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Fillers Demand Is Steadily Increasing- by Dr. Mark Bishara, MD

Dermal fillers are versatile tools for perfecting facial contours.
INJECTABLES ACCOUNT FOR MORE THAN HALF of the minimally invasive procedures performed today. Before Restylane (Medicis, restylaneusa.com), the first non-animal-based hyaluronic acid (HA) dermal filler, was introduced in the United States in 2003, botulinum toxin (Botox) was the most popular injectable in aesthetic medicine. Today, Botox has taken a backseat in growth to HA injections, which have increased to more than 1.3 million procedures per year.
As the demand for fillers has increased, the materials have too. Finding the right dermal filler is like choosing the right brush if you’re a painter. A free-flowing hyaluronic acid gel may be the perfect tool for painting a plumper lip, while a thicker filler with a higher molecular weight may serve you best for adding definition to the chin or cheekbones.

Choosing Your Tools

While today’s HA fillers are all non-animal sourced and stabilized, they do have some important differences, including the manner in which the molecules are cross-linked, the particle size and their affinity to bind water (hydrophilic properties). These distinctions determine a filler’s hardness or resistance to deformation. Picture squirting out the contents of a tube of toothpaste. If the paste retains its shape without flattening, the material reflects a high G prime; a runny liquid that rapidly loses its peak formation has a low G prime.
Restylane (Medicis, restylaneusa.com) demonstrate stiffer qualities, which translates to a higher lift capacity. The stiffer quality of these fillers provides not only lift but also structural support. These would be more suited for creating a cheekbone, increasing chin projection or temple lifting.
Other fillers, like Juvederm (Allergen, juvederm.com), are softer materials that are ideal for filling lips, nasolaboial folds and finer lines.
Juvederm, one of the more hydrophilic fillers, is a popular tool for imparting a soft shape around the lips but is not as well suited for treatment around the eyes. Restylane, which is not quite as hydrophilic, might work better for treating the tear troughs and the nasojugal folds.
For defining the border around the lips or filling fine lines, both Restylane and Juvederm are good choices. Many physicians prefer the softness of Juvederm for filling the lip.

Typically, HA fillers can last anywhere from six to 12 months. Expect fillers to dissipate more quickly in areas subject to more motion, such as the lips, where they generally last five to eight months. In more stationary areas, such as cheekbones, effects can last up to 12 months. In the periorbital area, treatments with HA fillers have been reported to last as long as two to three years.

Collagen-Stimulating Volumizers

While HA fillers are a top choice for specific indications, such as fine lines and icepick acne scars, collagen-stimulating fillers, such as Radiesse (Merz Aesthetics, radiesse.com) and Sculptra (Valeant Aesthetics, sculptraaesthetic.com), can help create volume across a larger region with results extending to 24 months or longer.
The stiffer quality of these fillers provides not only lift but also structural support.

Managing Complications

With modern HA fillers, the potential for allergic reactions is very low, and no skin testing is necessary. That said, injecting fillers can yield potentially significant complications if not managed properly.
The most common complications are bruising and swelling at the injection site, which can last up to a week. To reduce bleeding and bruising, ask patients if they are taking any anticoagulant medications or supplements, including ibuprofen, aspirin, fish oil, omega-3, vitamin E and herbal supplements, including ginkgo biloba, as these may induce more bleeding.
Another common problem is injecting too much of a product or injecting into the wrong plane. HA fillers are somewhat forgiving in that you can use the enzyme hyaluronidase to dissolve the HA when patients are not pleased with the results. This not true with non-HA fillers, such as Radiesse, Artefill and Sculptra.

The Future Of Fillers- Juvederm Voluma XC

Though dermal fillers have been part of cosmetic medicine for almost 30 years now, there are still some truly innovative materials entering the market. Voluma XC (Allergan, allergan.com), an HA filler, will soon offer U.S. patients effects that last 18 months or more and a high G prime for more lift and fill with less product.
JUVÉDERM VOLUMA™ XC injectable gel is the first and only filler FDA-approved to instantly add volume to the cheek area. Juvederm Voluma is the Juvederm specialty product for volumizing. It is designed for injection in the deep dermis to treat age-related facial volume loss. Voluma has the optimal thickness of a volumizer while still retaining the smooth nature of the Juvederm family.
It gives you a subtle lift, helping to restore contour and for a more youthful profile, for up to 2 years, in patients over the age of 21. It’s different than JUVÉDERM® XC and works on a different area of the face. JUVÉDERM® XC smoothes out moderate to severe wrinkles and folds around the nose and mouth, like parentheses. JUVÉDERM VOLUMA™ XC, however, adds volume to the cheek area.
As new fillers continue to come to market, the trend toward specialized products that treat specific concerns and regions of the face continues to grow. In the future, physicians can look forward to a growing variety of materials that smooth, volumize and fill the skin with fewer complications and longer results than ever before.

