Dermal Fillers

Dermal fillers allow the rejuvenation and filling of your face or lips to provide a new and youthful appearance. It involves the use of a natural filler, which is injected through an ultrafine needle to strategically plump up or re-contour your face, lips or eyelids.

It can also be used to camouflage any wrinkles or indentations in or around your eyes or forehead, and can be used to blend the junction between your lower eyelid and your cheek, or between your cheek and your upper lip. It can also be used to camouflage the lower cheek jowls or to redefine the angle of your jaw and mandible.

The treatment involves the strategic and careful injection of the natural sugar gel into the soft tissue. In the past this soft tissue augmentation was only really possible with collagen, which had a number of side-effects, and was particularly associated with excessive swelling and redness after the procedure.

The newer techniques use hyaluronic acid which is a natural sugar and works to attract the bodies natural water into the soft tissue. As it is very similar to the natural sugars in the body, there is minimal swelling and redness. In addition, the newer fillers also contain local anaesthetic in the injecting medium so the injection is extremely well tolerated with virtually no pain.

   

 

How is filler/soft tissue enhancement performed?

Soft tissue filler is performed with the same injection techniques and products as lip enhancement. The hyaluronic acid we use to treat the wrinkles is exactly the same as that used in lip fillers, but the consistency of the filler comes in a variety of different thicknesses, which are used in different parts of the face.

For example, a very fine and thin filler is used to treat the fine wrinkles and the very thin skin in and around the eyelids, whereas, in the cheeks where we are seeking to redefine and restructure the upper cheek or malar, we use a thicker product, particularly to give the cheek more support. It is critically important therefore that the technician or the person you are seeing to have your filler performed, is able to utilise and has access to all of the different types of filler so that you are able to achieve optimal results.

   

 

What are the benefits of dermal fillers?

Dermal fillers are able to enhance and re-volumise those areas of your face which deflate as we age. The most common areas that are targeted for dermal fillers are the upper cheek or malar mound, the junction between your lower eyelid and cheek, the area between your cheek and upper lip, the fine lines around your upper lip, or the area of the jowl and the lower neck where the soft tissue often drops and sags.

Dermal fillers in this area can re-suspend and re-support the soft tissue and can be used to camouflage any wrinkles, sagging and irregularities between different areas of the face. In general this allows you to look refreshed and more youthful with a less tired and saggy appearance.

   

 

What are the risks?

We use extremely low-risk biocompatible dermal fillers. Whilst these are extremely safe, and even though your dermal filler is performed by a fully trained plastic surgical nurse or by Professor Ashton himself, there are minor side effects of which you need to be aware.

Redness, itching and some swelling at the injection site is not uncommon, and usually persists for an hour or two after surgery. In rare situations this can be more pronounced and may persist for up to 24 hours. We would therefore recommend that after having the procedure done you plan a quiet night at home. Bruising is extremely uncommon, but can occur following this procedure. If there is any bruising, it is normally most prominent at four days after the procedure and is usually gone by day 10.

The most common side effect we see following dermal fillers is when they are performed by an improperly trained or a non-skilled technician, and there is an uneven or asymmetrical result. Occasionally we may also see an overdone look in which there is disproportion between the upper and lower parts of the face, or an unevenness between different areas of the injection.

Additionally, if the material is injected too superficially, there may be a palpable lump or thread of material which can be felt or even seen, particularly with flash photography. If the soft tissue filler is performed by an untrained physician or a practitioner who is not aware of the arterial anatomy of the upper lip, it is possible to inject filler directly into the artery supply of the upper face and this can lead to serious complications.

   

 

How many dermal filler treatments will I need?

We find that the dermal fillers used in soft tissue augmentation last between 12 and 18 months depending on the consistency of the filler used. Thinner fillers tend to last a little less than a year whilst the thicker fillers that were used in cheek augmentation or remodelling tend to last a little longer, and often up to 18 months. It is most important to remember, however, that not all of the filler will be absorbed at the end of this 12 or 18 month period. Hence it is crucial that a smaller amount of filler is required to achieve exactly the same result on a second or third visit.

If the same amount of filler is used year after year there is a creeping effect of progressively increasing amount of filler, which will lead to an overdone and non aesthetic look. Indeed, this is the reason behind many of the horror photos that you see in magazines advertising Hollywood actors who have overdone their dermal fillers.

   

 

Is it painful?

Whilst there are many nerve endings in and around the face, the fact that the newer products contain local anaesthetic means the procedure is particularly well tolerated.

If you are worried or concerned about pain, it is possible to simply block the nerves supplying the region of the face to be injected with a very small amount of local anaesthetic. With local anaesthetic and with the regional block, most peoples pain is reduced to 1/10.

   

 

What should I expect after treatment?

Initially the area will be slightly swollen and will be red as a reaction to the injection. You will not see the new shape of your face or the area immediately, it will take about a week for the area of your face to settle into its new shape. Importantly you may have more swelling in the first 24 hours after the injection.

It is important to realise this is not the long-term or final result of your Dermal Filler. It is important to take things gently and quietly in the first 24 – 48 hours after your treatment, and that you avoid heavy physical exercise or warm environments which increase the amount of blood flow to the head and neck area, and hence increase the risk of bruising and swelling.

   

 

What about if I do not like my dermal filler and I think the results do not suit my face?

The most important thing to realise about the newer soft tissue fillers is that they are completely reversible. In the unlikely event that you feel the procedure is not for you or if you feel the result is overdone, the product can be completely removed in a relatively straightforward and simple way here in our rooms.

   

 

What can I do to optimise my dermal filler and get the best result?

Everyone has different images of their ideal facial appearance. Some people prefer quite a full and angular face, others are seeking a more natural look. Often we find that photographs are a very good way for you to crystallise and communicate your ideal facial appearance so that we can give you the result you are seeking.

We would therefore recommend that ahead of your consultation you find photographs which closely resemble the look you are seeking and that you bring the actual image along so that we can discuss the result you are seeking and whether it is possible. It is also important that you allow time for you to recover and recuperate.

Squeezing a dermal filler into a busy and hectic schedule is less than idea, and we find that patients get the best results when they allow time to rest and recover after this relatively straightforward and predictable procedure.

If you do have any questions, please do not hesitate to contact us on 9344 5050.