10 Things to Know About Dermal Fillers

dermal fillers

Dermal fillers are one of the most popular non-surgical cosmetic treatments available, used to restore volume and decrease wrinkles. More than 3 million hyaluronic fillers were performed in in 2016 according to the ISAPS global survey*.

The popularity of dermal fillers stems from the increase in beauty consciousness, growing awareness of dermal fillers, increasing demand for non-surgical and minimally invasive cosmetic surgeries.

If you are considering dermal fillers – here are 10 things to know.

1 DERMAL FILLER BASICS

Dermal fillers are made from hyaluronic acid, which is a type of sugar (polysaccharide) naturally found in the skin and cartilage.

Hyaluronic acid is hydrophilic gel, which means it is able to combine with water and swell. This causes the smoothing and filling effect in the skin when injected.

Dermal fillers are often confused with Botox. While they are both injectables used for non-surgical anti-aging effects, dermal fillers are not the same as Botox. Botox is a neurotoxin which is used to immobilize over-active muscles of facial expression to reduce the appearance of unwanted facial wrinkles. Fillers as the name suggest – ‘fill’, to restore volume

and fill wrinkles.

2 THERE ARE DIFFERENT TYPES OF DERMAL FILLERS

The most popular dermal fillers used worldwide are made of hyaluronic acid. Restylane® and Juvéderm® are examples of commonly used dermal fillers made from Hyaluronic acid.

Different hyaluronic acid (HA) fillers have varying physical characteristics such as particle sizes and cross-linking, which will deliver different results. Fillers with larger particle sizes have the ability to restore volume in areas that have deflated in the aging process, such as the mid face and cheek area. Products with smaller particle sizes are better for correcting fine lines and plumping lips and disguising dark furrows beneath the eyes.

Other fillers include collagen, calcium hydroxylapatite and poly-L-lactic acid. These alternative fillers are used only in special instances.

Your plastic surgeon will explain all the details of the different products and the results you can expect with your filler treatment.

3 THE EFFECT OF DERMAL FILLERS CAN LAST FOR MONTHS

The rejuvenating results of fillers usually lasts for nine months and up to two years, depending on the location and type of the filler injection. This is because hyaluronic acid fillers are not permanent and are broken down by the body.

If you like the way you look after treatment you may want to have repeat treatments to maintain the improvement when you start to see the effects of the fillers fading.

4 EFFECTS OF HYALURONIC ACID FILLERS ARE REVERSIBLE

If you are not completely satisfied with the results of your filler treatment you can have it adjusted. The beauty of hyaluronic acid filler is that it can be dissolved using a specialized enzyme called Hyaluronidase. If more volume is needed, additional filler can be used for balance.

Interestingly, the hyaluronic acid continues to bind with water in the skin in the 24 hours or so after injection, maximixing the effect. And recent research suggests that HA fillers may stimulate the body to produce its own collagen.

Usually the full effect of your filler treatment is seen by two weeks, by which time you can properly judge the effect and your satisfaction with the treatment.

5 DERMAL FILLERS CAN BE USED IN THE FACE AND ALSO THE HANDS

Volume loss occurs in all anatomical ‘levels’ in the face with aging. The facial bones atrophy (shrink), the fat pads sag under the influence of gravity and the skin looses its elasticity and hydration. Fillers work by replacing this lost volume to lift and fill deflated areas and decrease wrinkles.

Dermal fillers are FDA approved for use in correcting moderate to severe facial wrinkles and skin folds, for lip and cheek augmentation, and to restore or correct the signs of facial fat loss in people with human immunodeficiency virus (HIV).

The aging process is also evident in volume loss in the hands and dermal filler is also FDA approved to fill and rejuvenate the aging hand.

6 THERE IS AN ART TO IT

Filler treatment is an art. To get the the most natural result, (the duck-lipped look is not a sign of well done fillers) dermal fillers should not be obvious, they should subtly enhance your features restoring lost volume and filling wrinkles where needed, and should be performed by someone qualified, trained and experienced.

7 FILLERS SHOULD BE DONE BY A QUALIFIED TRAINED EXPERIENCE INJECTOR

Think about this: “would you trust someone who has done a weekend flying course to pilot the aeroplane you board for your next holiday destination?” Then why would you trust someone with just a weekend fillers course with your face?

Do your homework. Check the credentials and be sure of your ‘injectors’ qualifications, training and experience. Ask to see before and after pictures of patients with similar concerns to yours, consider reviews and word-of-mouth references as part of your decision.

Plastic surgeons are trained in the detailed anatomy of the face and the anatomical changes that take place in the aging face. Your plastic surgeon can properly analyze and treat facial aging using both surgical and non-surgical modalities, without being restricted to one-solution-fits-all approach.

8 DERMAL FILLERS HAVE POTENTIAL RISKS

Dermal fillers do have potential risks. These include infection, skin discoloration and lumps or granulomas.

More serious side effects are rare but they can happen. Scarring, blurred vision, partial vision loss, and blindness can occur if the dermal filler is inadvertently injected into a blood vessel.

Your plastic surgeon will explain the pros and cons of your planned treatment with you.

9 SOMETIMES DERMAL FILLERS SHOULD BE POSTPONED

There are reasons to postpone having fillers:

if you are pregnant or breastfeeding,

if you are under 21

have a bleeding disorder or are using aspirin, non-steroidal anti-inflamatories or blood thinners (natural or prescription)

if you have a history of excessive scarring or pigmentation

have an infection (a sinus or tooth infection or skin break-out in the facial area).

Dermal fillers are not necessarily the right solution to a particular problem, and your plastic surgeon can advise you on the correct procedure. For example if you are considering body contouring, injectable fillers are not the answer. Surgical alternatives such as silicone implants or lipo-filling (fat grafting) or liposuction are better suited to body, breast or buttock contouring. Fillers are not safe for body contouring.

10 THE DERMAL FILLERS PROCEDURE EXPLAINED

Your plastic surgeon will have analyze your features and take medical photographs of the area to be treated.. Then he/she will strategically mark the areas for treatment. Your skin will be cleaned of any make-up or products.

Although most dermal fillers contain local anesthetic to reduce discomfort of the injection, your plastic surgeon may use a topical anesthetic or and injectable anesthetic to numb the face to ensure the procedure is painless.

An ultra fine needle or thin blunt canula is used to place the filler in the exact anatomical position to achieve the desired volume filling or smoothing effect. Each injection only takes a few moments per site. Occasionally massage of the deposited products is done to distribute it uniformly in the area.

There is usually some swelling and sometimes bruising, redness or sensitivity after treatment. You can continue with your daily routine albeit behind shades to hide the swelling and redness. But you should avoid strenuous exercise, too much sun or heat, and alcohol for 24h after treatment. Dermal filler treatment usually takes 30-45 minutes.

Resources

*ISAPS 2016 survey https://www.isaps.org/medical-professionals/isaps-global-statistics/

https://www.plasticsurgery.org/patient-safety/do-your-homework

https://www.juvederm.com/cheek-fillers

https://www.restylaneusa.com

https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049349.htm

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