710 Park Avenue, New York, NY

Injectables & Facial Fillers

Cosmetic injectables are treatments that can enhance beauty and restore youthfulness with minimal or no downtime. These rapid and effective aesthetic treatments play an invaluable role in the hierarchy of cosmetic plastic surgery, albeit without surgery. Advancements in the technology of injectibles and fillers have considerably improved the efficacy of these products over the years. It is not common for a professional surgeon to directly administer these products but it truly makes a difference.

Dr. Kolker's personal commitment to enhancing who you already are, not transforming you into someone else, as well as his attitude to both his surgical work and filler treatments bring amazing results. I have recommended him to several friends with no hesitation.C.H. / New York
Schedule a Consultation to See Our Work in Our Office

To preserve anonymity and to protect the confidentiality of all of his patients, Dr. Kolker maintains a comprehensive gallery of before and after photographs that can be viewed in the office for this procedure.

The cornerstones of these rejuvenating treatments are methods that:

  • RELAX - softens the effects of muscle action, such as Botox Cosmetic, Dysport, or Myobloc
  • REFILL - facial fillers restore volume to areas where soft tissue has dissipated or where shadows and lines become more prominent, including Juvederm, Restylane, Sculptra, Voluma, Belotero, Radiesse, fat grafting, and others
  • RESURFACE - addresses tone and texture of skin, and resurface by means of a variety of laser and light modalities, chemical peel, or dermabrasion

These approaches are complimentary and any one or a combination of these treatments can be chosen to soften, smooth, fill, or tighten to improve appearance comfortably, safely, and without surgery. These nonsurgical cosmetic injectable treatments can be a rapid and effective means of maintaining and restoring youth and beauty. Of course, in situations where more architectural "resuspension" is required (think of a drooping jowl, lax neck, or excess eyelid skin), procedures that require more downtime may be required.

As we age, volume is lost from the face, which can lead to starker shadows and transitions between the aesthetic subunits of the face, such as the shadow line or hollow between the lower eyelid and cheek (tear trough), or the transition from cheek to upper lip (nasolabial fold). Upper cheek fullness may be lost, the midface may become deflated, and the lips may thin. With this in mind, there has been a paradigm shift in the approach to aesthetic enhancement and rejuvenation:

Restoring volume is the key to restoring youth

There is a wide array of injectable fillers available, from the HA's (hyaluronic acid fillers) including Juvederm, Restylane, Voluma and Belotero, to volume stimulators like Sculptra, to autologous sources (from your own body) such as growth factor driven platelet rich fibrin matrix (Selphyl) and fat grafting. The ideal filler will be determined by your particular anatomy and unique desires. The best facial filler and restorative approach is always geared toward facial harmony and a beautiful, natural appearance.

Injectables and Facial Fillers with Dr. Adam Kolker

The myriad facial cosmetic treatments can be viewed like the rungs of a ladder, with the lowest rungs being the most simple and effective means to achieve a result, i.e. nonsurgical, and the upper rungs being those associated with more intervention and downtime, i.e., surgery. Dr. Kolker approaches all facial aesthetic treatments by focusing on attaining the most beautiful and most effective results by using "the lowest rungs" of that ladder, which will maximize beauty and safety while minimizing downtime.

With so many fillers to choose from, how do you determine the best facial filler for you? Dr. Kolker will spend time coming to understand your specific goals and desires, and will then carefully assess your anatomic requirements. As every individual brings unique physical features and desires, a cosmetic treatment plan will be personally formulated to achieve your goals.

The most beautiful facial filler results require finesse, experience and artistry. No two injectors are the same, and the physician you choose for facial filler treatments absolutely makes a difference. As a double-board certified plastic surgeon, Dr. Kolker brings tremendous experience in the nuances of facial anatomy at all levels including and beneath the skin. Blending artistic perspective with an eye toward natural, it is his goal to achieve results that are at once youthful, beautiful and understated.

Dr. Kolker's Message to Those Considering Facial Filler treatments

Youthful, natural results should be the goal of any aesthetic facial treatment, and whenever possible, facial harmony, balance, and beauty should be sought with the most conservative and minimal downtime approaches available. Volume is the cornerstone of restoring youthfulness. The best facial fillers are those that are introduced delicately, sculpturally, naturally, and beautifully, but with a subtlety that doesn't hint you've had anything done.Dr. Adam Kolker

Which are the Best Facial Fillers?

Choosing the best facial fillers is akin to an artist selecting from among different paints on a palette. The right filler will be chosen based on your specific anatomic needs and your particular desires. Occasionally, different fillers may be selected in the same treatment session, as there is no one facial filler that is the "best" for every situation. While not a comprehensive list, some of the facial fillers most commonly recommended by Dr. Kolker are:

Juvederm

Juvederm is a hyaluronic acid facial filler. Hyaluronic acid is abundant in our tissues in youth, and dissipates as we age. Hyaluronic acid fillers used today are crystal-clear, non-animal-derived, extremely hypoallergenic, and very safe. Juvederm comes in two main concentrations: Juvederm Ultra, and Juvederm Ultra Plus. The "ultra" formulation has a slightly less dense molecular concentration for finer, more superficial fill and wrinkle corrections, and Juvederm Ultra Plus is used for more intermediate depth fill and correction of deeper lines and shadows.

Additionally, Juvederm XC and Juvederm Ultra Plus XC are formulated with xylocaine, a local anesthetic that makes the injection process much more comfortable. Juvederm maintains volume fill for between six and 12 months; in areas that are prone to more motion, including the lips and nasolabial folds, 6 to 9 months is common. In regions that are less mobile, such as the cheek, tear trough, or glabella (the vertical lines between the brows), Juvederm may last for 12 to 15 months. Among the many indications for the family of Juvederm hyaluronic acid fillers, Juvederm can be used to fill the nasolabial fold, marionette lines, the tear trough, cheeks, lips, and glabellar lines.

