Wrinkle Treatment and Lip Augmentation
(Artefill, Restylane, Radiesse, Juvederm, Collagen Injection, etc.)

Because fuller lips and the reduction of wrinkles can be treated with similar materials and techniques, we've grouped the two topics on one page for your convenience.

Throughout recorded history, full lips have been recognized as a sign of youth, beauty, and sensuality. Likewise, the appearance of wrinkles, especially those around the mouth and eyes, detracts from the appearance of the face. Not surprisingly, therefore, lip enhancement (lip augmentation/lip injection) or wrinkle reduction are frequent desires of patients seeking cosmetic improvement and the restoration of a more youthful face. This is especially true here in Fleming Island (Orange Park) and the greater Jacksonville, Florida and Ponte Vedra Beach areas where there is an emphasis on looking one's best.

Such procedures are also attractive because the cost of injections is relatively low compared to many surgical procedures, and even the best anti-wrinkle creams can't compare to the results of these treatments.

Before & After Photo of Artefill (not Artecoll)

Most commonly, improvement is achieved through the use of soft-tissue fillers (injections) and implants. Until very recently, however, patients in the U.S. were restricted to a relatively limited set of options. Not anymore! In this section of our website we will focus on a few of the most common choices now available (and an important few that have just become available!).

Approved on October 30, 2006 by the Food & Drug Administration (FDA), Artefill® is the first and only permanent injectable filler available in the U.S.

Artefill is composed of 80% bovine collagen and 20% PMMA microspheres [see electron microscope photo]. PMMA is an inert acrylic plastic with a long history of use as a surgical cement and for intraocular lens implants in the eye. What makes Artefill unique is that the PMMA microspheres become encapsulated in the patient's own collagen as the bovine collagen component dissolves, thus achieving permanent correction with the patient's own tissues. Because of its bovine component, skin testing for allergy is still required.

Like with Restylane®, Dr. Pearson gained familiarity with Artecoll (Artefill's predecessor in Canada) during his training in Toronto. Artecoll has been used in over 400,000 patients world-wide with excellent overall results. But as Dr. Pearson notes, "Artefill's advantage is that it's permanent...it's disadvantage can be that it's permanent." Because of this, for patients who are candidates for Artefill, Dr. Pearson may occasionally recommend an initial injection with a temporary filler to confirm the patient's satisfaction with the appearance.

In addition to its use in filling facial wrinkles and folds, Artefill can also be used for non-surgical rhinoplasty in select patients. You can read more about this use on our Rhinoplasty page.

We are pleased to announce that Dr. Pearson was selected by the makers of Artefill to be one of the first providers in the greater Jacksonville, Florida and Orange Park/Fleming Island area to offer this unique filler. He as been using Artefill since its introduction in the U.S. and he has instructed other physicians across the southeast United States in its proper use. Please call us with any questions about appointments, cost, etc. for Artefill and "don't let the magic wear off."™

"Don't let the magic wear off."
—David C. Pearson, M.D. regarding the permanence of Artefill

Radiesse and Restylane Before and After PhotosSee "Before and After" photos of Artefill, Radiesse, and Restylane patients of Dr. Pearson's. (The gallery will open in a new window.)

Formerly known as Radiance FN, Radiesse™ is a soft-tissue filler made from calcium hydroxylapatite, the same substance that is the major mineral in our bones. Calcium hydroxylapatite has been used for other medical purposes for over 15 years, requires no allergy testing, and is extremely compatible with our tissues. Radiesse's greatest advantage is that it is very long lasting, with resorption taking as long as one to three years (although Dr. Pearson suggests that one to one-and-a-half years is a more realistic expectation). Usually this long-lasting correction is achieved over the course of two injection sessions separated by a month or more to achieve optimal contour.

Before & After Photo of Radiesse (Radiance)

Radiesse is an extremely good choice for correction of the melolabial folds (the folds that run from the edge of the nostrils to the corners of the mouth.) and it has become Dr. Pearson's preferred filler for this otherwise hard-to-correct area. It's potential drawback when used for lip enhancement, on the otherhand, is the small chance of developing nodules or bumps around the filler which occurs in as many as 10% of patients having their lips treated and may require additional treatment. For this reason, Dr. Pearson rarely uses Radiesse within the lips, preferring instead fillers such as Restylane for lip enhancement.

Like Artefill, Radiesse can also be used for non-surgical rhinoplasty. You can read more about this use on our Rhinoplasty page.

Note: Bioform Medical, the makers of Radiesse, were so pleased with his results that they have selected one of Dr. Pearson's patients to include in their nationwide patient brochures as a "before and after" example of the results achievable with Radiesse injections. Dr. Pearson was one of only three doctors in the entire country selected for inclusion in the Radiesse pamphlet.

