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Procedures

Go to Photo Gallery Cosmetic Procedures  Fillers: Radiesse, Juvederm, Restylane, Perlane
Do you have sad looking eyes, deep shadows under your eyes, thin lips, or hollow areas in your cheeks or around your mouth?  

Injectable Fillers can Solve Your Problems.  They are the “Magic Rejuvenators” We Have Always Wanted


They can transform a tired looking, aging face into a youthful, rested face during a simple office visit without surgery.  Fillers are so exciting because they offer a simple, predictable, cost effective way to fill depressed facial areas for years without surgery.

The best fillers are Radiesse, Belotero, Juvederm, Perlane and Restylane.  Of these, I use Radiesse for ninty percent of my injections because it lasts longer, and creates and maintains the desired contours much better in my hands.  These fillers are made from materials that are identical to what is already naturally present in your body, and can be injected to fill depressions without surgery.

Fat is also an excellent filler but is discussed separately because it requires surgery.



Worried About Discomfort During The Injections?  Try Dr. McBride's Special Injection Technique

Dr. McBride has developed an approach to injecting fillers which eliminates needle marks in the face and reduces discomfort dramatically.
Almost all injections are made from inside the mouth.  
Dr. McBride mixes a small amount of local anesthetic solution with the filler to prevent discomfort. By injecting from inside the mouth, there is almost no bruising.

This approach lets him easily inject at multiple levels for ideal contour restoration, and it helps to avoid blood vessels in the skin that cause bruising. By injecting in several layers of tissue he can produce more augmentation while maintaining an extremely smooth contour.

He applies a vibrator to the face during all injections to almost completely eliminate any discomfort during the local anesthetic - filler injections. He also uses the vibrator to spread the filler so it is perfectly smooth.   

Dr. McBride gives each patient a steroid pill before the injections, and an additional pill to take a few hours after treatment. The prednisone is very effective at preventing swelling.

The advantages of Dr. McBride’s filler technique include:

     All injections are done by Dr. McBride


•    No needle marks on the skin
•    Reduced bruising
•    Reduced swelling
•    Almost no discomfort
•    Precise contouring and ideal smoothness


What causes lines and wrinkles?

As we age we loose elastic tissue in our skin and fat from under our skin. Collagen and hyaluronic acid in our skin decreases and the elastic fibers become looser, creating wrinkles and folds. However, age is not the only cause of wrinkles. Heredity, smiling, frowning, squinting, smoking, sun bathing and pollution damage the structure of your skin, irrespective of age.

The formation of lines and creases on the face and the thinning of lips are a natural part of living, not just aging. In other words, these marks of maturity are inevitable. But, now you can dramatically minimize lines and creases and restore vitality to your face with injectable fillers.

Many people are looking for a slightly fuller shape for their chin, or perhaps a rounder more sensuous contour for their cheeks or lips. Just a touch of additional volume can make an enormous difference to your appearance.

The ideal approach to reversing these aging effects would fill in the lines and creases that normally develop, and restore fullness to the lips and cheeks. It would be safe and totally compatible with the body. And it would last for many years. Restylane and Radiesse are the fillers for which we have been waiting.

What is Radiesse?

Radiesse is a pure, synthetic compound with a record of safety that extends more than 25 years. Radiesse consists of tiny micro spheres of a synthetic material called calcium hydroxylapatite (30%) that is combined with a common hydrogel (70%) used in a vast array of products. The result is a white, creamy like substance. Calcium hydroxylapatite has chemical and structural characteristics similar to bone and therefore is naturally compatible with the body.

When injected, the cream-like texture of Radiesse feels soft and natural. Following injection, the body forms a tissue matrix around the Radiesse microspheres. Unlike temporary treatments that must be repeated frequently, Radiesse provides years of rejuvenation. Throughout its life, Radiesse remains soft and flexible and also exceptionally compatible with the body. It is gradually replaced by the body's own tissue, and slowly dissolves away in 2 to 3 years.

Has Radiesse been tested for safety?

Radiesse has undergone extensive safety testing, and calcium hydroxylapatite has been used for many years as an implant in dentistry and surgery. Prior to its introduction, the Radiesse formula was extensively tested in the United States and Europe.

No substantial adverse reactions or rejections have been reported to date. Because Radiesse is a synthetic material and not comprised of any human or animal tissue, you cannot contract a disease from its injection. The natural compatibility of Radiesse with the body also means that no allergy testing is required, and treatment can take place immediately.

