and JUVEDERMtm is a trademark owned by Corneal Industries SAS.
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Juvederm- You are probably hearing a lot about Juvederm, made by Allergan, the company that brought us BOTOX® . It has been all over the media. Virginia Madsen, and her mom, are speaking out about their great results with it, along with Botox. 