Restylane®, Juvéderm™, and Perlane®
Restylane and Juvederm are injectable fillers made from hyaluronic acid gel. Hyaluronic acid is a natural carbohydrate found in the tissues of all vertebrate animals and is chemically identical across all species. Because of this, no skin testing for allergies is required. To further enhance safety, the hyaluronic acid used in Restylane® and Juvederm is derived from a non-animal source by using genetically-engineered bacteria to produce it. Dr. Pearson first used hyaluronic acid gels during his fellowship training in Canada (where the product has been available for many years), and is particularly pleased to offer it to his patients here in Florida.

RESTYLANE: Approved by the FDA in December 2003, Restylane's big advantage over collagen is its longevity. Studies, as well as our experience, suggest Restylane® lasts up to twice as long as collagen. Generally patients can expect the product to last about 4-6 months. Restylane is very good for lip enhancement, both for creating fuller lips and for filling so-called "smoker's lines" and other fine wrinkles on the face and is usually a much better choice than collagen, in our experience.

JUVEDERM: The newest hyaluronic acid gel filler on the market is Juvederm (from the makers of Botox, and produced as Juvederm Ultra, Juvederm Ultra Plus, Juvederm XC Ultra, and Juvederm XC Ultra Plus). Approved by the FDA since 2006, these injectable gels are somewhat thicker than Restylane and seem to provide even longer-lasting results. Particularly for our patients seeking fuller lips and lip enhancement, Juvederm seems to be especially good due to its very smooth consistency and its longer duration of effect. On average, we've been seeing Juvederm last for 6 to 8 months (or more!), depending on the area injected and patient factors. So far, the results with Juvederm have been very positive. So much so, that in most cases, Dr. Pearson has largely replaced his use of Restylane in favor of Juvederm.

Collagen Injection
Collagen injections have been the old standard by which all other injectable fillers have been judged. Collagen is a structural protein of skin and is a natural choice for a material to plump and define the lips. Most of the collagen used for cosmetic procedures is bovine collagen (Zyplast® and Zyderm®, derived from cows) and has a long track-record of safety and effectiveness. And until the last few years, collagen was the only FDA-approved injectable filler. Since bovine collagen is slightly different from human collagen, about 3% of patients are potentially allergic to it. Because of this, a skin test for allergy to bovine collagen is mandatory for the first-time collagen patient.

More recently, though, the manufacturer of bovine collagen now offers injectable human collagen (CosmoPlast® and CosmoDerm®) which has all the same great properties of bovine collagen but none of the risk of allergic reactions. The injections are usually done in the office and require only local or topical anesthesia. So what's the downside? Transience. Over time, collagen injections are slowly resorbed by the body and disappear. For lip augmentation, Dr. Pearson expects patients will have results lasting only about 2-4 months, at which time patients may return to the office for re-injection. Because of this, and the availability of longer-lasting fillers, like Restylane and Juvederm, Dr. Pearson does not use collagen injections anymore, but we mention it here for completeness.

What to expect

Two of the most attractive aspects of the various fillers described above is that they are relatively inexpensive and also require little to no "down time" for the patient. The procedure only takes a few minutes to perform, and requires no bandages, dressings, or ointments afterward. And because the fillers are injections done in our office in Fleming Island (Orange Park) and require local anesthesia at most, patients can resume their normal activities immediately.

After cleaning the overlying skin with an antiseptic, the appropriate filler is injected into the selected wrinkles or folds, or into the lips, using a very fine needle to deposit the filler into the tissues. With the exception of Sculptra, correction is nearly immediate except for any swelling added by the needle site itself. As always, our goal is to create a natural, more youthful improvement, not a "done" or over-corrected look.

Post-procedure, the only patient restriction is to avoid strenuous physical activity for the first twenty-four hours after the injection. It's also important not to rub or massage the treated areas for the first day or two afterwards to avoid displacing the filler. The possibility of swelling or bruising can be minimized by the application of cold packs to the area for the first 24 hours as well. The specific potential risks of injectable fillers will be thoroughly discussed with you before your first treatment.

For more information about wrinkle fillers, lip augmentation, and cosmetic facial plastic surgery here in Orange Park and the greater Jacksonville, Florida area, please check our Frequently Asked Questions page or call to schedule an appointment.

To schedule a private consultation with Dr. Pearson,
please call 904-215-7377 or e-mail us.

"When beauty fires the blood, how love exalts the mind!"
—John Dryden (1631-1700)
Why Choose Dr. Pearson?   • More than 13 years in practice   • Mayo Clinic trained & former Mayo staff   • Board-certified in Facial Plastic Surgery   • Our Results!