Have there been complications with Radiesse?

Radiesse has been safely injected in over 30,000 patients worldwide without a report of reaction to the product. There have been minor complications reported by some patients receiving large volume lip augmentation where some lumpiness or small nodules have occurred within several days of treatment. Complications of this nature have been normally resolved clinically within 30-60 days with patients reporting satisfaction.

Dr. McBride uses Restylane to augment lips to avoid the irregularity that occasionally occurs with Radiesse. However, he uses Radiesse along the margin of the lips to produce a youthful rolled edge. Radiesse does not produce irregularities when used under the skin along the edge of the lips.

What will Radiesse look and feel like after you've been treated?

As a material, Radiesse is cream-like in texture and remains that way throughout its life. The sensitivity and feeling of enhanced areas are retained.

Once injected, its softness resembles that of your normal facial tissue. In fact, your own tissues will integrate with the Radiesse microspheres as a natural process of your body.

The amount of Radiesse injected can be accurately controlled, so you can achieve the exact amount of enhancement you desire. Individuals who have received Radiesse treatment are very pleased with its natural look and feel. Most important, they say it passes the most crucial test of all — the "kiss test?

What are the benefits of Radiesse?


Radiesse offers a combination of benefits unavailable with other approaches:
•    A time-tested synthetic material used in medicine and dentistry.
•    Safety and compatibility with the body.
•    Produces a soft, natural-looking appearance.
•    Lasts up to three years.
•    Animal and human tissue-free; no allergy testing required.
•    Can be performed during an office visit.
•    Results are immediately visible.

Typical Radiesse treatment includes:
•    Cheek augmentation
•    Depressions under the eyes
•    Deep nasolabial folds
•    Horizontal forehead lines
•    Frown lines between the eye brows
•    Wrinkles at the corners of the mouth
•    Vertical lip lines
•    Acne scars
•    Providing lip definition


Many options exist for reversing the effects of time and aging on the face, from major surgical procedures to injectable enhancements. Radiesse is a safe, durable and worry-free treatment. In less time than it takes for a hairstyle, you can present a renewed, revitalized face to the world.

Click here to learn more about RADIESSE® Volumizing Filler


What is Belotero?
Belotero is
a unique hyaluronic acid dermal filler that seamlessly integrates with your skin and adapts to your facial contours, therefore plumps and adds volume to your face. It softens and smoothes lines and wrinkles.


Belotero is an HA dermal filler, made of the same volumising and moisturising component of your skin, so it is the natural choice for reducing the appearance of lines and wrinkles.  When injected, it instantly plumps and adds volume to the areas where it has been lost. Even the finest lines can be treated with confidence with Belotero.


What is Restylane?


Restylane is made from hyaluronic acid, which occurs naturally in your skin and other tissues. The resilience and youthful contours of our skin, and its ability to counter the effects of time, wind and weather, depend upon hyaluronic acid.

Hyaluronic acid also plays an important role in giving volume to the skin, shape to the eyes and elasticity to the joints. Hyaluronic acid has a chemical structure similar in some ways to sugar, and is identical in all species and in all tissue types.

With Restylane, you can have a natural beauty lift with the body’s own material. The crystal–clear gel is injected under the skin in tiny amounts with a very fine needle. The result is instantaneous and produces a long-lasting, natural enhancement, which is gentle and safe. With Restylane there is no risk of transmitting disease or eliciting allergic reactions.

No previous skin test is needed, which means that you can have the treatment immediately. The session usually takes less than thirty minutes, and the results are instantaneous. With Restylane, lip augmentation can be carried out without the use of foreign elements.


What is Perlane?

Perlane is a thicker, more viscous, longer lasting version of Restylane. The description of
Perlane  is the same as Restylane, except that it is a little firmer, and has less tendency to move through the tissue compared to Restylane.  Perlane also lasts a few months longer than Restylane.

What is Juvederm?

JUVÉDERM™ Ultra Plus injectable gel is another  hyaluronic acid gel that is injected into facial tissue to smooth wrinkles and folds, especially around the nose and mouth. Juvederm  Ultra Plus is more viscous than Restylane, and therefore maintains a desired contour better than Restylane because it does not flow through the tissue as readily. Hyaluronic acid occurs naturally in the human body. The role of hyaluronic acid in the skin is to deliver nutrients, hydrate the skin by holding in water, and to act as a cushioning agent. This is exactly what Juvederm does for us, and why it feels completely normal in our tissue.

