Expression

Cosmetic dermal fillers add volume and help fill, smooth, and minimize lines and wrinkles on the face, as well as fill the lips. A great deal of artistry, skill, and attention to detail are required when working with the subtleties of dermal fillers like Expression. In December 2012, Dr. Rueckl was asked by the makers of Expression to use their newer dermal filler (which has been in use since July 2012) on some of his existing patients, and see if it was something we'd like to add to our service line. The patients and Dr. Rueckl were so impressed with the results, Expression is now available at Lakes Dermatology.

Dr. Rueckl has always been the only injector of Expression at Lakes Dermatology. He has never delegated this responsibility to a Physician Assistant, Nurse, Medical Assistant, or anyone else. This fact is important to the integrity of his practice and to his patients' consistent care and his high patient return rate.

What is Expression and what does it do?

Created by Enhancement Medical, Expression is considered a third generation hyaluronic acid (HA) filler. It was created by some of the original creators of the injectable, Radiesse, which has been used as a dermal filler for many years. Like other HA fillers, Expression is a smooth gel made of hyaluronic acid—a naturally occurring substance in your body. Over recent years, hyaluronic acid, a complex sugar, has become a favored compound for replenishing the areas of the face and lips where the skin's volume and fullness have been lost due to age, sagginess, or other reasons. Dr. Rueckl injects Expression into the necessary areas of the skin to restore your skin's volume and smooth away facial wrinkles, lines, and folds, and add volume. Expression provides a smooth, natural look and feel to sites where it is injected and has been shown to last 6 months or more.

For more information on Expression, including all FDA information, please visit the Enhancement Medical website at www.enhancementmedical.com.

Where is Expression used?

Because of its specialized cross-linking and compound, Expression can be used for more shallow injections and finer lines, as well as into deeper folds, wrinkles, and the lips. It can also be used under the eyes or into the cheeks to add volume. Depending upon the site of injection and your specific volume loss, multiple syringes may be needed for full effects. If patients are truly unhappy with a hyaluronic acid filler like Expression, or if an error has been made with an injection, the filler itself can be destroyed with the injection of Vitrase/hyaluronidase.

Why is Expression different than other fillers?

Expression features the first HA to be produced with the pathogen free medium, Bacillus Subtilis. The manufacturing also uses a water-based process, free of organic solvents such as ethanol, and without the use of animal derived materials. Unlike some other HA fillers, Expression does not contain any suspended lidocaine in the syringe. Dr. Rueckl will still, as always, pre-numb with a block though. Another difference is that a syringe of Expression is 1.5ml – so 1½ the size of JUVÉDERM®, Restylane®, or Perlane® syringes, which means there is more to use. And finally, the scientific compound of this HA filler is different in that it doesn't draw water to itself upon injection. Other HA fillers draw water to themselves, so patients can be a bit more swollen post-injection. With less swelling, that means less downtime for you, and a better understanding of what the final result will look like right after the injection is complete.

Depending on your desires and the areas you want injected, Dr. Rueckl can help you decide if Expression is the right filler for your needs through a free consultation.

What is an Expression treatment like?

As with all filler injections, Expression is only injected by Dr. Rueckl. He will begin by discussing the treatment with you and have you sign a consent for the procedure. Dr. Rueckl will prep the site with a lidocaine with epinephrine block to further reduce any pain or discomfort during the procedure and have you wait about 10 minutes. By waiting this amount of time, the blood flow to that area is able to dissipate a bit, resulting in less bruising and swelling. After about 10 minutes, Dr. Rueckl will administer the Expression syringe and expertly and artistically inject the substance into the areas to be filled and re-volumized. Dr. Rueckl will apply ice packs to the injected areas and have you sit for a few minutes to apply pressure, thereby further minimizing swelling and bruising. The full procedure should take approximately 30-45 minutes. You will leave the office having minimal discomfort or other affects and be able to return to normal activities.

What kind of results can I expect from an Expression treatment?

You should see an immediate improvement in the treatment areas with minimal bruising or swelling. Sometimes bruising and swelling can be minimized by taking Arnica pills, using Arnica gel, or applying Arnica gel packs post procedure. Arnica is a natural medication that can be obtained from a local health foods store. It is not necessary to take it, but some people find it helpful, particularly if they are prone to bruising. Ice packs and avoidance of aspirin for a few days will help should you encounter either of these as well. Expression will help fill, smooth, and minimize the lines, wrinkles, and/or folds into which it is injected. For most patients, Expression will last 6 months or more, although in some cases and areas, the duration of the effect may be shorter or longer. Supplemental treatments may be required to achieve and maintain optimal results.

How much does Expression cost?

As with all fillers at Lakes Dermatology, Expression is charged by the syringe. One syringe of Expression is 1.5ml and costs $750.