Why don’t I inject Bellafill? Patients want to know!

If you know me you know that i only use products I believe in! Bellafill”s main components are collagen and PMMA microspheres. What is PMMA? Polymethylmethacrylate is PMMA also known as PLEXIGLASS! Yes, Plexiglass the very product that protects you from being hit in the head with a puck at a hockey game! A common side effect of Bellafill is granuloma. It is definitely contraindicated for use in the lips. The product Bellafill was previously on the market with the name Artifill and went out of business for what I see as obvious reasons. 

Enough said?

Why are injecting fillers into tear troughs not a great idea?

First of all the nasolacrimal is an area of drainage. Oftentimes we have extra fluid accumulation or puffiness around the lower eye area. This puffiness can be brought on by allergies, environment, alcohol too much sleep, not enough sleep, crying, diet, salt and on and on! We have so many factors in out life that can contribute to fluid accumulation around the lower eyelid area. 

Now let's look at the fillers…
Hyaluronic acid fillers: Juvederm, Restylane, Belotero  Hyaluronic acid is a large molecule that attracts water!!! In an area where we already have drainage issues! More often than not patients get their tear troughs injected only to live a life of increased festoons or bags which require surgical intervention to get rid of!
1 Reason not to do this is - if a tiny blood vessel that profussess the eye becomes occluded it would be extremely difficult to dissolve product before blindness occurs!

Other fillers...Radiesse, Bellafill *Not reversible.* Can cause granuloma. *can turn out bumpy
#1 Reason not to do this is - if a tiny blood vessel that profussess the eye becomes occluded it can cause blindness and again NO reversal!

Autologous Fat grafts… sounds great your body would certainly accept itself! Maybe not! The fat is spun down in a centrifuge with some chemicals added depending on each doctor's recipe. Then the dense fat is injected into the area.The fat may occlude the vessel causing blindness. This fat is not tested and tested like FDA approved fillers so we don't know how long it will last or how exactly it will behave (duration, symmetry etc)

Sculptra: PLLA is actually ground up suture material and may occlude vessel causing blindness. May grow uneven or may not grow at all. The ground up suture material is intended to irritate the tissue into promoting collagen growth. I firmly believe chronic irritation is bad for my body and at age 60 I question how much collagen I have to stimulate.

Summary: I do not think injecting Tear Troughs is a good idea on the best of days! The best solution for eye area issues is usually surgery with a Board Certified Plastic Surgeon who performs this surgery with great results. My choice is Mark Vincent Sofonio in Rancho Mirage California 760-341-5555

What is “Fine Line and Crack Filling”? Art meets Filling

What is “Fine Line and Crack Filling”?

Choose an experienced injector who is an artist!

“Fine Line and Crack Filling” is Nurse Shirley's way of referring to facial rhytides or fine facial lines. “Fine Line and Crack Filling” according to Nurse Shirley is where injections and art truly intersect! Nurse Shirley also calls this procedure “needlepoint of the skin”. When it comes to fine line and crack filling the injector must not be in a hurry and must pay attention to minute details!  When done properly (if the patient is not on blood thinners and has a normal clotting time) there is very little chance of deep bruising as the only vessels the injector comes in contact with are tiny capillaries. The injector doing this procedure needs to be very experienced, and know where the bevel of the needle is at all times. As a matter of fact this injection is so superficial that sometimes a small squirt of filler may escape a skin pore like a fine mist.

This is a great procedure for people who don’t want the downtime of deep lasers or chemical peels. Even after lasers and deep peels some fine lines usually remain which may be mitigated with this procedure.

Depending on the condition of the skin, and other factors considered during consultation some patients may benefit with a combination of C02 laser with a finishing touch of “Fine Line and Crack Filling”. Often the first treatment may be combined with botox depending on the location of the affected area on the face.

For Patients who absolutely do not want the downtime of deep laser procedures then injections maybe the answer for them.
Nurse Shirley explains that even though this is technically a filler, the patient should think of it as a treatment, because treatments results improve over time. Explanation: Each time the needle goes into the fine line or crackle it breaks the collagen fibrinogen matrix, and causes it to grow back with a tighter weave. The injections deposit  a small amount of low cross linked hyaluronic acid filler that moisturizes the skin and brings nutrients to the previously dry “crackeld” area.
As a treatment the small amount of filler injected into facial lines improves the appearance more and more with each application. Depending on the condition of the patients lines Nurse Shirley encourages the patient to make a commitment to themselves to repeat this treatment 2-4 times the first year, and then not as often the next year (just as necessary). A usual “Fine Line and Crack Filling” treatment involves injection of 1 to 2 syringes.

After (2 treatments)

Voluma XC ®

Nurse Shirley only uses the best products on the market and always keeps her clients up to date on what is available. 

Since its initial release in early 2014, Juvederm Voluma XC®  has been a revolutionary product that leaves her clients extremely pleased with the results and keeps them coming back. It’s not only the results that have her clients jumping for joy, it’s how long the application lasts. The application lasts up to two years, that is up to twice as long compared to any other hyaluronic acid fillers. Juvederm Voluma XC®  is the first FDA approved injectable gel that will instantly improve volume in the cheek area and will correct age-related volume loss in adults over the age of 21. 

The gel is a Hyaluronic Acid (HA) that contains lidocaine to help make its application as comfortable as possible. According to Allergan, “subjects rated themselves as looking an average of 5 years younger 6 months after their last treatment.” Secondly, Allergan reported that “more than 75% of subjects expressed an improvement in their overall satisfaction with their facial appearance at 2 years after their last treatment.” 

So how does Juvederm Voluma XC®  work you may ask? Hyaluronic acid is a naturally occurring substance in our bodies and it is a major component in our skin. Juvederm Voluma XC®  is injected into the dermal layers of the skin in order to fill lines, wrinkles, folds, and lips. This is an excellent product, however, results will only be as good a the person injecting them. Nurse Shirley is an experienced practitioner of aesthetic medicine and has participated as a demonstrator of proper technique for Allergan Corporation’s Master’s training course.


Allergan INC. "ABOUT JUVÉDERM VOLUMATM XC® ." Allergan, INC., Oct. 2013. Web. Mar. 2016.

Hands don't need to give away your age!

Do your hands give away your real age?

Do your hands make you look older than you are? Nurse Shirley can help you look more youthful by rejuvenation of your hands. This is a quick and easy procedure. 

Book your appointment for a consultation with 
Nurse Shirley today! 760-341-5555