What is the difference in duration of Radiesse and Restylane?

The amount of augmentation or filling that can be obtained with either product is similar, depending on the location of the treatment and the nature of your skin. Radiesse is thicker so it produces longer lasting, more esthetic contours than Restylane. The other important difference is in the duration of the effect.

Radiesse will loose half of its volume in 6 to 9 months, but will keep the other half for 1 to 2 years. So you will probably want to do a touch-up with Radiesse in 6 to 9 months. The gel component is broken down by the body over a period of about four months, The gel is replaced by new collagen that developes as the gel breaks down. This new collagen plays a big role in the durability of the augmentation effect.

Restylane lasts for 3 to 9 months. Perlane will usually last a little longer. Highly mobile areas like the lips tend to require a touch-up treatment after about 5 to 6 months. Areas where there is less movement may only require additional treatment after 6 to 9 months.

Radiesse and Restylane produce about the same mild swelling and occasional bruising, and both feel just like normal tissue after a few days.  The swelling is mild and will usually resolve in a few days, but occasionally it can linger for a few weeks.

Typical Restylane, Perlane or Juvederm treatment includes:
•    Lip augmentation
•    Smoothing crows feet
•    Filling and smoothing fine lines and wrinkles of the face





BEFORE:  Lip augmentation
Both lips are small, but the upper lip is particularly small and not balanced well with the lower lip size or contour.
 
AFTER:  Lip augmentation with Restylane
In these photos, the lips have beeen filled out to produce an excellent contour and normal definition of the edges. You can see in this "after" photo that the attractive, youthful elevated roll along the edge of the upper lip has been restored.  But it is not overdone.  The lips move normally, and they look, and feel perfectly natural


What is the difference between Restylane, Juvederm, Radiesse, and Botox?

Botox relaxes the muscles which cause many fine facial lines and unwanted facial expressions, but it does not “fill” any depressions. Fillers like Restylane, Perlane, Juvederm and Radiesse fill fine and deep creases, augment lips and cheekbones, and reduce defects like acne scars.

Botox is used in combination with Restylane, Perlane, Juvederm and Radiesse when treating certain areas where permanent deep lines have resulted from over activity of the underlying muscles. Typical examples are frown lines on the lower forehead or wrinkles around the lips.

Is Restylane or Radiesse treatment uncomfortable?

The needles used for fillers are very fine and many patients are pleasantly surprised by the minimal discomfort of the treatment. Dr. McBride mixes a small amount of local anesthetic solution with the filler and injects from inside the mouth to prevent discomfort. By injecting from inside the mouth, there is almost no bruising.

How do you pick the best product to use in a specific area?

Radiesse has the thickest consistency, and is longest lasting, Juvederm has a medium consistency and lasts longer than Restylane and shorter than Radiesse, and Restylane has the thinnest consistency and is the shortest lasting. Therefore, we tend to use Radiesse to fill all areas of the face except the lips.

Restylane and Juvederm are used for thin skin areas like the lips, and for filling very fine lines.

Can a face-lift or other surgery be performed after Restylane, Perlane, Juvederm or Radiesse treatment?

Yes. A face-lift can be performed after Restylane, Juvederm or Radiesse treatment. These fillers can sometimes reduce or eliminate the need for a facelift or other surgery, or can delay the need for repeated surgery.

These fillers may also be injected at the time of facelift, or other surgery, to assist in achieving the desired result.

When is Fat Transfer Augmentation preferred over Restylane, Perlane, Juvederm or Radiesse?


Fat Transfer Augmentation is preferred over other fillers when the volume of material needed is more than 6 or 7 syringes of Radiesse(1.4cc per syringe). If more than this amount of filler is needed, it will be less expensive to do fat transfer, and the effect may last considerably longer with fat.
In many full face fat transfer cases, more than 40cc of fat are injected. Each 1cc of Radiesse will produce augmentation equivalent to 2cc of fat, but it will need to be repeated in 6 to 9 months. This volume of augmentation with Radiesse would cost twice as much as fat transfer. But some people prefer the simplicity of Radiesse, and some men do not have enough good fat to harvest for fat transfer.

How much do Restylane, Perlane, Juvederm and Radiesse cost?

Restylane, Pertlane, Juvederm and Radiesse are very affordable even for those with modest incomes, but some people need to budget for these treatments, just as they would for buying accessories like shoes and having their hair styled.

