If You’re Considering Injectable Fillers

As we age, our faces begin to show the effects of gravity, sun exposure and years of facial muscle movement, such as smiling, chewing and squinting. The underlying tissues that keep our skin looking youthful and plumped up begin to break down, often leaving laugh lines, smile lines, crow’s feet or facial creases over the areas where this muscle movement occurs.

Soft-tissue fillers, most commonly injectable dermal fillers or fat, can help fill in these lines and creases, temporarily restoring a smoother, more youthful-looking appearance. When injected beneath the skin, these fillers plump up creased and sunken areas of the face. They can also add fullness to the lips and cheeks. Injectable fillers may be used alone or in conjunction with a resurfacing procedure, such as a laser treatment, or a recontouring procedure, such as a facelift.

If you’re considering a facial-rejuvenation treatment with dermal fillers or fat, this page will give you a basic understanding of the procedure – when injectables can help, how the procedure is performed, and what results you can expect. It may not answer all of your questions, since a lot depends on your individual circumstances. Please ask Dr. Mabourakh if there is anything about the procedure you don’t understand.

Knowing Your Options

Injected dermal fillers and fat are primarily used to improve the appearance of the skin’s texture. They can help fill out deep facial wrinkles, creases and furrows, “sunken” cheeks, skin depressions and some types of scars. They can also be used to add a fuller, more sensuous look to the lips.

Injectables are usually not sufficient for severe surface wrinkles on the face, such as multiple vertical “lipstick lines” that sometimes form around the mouth. Instead, Dr. Mabourakh may suggest a resurfacing technique, such as chemical peel or laser treatments. Rather than filling in facial lines, resurfacing methods strip away the outer layers of the skin to produce a smoother appearance.

Deep folds in the face or brow caused by overactive muscles or by loose skin may be more effectively treated with cosmetic surgery, such as a facelift or browlift. Injectables are sometimes used in conjunction with facial surgery procedures; however, injectables alone cannot change facial contour the way surgery can.

Keep in mind that Dr. Mabourakh is a specialist that can offer you the full gamut of the most advanced treatments ranging from cosmetic surgery, refinishing techniques, laser therapy, injectables and the use of other fillers. You and Dr. Mabourakh may determine that a single procedure or a combination of procedures is the best choice for you.

Brochures are available on chemical peels, laser treatments, facelift and browlift. If you and Dr. Mabourakh think that one of these other procedures might be more appropriate for you, ask your Dr. Mabourakh to provide you with a copy.

A Word About Other Types Of Fillers

This page deals with the most commonly used types of injectable fillers and fat. However, there are a number of other filler materials are also being used for facial-rejuvenation purposes. Such as Juvederm, Restylane, Belotero, Voluma and Radiesse. These offer excellent results with little or no down time.

Each of these options has its own set of risks and benefits. If you’re considering any of these alternative filler treatments, tell Dr. Mabourakh.

What To Expect From Treatment

The most important fact to remember about injectable fillers is that the results are not permanent. Injected material is eventually metabolized by the body. You should not expect the same long-lasting results that may be gained from cosmetic surgery.

In some individuals, the results may last only a few weeks; in others, the results may be maintained indefinitely. Researchers believe that age, genetic background, skin quality and lifestyle as well as the injected body site may all play a role in the injected material’s “staying power.” However, the precise reason for the variation of results among patients has yet to be identified.

If you’ve had short-lived results from fat injections, you shouldn’t necessarily assume that dermal filler injections will work better for you. And, conversely, if you’ve had disappointing results from dermal fillers, don’t assume that injected fat is the answer. Although it’s true that some individuals’ bodies are more receptive to one substance than the other, others may find that neither substance produces long-lasting results. Sometimes one substance may work better than the other for a specific problem.

Planning For Treatment

Facial rejuvenation is very individualized. That’s why it’s important to discuss your hopes and expectations with Dr. Mabourakh who has experience with many different types of surgical and non-surgical facial procedures.

In your initial consultation, Dr. Mabourakh will evaluate your face – the skin, the muscles and the underlying bone – and discuss your goals for the surgery. Dr. Mabourakh will help you select a treatment option based on your goals and concerns, your anatomy and your lifestyle.

Where Your Treatment Will Be Performed

Injectables are usually administered in Dr. Mabourakh’s office-based facility in Sacramento, CA. If, however, you are on the schedule for a facelift, necklift, browlift, or any other procedure, your injections may be combined with your surgical procedure as well.

Types Of Anesthesia

Dermal Fillers: Because the anesthetic agent lidocaine is sometimes mixed in with the filler, additional anesthetic is usually not used. However, if you are especially sensitive to pain, Dr. Mabourakh may use a topical cream anesthetic or a spray to numb the injected area. Or, you may elect to have an injected local anesthetic or sedative drugs.

Fat: Both the donor and recipient sites are numbed with local anesthesia. Sedation can be used as well. If you elect to use sedation, be sure to arrange for a ride home after your treatment.

Dr. Mabourakh can help you determine how long you can go between treatments to best maintain your results

The Treatments


Collagen is a naturally occurring protein that provides support to various parts of the human body: the skin, the joints, the bones and the ligaments. Injectable collagen, patented by the Collagen Corporation under the trade names Zyderm and Zyplast, is derived from purified bovine collagen. The purification process creates a product similar to human collagen. Injectable collagen received approval from the Food and Drug Administration in 1981. It is produced in various thicknesses to meet individual patient needs.

Collagen is used primarily to fill wrinkles, lines and scars on the face and sometimes the neck, back and chest.

The procedure: Treatment with collagen can begin after a skin test determines that you’re not allergic to the substance. The collagen is injected using a fine needle inserted at several points along the edge of the treatment site. If a local anesthesia has not been used, you may feel some minor stinging or burning as the injections are administered.

Since part of the substance is salt water that will be absorbed by the body within a few days, Dr. Mabourakh will slightly overfill the area. You may be asked to hold a hand mirror during the procedure to help him decide when you’ve had enough.

After treatment: Immediately following treatment, you may notice some minor discomfort, stinging or throbbing in the injected area. Occasionally some bruising or swelling will occur, but it is usually minor. Any redness that appears in the injected site usually disappears within 24 hours. However, in some individuals, particularly fair-skinned patients, this redness may persist for a week or more. Tiny scabs may also form over the needle-stick areas; these generally heal quickly.

No bandaging is needed and you are free to eat, drink, and wear makeup with sunblock protection shortly thereafter. There may be some temporary swelling and redness in the treated area which should dissipate within a few days. If these symptoms persist, contact Dr. Mabourakh.

Results: As stated earlier, the duration of results from collagen injections is variable. Collagen’s longevity depends on the patient’s lifestyle and physical characteristics as well as the part of the body treated. In general, the injected material is likely to disappear faster in areas that are more affected by muscle movement.

Dr. Mabourakh can help you determine how long you can go between treatments to best maintain your results.