Dermal Fillers in Newport Beach

Where Naomi uses ultrasound

Filler works by occupying space in a specific layer: within the skin, in the fat beneath it, or down on the bone. The vessels that run through those layers are not in the same place in every face, and filler placed years ago can still be there. Naomi plans your placement for your anatomy rather than for an average one, and in two situations she looks beneath the skin before she starts.

For a non surgical nose job, Naomi scans the nose with ultrasound before injecting, so she can see where the blood vessels run in your nose and place product around them. And when someone comes to her to have filler dissolved, whether it is her own work or someone else’s, she uses the same imaging to find the filler before the enzyme goes in.

Areas Naomi treats with filler

Filler is one tool among several, and the areas below are the ones people ask Naomi about most. In each, the aim is to restore what volume loss has taken, soften a line that stays put when your face is at rest, or bring a feature into better proportion with the rest of the face.

• Upper face: forehead lines, frown lines between the brows, hollow temples, and hollowing of the upper eyelid area.
• Midface: the cheeks, hollows under the eyes, and smile lines (the folds that run from the nose to the corners of the mouth).
• Nose: a non surgical nose job places small amounts of filler along the bridge and tip, aimed at smoothing a bump or lifting the tip without surgery, after an ultrasound scan of the nose.
• Lips: lip filler for volume, definition of the border, and the vertical lines above the lip.
• Lower face: the chin, the lines around the mouth, marionette lines, and the jawline.
• Neck, hands and body: the backs of the hands, the neck, and thin or crinkled skin on the arms, thighs and knees.

Which product goes where, and in which layer, is decided at your consultation. Naomi will also tell you when filler is not the right tool. Some concerns respond better to a wrinkle relaxer such as Botox, some to a biostimulator, and some are better left alone.

How a filler appointment works

1. Consultation and assessment. Naomi looks at the whole face, not one line, and asks what bothers you and what you want left exactly as it is. She takes your medical history: allergies, bleeding problems and medications, cold sores, pregnancy or breastfeeding, and any filler you have had before.
2. The plan. Product, layer and amount, with the price. Nothing is decided for you. For a non surgical nose job, this is also when she scans the nose with ultrasound and shows you what she sees.
3. Treatment. The skin is cleaned, and most of the products Naomi uses contain lidocaine, a local anesthetic, so numbing builds as she works. She places product in small amounts and checks the shape as she goes.
4. Aftercare and follow up. You leave with aftercare instructions and a way to reach the clinic. Naomi sees you again once the swelling has settled to review the result.

Plan on about 45 to 60 minutes for the visit.

The fillers we use

Two kinds of product do most of the work. Hyaluronic acid gels (Restylane Refyne, Restylane Lyft and RHA Redensity) are made from a sugar your body already produces. They hold water, show their result immediately, and are absorbed over months. Biostimulators work more slowly. Radiesse is made of calcium hydroxylapatite, a mineral found in bone and teeth, suspended in a gel. Sculptra is poly-L-lactic acid, which is absorbed gradually; as it goes, the body may produce new collagen where it was placed, so the result builds over several weeks and usually takes more than one session.

Each of these products is FDA approved: Restylane Refyne and Restylane Lyft for moderate to severe facial wrinkles and folds such as smile lines, with Lyft also covering the cheeks, the chin and the backs of the hands; RHA Redensity for moderate to severe lines around the mouth; Radiesse for moderate to severe facial wrinkles and folds, the jawline and the backs of the hands; and Sculptra for smile lines and other facial wrinkles and for fine lines and wrinkles in the cheeks.

PRF EZ Gel is different. It is made from a small sample of your own blood, spun and warmed into a gel, and it is the option for people who want a filler made from their own tissue rather than a manufactured product. Here is how it compares with traditional fillers. Read more about Restylane, RHA Redensity, Radiesse and Sculptra on their own pages.

What to expect afterward, and the risks

Swelling, bruising, tenderness, redness and small lumps are normal in the first days. For most people they settle within two weeks; the lips can take the full two weeks, and swelling in the backs of the hands can last longer than that. Cold compresses help on the first day. Until swelling and redness have gone, avoid heavy exercise, heat and sun, and for the first week avoid aspirin, ibuprofen, St. John’s Wort and high dose vitamin E unless a doctor has prescribed them. Try not to touch the area for the first six hours while it is numb.

Every filler carries one serious risk that Naomi wants you to understand before you decide: unintentional injection into a blood vessel. The chance is very small, but when it happens the complications can be serious and may be permanent, including vision changes, blindness, stroke, temporary scabs, or permanent scarring of the skin. Other uncommon problems are infection, filler that moves from where it was placed, firm nodules that may need treatment, and inflammation that appears weeks or months later, sometimes after an illness, a vaccination or dental work. Knowing the anatomy in front of her is how Naomi lowers that risk, and for a non surgical nose job she maps the vessels in the nose with ultrasound before she places product. Nothing removes the risk entirely, and no injector can promise that. The FDA’s patient information on dermal fillers describes these risks in full and is linked in the sources below.

Call the clinic right away if you notice any of these after treatment: changes in your vision; signs of a stroke (sudden difficulty speaking, numbness or weakness in your face, arms or legs, difficulty walking, face drooping, severe headache, dizziness or confusion); a white, gray or blue appearance of the skin near the injection site; or unusual pain during or shortly after treatment.

Tell us before treatment if you have a history of severe allergies or anaphylaxis, an allergy to lidocaine, a bleeding disorder or take blood thinners, a tendency to keloid scarring, a cold sore or any active skin infection near the area, or if you are pregnant or breastfeeding. Sculptra is for people with a healthy immune system.

Hyaluronic acid filler can be dissolved with hyaluronidase, an enzyme that breaks it down. Naomi locates the filler with ultrasound before dissolving it, whether it is her own work or someone else’s. Radiesse and Sculptra cannot be dissolved; they are absorbed by the body over time.