Our fee is the same for Radiesse, Perlane, Juvederm and Restylane, but Radiesse has the advantage of usually lasting several months longer. Please call our office regarding our fees for these treatments.


BEFORE:  Lip augmentation
The upper lip is thin and vertical lines are prominent.
 
AFTER: Lip augmentation with fat
The lips are fuller, better balanced for size and the filling under the edge of the upper lip has reduced the lip lines dramatically.



BEFORE  Lip augmentation
These lips are fairly well balanced, but some augmentation will make them more interesting.
 
AFTER  Lip augmentation with Restylane
The added fullness of the lips is very attractive.


BEFORE  Lip augmentation
A profile view of the lips in the above photos show the lack of fullness in the upper lip. The upper lip should project in front of the lower lip.
 
AFTER  Lip augmentation with Restylane
The upper lip profile is much more attractive and the fullness of the upper lip is better balanced with the lower lip.

How much experience do we have with Restylane and Perlane?

More than 27 million patients all over the world have been treated with various hyaluronic acid based products over the years. Restylane is extremely safe.

More than five hundred thousand men and women in all age groups around the world have been successfully treated with Restylane since 1996. Studies show that the vast majority of them were so happy with their results that they wanted to have the treatment again.

What will Restylane, Perlane  or Juvederm look and feel like after I have been treated?

Restylane, Perlane and Juvederm are clear gels with textures just like your normal tissue. And they remain that way throughout their life. The sensitivity and feeling of enhanced areas are retained.

Once injected, its softness resembles that of your normal facial tissue. In fact, your own tissues will integrate with the material as a natural process of your body.

The amount injected can be accurately controlled, so you can achieve the exact amount of enhancement you desire. Individuals who have received Radiesse or Restylane treatment are very pleased with its natural look and feel. Most important, they say it passes the most crucial test of all — the "kiss test"!


Can Restylane, Perlane, Juvederm and Radiesse be used together?

Restylane, Juvederm and Radiesse can be used in combination with each other. For example, a deep fold can first be treated with Radiesse, then Restylane or Juvederm can be used at a later date if you wish to correct residual lines in that area.

Restylane can be used for thin, superficial lines, for example around the eyes, around the mouth and on the forehead. Fat may be used in combination with Restylane, Juvederm and Radiesse.

In Summary - Restylane:
•    Is long-lasting, but ultimately biodegradable and non-permanent.
•    Can last 6-12 months or more before being completely reabsorbed
•    Effects can be cumulative – smaller volumes are sometimes needed for maintenance treatments
•    Have no animal ingredients
•    No skin test is needed


Can Restylane, Perlane, Juvederm or Radiesse be used during pregnancy?

There is no technical or medical reason why Restylane, Juvederm or Radiesse should not be used during pregnancy.


Pre-treatment instructions:

Many patients like to take a couple of plain Tylenol or Advil an hour or two before treatment (similar to what you might do before having a flu shot) to prevent discomfort.

Bruising is seldom a problem after Radiesse or Restylane treatment. The chance of bruising can be reduced by avoiding aspirin for 7 days prior to treatment, and minimizing your consumption of Vitamin E for 3 days before treatment.

You can bring makeup with you, and you may apply your makeup immediately after treatment.

Post-treatment instructions:

After Radiesse, Juvederm or Restylane treatment, you will have some swelling. Bruising is possible but uncommon. However, occasionally there is some mild pain, swelling, itching or redness at the site of injection - similar to what you could experience after any injection. Dr. McBride will give you steroid pills to take which will reduce the degree and duration of swelling.
 
You may use cold compresses, or take acetaminophen, naproxen, Motrin, or other anti-inflammatory medication, to reduce swelling or discomfort. Redness may last for 1 - 2 days, occasionally longer in some patients. Swelling in the lips usually lasts for 2 days, but can last for up to a week, and the lips may appear somewhat uneven until the swelling subsides.

In order to allow the filler to stabilize, try to avoid excessive movement of your facial muscles for the first few days, and in particular during the first 6 hours after your treatment.

If swelling or redness occur, do not expose the treated area to intense heat (e.g. hot packs or sunbathing) or extreme cold, until these problems have resolved.


Call Today for a complimentary consultation
Please call our office at 972-566-4900 if you have any questions about Restylane or Radiesse, and to arrange for a confidential consultation and treatment.

Treatment can be done the same day as the consultation, if you wish.
Our staff will take the time necessary to discuss your wishes and treatment options, and answer all of your questions.