Dr. Mark Bishara offers minimally invasive procedures, such as injectables- for patients. These treatments are designed to provide subtle enhancements that can improve your targeted problem areas, while allowing you to return to work and your regular activities the very same day. Dr. Bishara is proud to offer a wide range of enhancing, minimally invasive procedures such asBotox, Xeomin, Juvederm Ultra Plus XC and Radiesse.  Juvederm Voluma XC will be available soon. We will keep you updated or call our office for more information at (817) 473-2120.
 

 

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FDA Okays Cheek Volume Filler Juvederm Voluma XC- by Dr. Mark Bishara, MD

The US Food and Drug Administration (FDA) has approved Juvéderm Voluma XC(Allergan) to correct age-related volume deficits in the midface in adults aged 21 years and older, the company has announced.

Juvéderm Voluma XC is a gel composed of cross-linked hyaluronic acid suspended in phosphate-buffered saline with 0.3% lidocaine. It is the first dermal filler approved in the United States specifically for deep (subcutaneous and/or supraperiosteal) injection for cheek augmentation to correct age-related volume deficit in the midface.
As reported by Medscape Medical News, the FDA’s General and Plastic Surgery Devices Panel unanimously agreed that Juvéderm Voluma XC is effective and safe and that the benefits outweigh the risks, according to the clinical trial data presented to the panel.
“As people age, the cheek area can lose volume, causing the cheeks to flatten out and the skin to droop and sag,” Derek H. Jones, MD, said in a company news release announcing the approval. Dr. Jones is associate professor of dermatology at the University of California, Los Angeles; founder and medical director of Skin Care and Laser Physicians of Beverly Hills; and clinical investigator in the Juvéderm Voluma XC pivotal study.
In the study, “physicians and patients were able to see instant and visible results, including correction of age-related volume loss in the cheek area and a more youthful appearance to the face,” Dr. Jones said.
JUVEDERM VOLUMA(TM) XC is made with Allergan’s proprietary VYCROSS(TM) technology, an advanced manufacturing process that results in a smooth gel that flows easily and consistently. This unique formulation contributes to the lift capacity to correct volume loss in the cheek area and to the duration of the product.(2,3) Additionally, JUVEDERM VOLUMA(TM) XC contains a small amount of lidocaine which helps to numb the treatment area during the injection procedure. The JUVEDERM VOLUMA(TM) formulation without lidocaine was first introduced in Europe in 2005. JUVEDERM VOLUMA(TM) with lidocaine was first introduced outside the U.S. in 2009. As of August 31, 2013, JUVEDERM VOLUMA(TM) with lidocaine (branded as JUVEDERM VOLUMA(TM) XC in the U.S.) is distributed in 72 countries, including markets in Europe, Latin America, Middle East, Asia Pacific, and Canada. The JUVEDERM(R) family of products, including JUVEDERM(R) Ultra and Ultra Plus, are marketed and sold in 85 countries outside the United States.(4)
The most common adverse effects observed in the clinical trial included temporary injection-site tenderness, swelling, firmness, lumps/bumps, bruising, pain, redness, discoloration, and itching. The adverse effects were predominantly moderate (uncomfortable) in severity and lasted 2 to 4 weeks.
Juvéderm Voluma XC will soon be available at Dr. Mark Bishara’s office.  We will keep everyone updated when the product will be available in both of our Mansfield and Southlake offices.
This news is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa


 

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Skinceuticals CE Ferulic Made Top 10 List!

Overview of Skinceuticals CE Ferulic

Research and innovation are at the core of the SkinCeuticals company mission, and their dedication to science has established the brand as a leader in the advanced skincare arena.  At the office of Dr. Mark Bishara and The Paragon Med Spa- we offer an extensive line of the Skinceuticals skincare line.  Here is one that just made a top 10 list for great skin care.
Skinceuticals CE Ferulic is a revolutionary antioxidant combination that delivers advanced protection against photoaging by neutralizing free radicals, boosting collagen synthesis, and providing unmatched antioxidant protection. More protection means more youthful looking skin and better defense against environmental aging.
How it works:
C E Ferulic contains ferulic acid, a new antioxidant that doubles the synergistic benefits of C E – neutralizing free radicals,building collagen, and providing improved antioxidant protection. No other antioxidant technology has been shown to deliver comparable levels of photoprotection.
-Provides advanced environmental protection against UVA, UVB and infrared radiation A.
-Stimulates collagen synthesis to improve signs of aging.
-Increases firmness and replenishes lipids to reduce wrinkles.
-Once absorbed, this serum can’t be washed or rubbed off. It remains effective for a minimum of 72 hours, making it an excellent addition to sunscreen.
Spotlight Ingredients:
L-ascorbic acid: Neutralizes free radicals and promotes collagen synthesis.
Alpha tocopherol (vitamin E): Potent antioxidant which promotes the healing process.
Ferulic acid: This plant-based antioxidant neutralizes free radicals, inhibits UV-induced melanogenesis, and has anti-inflammatory properties.
Pros:

  • Highly effective anti-wrinkle serum
  • Concentrated formula provides quick results

Other Notes:
A huge benefit from using CE Ferulic is its photoprotection benefits. Photoprotection is a measure of a product’s ability to neutralize free radicals and protect against oxidative stress. SkinCeuticals CE Ferulic reduces sunburn cell formation up to 96% in UV irradiated skin. Though the smell of the serum is a bit off-setting, the effectiveness of CE Ferulic is apparent after the first time I used it. Its skin firming abilities are incredible, earning it a #3 spot on the top 10 list.
Please call our office at (817) 473-2120 or visit our website to learn more about us as www.markbisharamd.com.
 