Restylane

Restylane is a hyaluronic acid facial filler, and can be used in scenarios identical to Juvederm. Restylane is available in a variety of concentrations of increasing density: Restylane Fine Lines, Restylane, and Perlane. The applicability and longevity of Restylane is comparable to those described for Juvederm above, as Restylane and Perlane can be used to treat superficial lines and wrinkles or deeper volume concerns as well. Is Restylane better than Juvederm, or is Juvederm better than Restylane? In fact, both are outstanding choices as facial fillers, and are virtually identical in their efficacy and safety. The decision between Juvederm and Restylane is often made based on patient and physician preference.

Voluma

Voluma is a hyaluronic acid filler from the Juvederm family of facial fillers. Voluma has a density and viscosity that provides for more structural and sculptural fill, restoring lost volume predominantly in the upper cheek and mid-cheek regions. Placed somewhat deeper than Restylane or Juvederm, Voluma can be expected to last for 12 months or more.

Belotero

Belotero is a hyaluronic acid facial filler that is the least viscous of all, and can be used at the most superficial levels within the skin. Treatment with Belotero is an excellent solution for fine lines above and below the lips, and for crows-feet wrinkles around the eyes.

Radiesse

Radiesse is a facial filler that differs from the hyaluronic acid fillers, although it can share the same HA acronym. An injectable hydroxyapatite, Radiesse is well suited for intermediate depth and deeper facial volume restoration, with applicability in the nasolabial fold region and cheeks. It may last for 12 months or more.

Sculptra

Sculptra is a an outstanding facial filler that is used for the correction of deeper volume deficiencies of the face, including the mid-cheek, jawline, cheekbone, and temporal (temple) areas. Sculptra's effects are gradual, as the "fill" that remains after a Sculptra injection is created by your body's natural reaction to it. Collagen is laid down by the deeper tissues within the face to gradually increase natural volume. In general, three Sculptra treatments are necessary to achieve a natural, long lasting volume restoration. Once achieved, the results of Sculptra treatments may last for several years.

Selphyl

Selphyl is an autologous injectable treatment, meaning it is derived from your own body. After drawing a small amount of blood, it is prepared by centrifugation, separating the cells and serum, and producing a natural, platelet rich fibrin matrix for injection. A Selphyl injection does give an immediate volume restoration to the area being treated, although this often dissipates over a few weeks or months following an individual treatment. It is hypothesized that the PRP transfer with Selphyl will transfer growth factors to the treated region of the face, thus increasing the volume in that area. To date, short-term results are very encouraging, but the longevity of these treatments is not supported by long term data. Several treatments may be required.

Fat Grafting

Autologous fat grafting is an outstanding means of restoring youthful volume and fullness to the face. Fat can be gently removed (harvested) with fine cannulas through needle access sites from other areas of the body, which may include the abdomen, love handles, or thighs, using liposuction techniques. The fat is then prepared, and delicately transferred to lines, wrinkles, folds, and volume-deficient areas of the face. Fat grafts to the face can often be performed under local anesthesia, although some may opt for light sedation during this procedure. Unlike the other facial filler treatments listed above that do not require local anesthetics (other than topical gel) and are associated with minimal or no downtime, there may be a bit more bruising and swelling with fat grafting to the face. The longevity of fat grafts may be the greatest, as when the fat cells transferred "take" as grafts, they are permanent.

Hear From Dr. Kolker's Patients

Dr. Kolker's personal commitment to enhancing who you already are, not transforming you into someone else, as well as his attitude to both his surgical work and filler treatments bring amazing results. I have recommended him to several friends with no hesitation.C.H. / New York

Facial Filler / Cosmetic Injectable Preparation and Procedure

Dr. Kolker recommends that any nonsteroidal anti-inflammatory medications (Advil, Motrin, ibuprofen, aspirin, Aleve, etc.) are avoided for approximately ten days prior to facial filler treatments to minimize the potential for bruising. Injectable treatments are performed exclusively by Dr. Kolker in his Park Avenue practice in New York. Restylane, Juvederm, and other fillers are administered after a topical anesthetic has been applied. Otherwise, no other anesthetics are required for facial filler injections. Anatomic landmarks and areas to be treated will be marked, and the injections take several minutes to perform.

Dr. Kolker favors the use of blunt-tipped needles that are extremely gentle, which dramatically decrease post-treatment bruising and increase the ability to inject facial fillers with meticulousness and finesse. Downtime after facial fillers is most often minimal or nonexistent.

Exercise after Injectables and Facial Fillers

Return to light exercise (walking, elliptical, treadmill, stationary bike) is immediate, and unrestricted activities are resumed the following day.

More Questions?

Dr. Kolker's website and other internet-based resources can be helpful in providing basic information about facial cosmetic treatments including injectables and facial fillers. There is no substitute for an in-depth, personal consultation with a board-certified plastic surgeon experienced in the numerous and varied facial rejuvenation methods. Dr. Kolker will recommend a treatment strategy and options that are specific to your anatomy and goals. Not all facial aesthetic treatments are the same; facial filler treatments require customization, finesse, experience, appreciation of anatomy, and artistic vision to achieve the most beautiful and natural outcomes, and the physician you choose makes a difference. We invite you to schedule a consultation to discuss nonsurgical aesthetic treatments, and facial fillers including Juvederm and Restylane in NYC with Dr. Kolker, and look forward to warmly welcoming you to our practice.

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