Dermal Fillers By Dr. Maas in San Francisco

Bruising is the most common side effect, which happens anytime a needle passes even the smallest blood vessel. Dr. Maas will provide instructions to avoid using non-steroidal anti-inflammatories like Advil and Aspirin to prevent significant bruising. The use of ice before injection will also help constrict the small blood vessels. The puffy or 'blown-up' look that some patients see after fillers is often just a result of poor technique. When applied with skill and care, patients should achieve a natural restoration of facial contours rather than a pulled or overly tight result. Infections or granulomas are exceedingly rare and often the case of poor injection techniques. You must visit a licensed expert practitioner when seeking treatments with these products.

Dr. Maas prefers hyaluronic acid-based fillers for lip augmentation because they are reversible and adjustable and provide soft and natural results when used correctly.

To answer this question accurately, Dr. Maas will first examine your lips and their condition, learn more about your expectations, and most importantly, what you want. For some patients, it is filling the little lines that develop around the lips. For other patients, it might be addressing the marionette lines that form around the corners of the mouth. Or, it might be that you're after fuller lips. Dr. Maas will then be able to lay out a menu of options to address your concerns based on your budget for you to decide on. The different fillers all have comparable costs, but remember that you are also paying for the skill and experience of the injector as well.

While we can use fillers to enhance the philtral ridges, or the portions of the lip that make up the Cupid's Bow, there's no specific way to create a Cupid's Bow in isolation with fillers alone. A lip lift is a surgical procedure that can help. Dr. Maas will usually not make the incision along the lip border but rather hide them inside the nostril, right along the border of the nostril rim and the columella (the skin between the nostrils). Because no one lip type or shape makes the lip attractive, Dr. Maas believes it's most important to address the relative proportions of the lip and will take the time to educate each patient about their options.

Dr. Maas's patients rarely see more than pinpoint bruising that wears off quickly, so if you're seeing significant swelling, asymmetry, and hard lumps in your lips post-filler, it is essential to get it treated. The beauty of the Hyaluronic Acid formulations in fillers like Restylane, Juvederm, Perlane, and Belotero is that they are entirely reversible with a bit of injection of an enzyme for patients with over-treated lips. Symmetry and balance are fundamental concepts in lip enhancement and the keystone of a natural result. Dr. Maas can help patients fix their look by selecting the right materials and injecting them with proper techniques.

The answer depends entirely on the results you're after. Different filler formulations have different textures, stiffness, and levels of water-loving hyaluronic acid molecules, which affects your look. However, the techniques are more important than the chosen product. Lip augmentation is an art, and whatever your desired look, Dr. Maas can accurately place the suitable filler to sculpt a naturally beautiful result.

For people with small to moderately sized lips, Dr. Maas will typically use 0.5 ml to 1 ml of fillers to enhance the vermillion border of the lips. Up to 1.5 ml of filler can be used for those with larger lips. Because getting a beautiful and natural-looking result is essential to Dr. Maas, he believes in building volume rather than overdoing extreme amounts of filler.

Fine lines occur in the dermis (the second layer of the skin) and create little 'H' lines best exemplified by the ones we see around the lips, at the corners of the eyes, and in the forehead area between the brows. In the upper face, fine lines are best treated with neuromodulators like BOTOX, Dysport, or Xeomin; by relaxing the overactive musculature that pushes the skin into these lines when we squint, frown, or raise our brows, it addresses the root of the problem. Fillers are best used around the lips where relaxing the muscles would affect speech and your ability to sip from a straw and to further correct lines so deep that no amount of muscle relaxing will smooth them out. As a leader in this field, Dr. Maas has performed extensive comparative studies and largely uses Belotero or Restylane Silk to address fine lines due to their thinner and more malleable formulations. The ultimate treatment for fine lines overall involves skin resurfacing. While dermabrasion was popular in the 80s and 90s, deep chemical peels and laser skin resurfacing are the preferred methods of selectively injuring the skin surface to stimulate collagen production. The wound-healing process produces a more youthful skin architecture, smoothing out fine lines as the underlying foundation is reformed with new cells. While up to a week of downtime may be necessary depending on the method of skin resurfacing used, the improvement to the skin can last for a very long time. At The Maas Clinic™, we offer many modalities for treating fine lines, and the best way to determine what will work for you is to schedule a consultation with Dr. Maas today.

Like the smile lines that form between the corner of the nose and mouth, in areas where the soft tissues are pulled downward by gravity, they will invariably hit a platform where the skin is closely attached to the underlying muscle. As tissue builds up, steep curvatures appear as wrinkles. A surgical lift can be beneficial in the long term to soften the transition between the cheek and the lip, under the eyes, or around the lip and the chin. Non-surgical alternatives include suture lifts like the Silhouette Insta-Lift or facial fillers. Dr. Maas is at the forefront of the best filler techniques and formulations and provides a wide range of patient options depending on their aesthetic goals and needs. From stimulatory fillers like Radiesse and Sculptra to Hyaluronic Acid fillers like the Belotero, Juvederm, and Restylane family, he will help you find the right product to rejuvenate your facial features naturally.

Some patients have asked us about mixing different neuromodulators to take advantage of their subtle differences in hopes of achieving better results. With no controlled trials looking at mixing these products, Dr. Maas generally advises against doing so. Theoretically, it could lead to the body more quickly producing antibodies that recognize the ingredients of these injectables as foreign invaders, preventing you from getting the results you want. Instead, he will work with you to pick and choose the right injectable for your needs.

Before you come in for your consultation, Dr. Maas would like to see photographs of your face and some of your younger self and get to know more about your concerns. These photographs are to Dr. Maas what an EKG is to a cardiologist – a baseline to measure success again. During your consultation, he will take the time to assess your features and discuss your aesthetic goals. For your comfort, we will apply a specially compounded topical numbing cream to reduce the sting of the injection needle. It reaches peak effectiveness after 30 minutes, so we kindly request you schedule sufficient time for your appointment. The cream will be removed before the injection, and you can reapply any makeup afterward. Please avoid non-steroidal anti-inflammatories like Ibuprofen, Advil, and Aspirin, as they increase your chances of bruising and swelling. Patients having fillers with immediate results performed will be photographed after their session, and for patients getting neuromodulator injections two weeks after your procedure, Dr. Maas would like to see you again for a quick check and to get images of your face in various expressions including smiling, squinting, and raising your brows. This step will help him measure your outcomes and ensure you get the best possible results he can achieve. At The Maas Clinic™, we want you to have a good experience and the perfect outcome, as Dr. Maas considers it a great honor that you've trusted us with your care and appearance. If things aren't perfect, let us know immediately, and we will do all we can to ensure you are happy with your results.