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Skinceuticals CE Ferulic Made Top 10 List!

Overview of Skinceuticals CE Ferulic

Research and innovation are at the core of the SkinCeuticals company mission, and their dedication to science has established the brand as a leader in the advanced skincare arena.  At the office of Dr. Mark Bishara and The Paragon Med Spa- we offer an extensive line of the Skinceuticals skincare line.  Here is one that just made a top 10 list for great skin care.
Skinceuticals CE Ferulic is a revolutionary antioxidant combination that delivers advanced protection against photoaging by neutralizing free radicals, boosting collagen synthesis, and providing unmatched antioxidant protection. More protection means more youthful looking skin and better defense against environmental aging.
skin cedescribe the image
How it works:
C E Ferulic contains ferulic acid, a new antioxidant that doubles the synergistic benefits of C E – neutralizing free radicals,building collagen, and providing improved antioxidant protection. No other antioxidant technology has been shown to deliver comparable levels of photoprotection.
-Provides advanced environmental protection against UVA, UVB and infrared radiation A.
-Stimulates collagen synthesis to improve signs of aging.
-Increases firmness and replenishes lipids to reduce wrinkles.
-Once absorbed, this serum can’t be washed or rubbed off. It remains effective for a minimum of 72 hours, making it an excellent addition to sunscreen.
Spotlight Ingredients:
L-ascorbic acid: Neutralizes free radicals and promotes collagen synthesis.
Alpha tocopherol (vitamin E): Potent antioxidant which promotes the healing process.
Ferulic acid: This plant-based antioxidant neutralizes free radicals, inhibits UV-induced melanogenesis, and has anti-inflammatory properties.
Pros:

  • Highly effective anti-wrinkle serum
  • Concentrated formula provides quick results

Other Notes:
A huge benefit from using CE Ferulic is its photoprotection benefits. Photoprotection is a measure of a product’s ability to neutralize free radicals and protect against oxidative stress. SkinCeuticals CE Ferulic reduces sunburn cell formation up to 96% in UV irradiated skin. Though the smell of the serum is a bit off-setting, the effectiveness of CE Ferulic is apparent after the first time I used it. Its skin firming abilities are incredible, earning it a #3 spot on the top 10 list.
Please call our office at (817) 473-2120 or visit our website to learn more about us as www.markbisharamd.com.  You can also click on on of the buttons below.
skincare
 

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Get Rid of Sun Spots This Fall & Winter at the office of Dr. Mark Bishara

Are sun spots on your skin becoming unwelcome reminders of aging? Today there are treatments available that can help you get rid of them.

Sun spots usually start appearing after the age of 30 and are common in people with light skin. They start spreading more once you cross 50. Long hours or days spent in the sun during your early years are one of the most likely causes of sun spots.
While sunspots are medically harmless, many people seek to hide sun spots for cosmetic reasons.
Sun spots can occur both in males and females, but women are more likely to opt for a treatment to get rid of them. Today, a wide variety of remedies, including peels and laser therapy, are available to treat sun spots.
Laser treatments are one of the most effective. After the treatment it’s necessary to avoid the sun by wearing protective clothing and using sunscreens in order to prevent these spots from reappearing.
At the office of Dr. Mark Bishara and The Paragon Med Spa we want to teach patients about proper skincare and help them regain the healthy skin tone that they desire.
Join us this Fall and Winter for Skin Rejuvenation

  • For those who want the best possible results before the holidays, purchase our Ultimate Laser 360 treatment; a combination of Fotofacial, skin tightening and laser resurfacing. $3,000 for 3 treatments or $1,100 for 1 treatment.
  • For the time honored effective treatment for sun spots and discolorations, with the added benefit of eliminating broken capillaries, buy a package of 4 IPL Fotofacial treatments and get 2 FREE.
  • To help you achieve that perfect glow try out our SkinCeuticals Chemical Peels. Prices range from $100-$250 depending on exact treatment
  • Our VI Peel is a facial peel for ALL complexions.  It helps improve the appearance of acne, unwanted pigmentation and melasma.  It is the only peel of its kind to contain synergistic blend of TCA, Retin-A, Salicylic Acid, Phenol, and Vitamin C.  It gives great results in as little as one treatment.
  • For people who want skin rejuvination with no downtime, smoother and softer skin and a reduction of fine lines tryMicrodermabrasion treatments. Buy 4 for $255

Call 817-473-2120 today to make an appointment

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