Why do we use Dermal Fillers?

 

Throughout the ageing process we lose some of the skin’s ‘building blocks’ such as collagen and fat, which are the materials that prevent skin from becoming loose and saggy. The facial bones and fat pads begin to shrink, accelerating the creation of folds and deep wrinkles. Dermal filler acts as a replacement for the facial volume loss and helps to restore the skin to its former youthful appearance. Fillers improve not just volume loss, but aid

facial symmetry, improve overall skin quality and to rebalance/harmonise the facial features. Filler material is carefully injected into different layers of the skin depending on patient presentation and desires. Dermal fillers are available in different thicknesses and viscosity that match to desired treatment areas. The thicker products are generally reserved for deep folds, volume loss or wrinkles, whilst smoother products are used to plump out fine lines and wrinkles.

 

What are fillers made of?

 

We only use Hyaluronic Acid based dermal fillers. The reason behind this is due to the lessened allergenic profile, the reversibility factor & the benefits to skin health. Hyaluronic acid is a skin health essential with an array of attributes beneficial to non-surgical facial rejuvenation.

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Hyaluronic Acid (HA)

 

Hyaluronic acid is found naturally throughout the body, with the highest concentrations in the connective tissue, joints, eyes, and skin. With age, the concentration of Hyaluronic acid present in the skin’s tissue decreases.

Natural HA has a short half-life, lasting no longer than 24-48 hours within the skin. For this reason, HA molecules in dermal filler undergo a process called crosslinking which ensures longevity in the face. Hyaluronic acid attracts water, which allows the skin to become hydrated and plump. Injectable HA creates structure, framework, and volume to the face. The effects of injectable hyaluronic acid are seen immediately.

 

What Products do you use?

 

We only work with premium brands, including Teoxane, Belotero, Juvéderm & Restylane. FDA approval and extensive research behind the products utilised is essential for us as clinicians. The products we use will vary for

each patient and facial location, all of which is discussed during consultation. Filler is not only specific to the brand, and each range comes with an array of products with varied characteristics. For example, the filler utilised in the cheeks is designed to mimic bone and is a firmer product with a high g-prime to withstand resistance. Lip filler however, is a softer and less firm product to allow natural lip movement and subtle outcomes. The product selected for your face will always be discussed during a consultation.

 

Do you use a needle or a cannula for fillers?

 

A cannula is a blunt tip instrument and is inserted by one small entry point made by a needle. A cannula is generally significantly longer than a needle, and more flexible. It's length and flexibility mean that a cannula allows for smoother, continuous delivery of filler, in larger areas such as the cheeks & jawline. A needle is a short sharp tool that provides direct entry into the desired area, provides improved precision and definition for filler placement.

Both tools have their own pro’s & con’s, a needle allows for improved precision but a cannula is better for filling wider areas. Bruising is more common with a needle & there is seemingly less inflammation with a cannula. In terms of safety, vascular injury is possible with both needle or cannula and one tool is not safer than the other. We are experienced in using both needle and cannula, and tend to utilise needles for lip & nose augmentations, with cannula for every other region of the face.

 

Are fillers painful?

 

The dermal fillers we use contain lidocaine which is a local anaesthetic. The use of lidocaine with the facial filler injection eases the temporary discomfort and pain some patients feel when they receive facial filler injections. We also apply a topical numbing agent prior to injection to ensure optimal comfort for all patients.

 

Who isn't the right candidate for fillers?

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HA is not recommended for patients who have:

 - Active facial or oral herpes infection

- Infection/active acne in the treatment area

- Current systemic infection

- Undergoing dental work

- Uncontrolled diabetes

- Blood-clotting problems

- Allergy to any components of injectable hyaluronic acid

- Patients whom are pregnant or breast-feeding

 

HA should be used with caution in patients who have:

- Current immunosuppressive therapy

 

How long do dermal fillers last?

 

Typically, most fillers last around 12 months, however recent studies have shown HA fillers lasting over 10 years. Product selection, amount used, patient factors all contribute to longevity factors and each treatment result will vary.

 

What are the risks of dermal fillers?

 

Whilst injection complication is incredibly rare, it is essential that you are aware of the possible risks and side effects of treatments so that you can properly consent to treatment. This is also why it is imperative that you use a medical professional for treatment so that should any adverse event occur, your provider is able to assess, diagnose and treat as required. Full information on all formalities is always discussed at your consultation.

 

Bruising – Probable

Swelling/Inflammation - Probable

Infection – Unlikely

Delayed onset inflammation/granuloma - Unlikely

Herpetic outbreak – Patient dependant (always disclose your cold sore 

history at consultation so that measures can be put in place to prevent herpetic outbreak)

Allergic Reaction/Anaphylaxis – Incredibly Rare

Vascular Occlusion (blocked artery/vein) – Rare

Necrosis – Incredibly Rare

Blindness – Extremely Rare

What areas can be treated?

 

Lips - Lip filler delivers immediate results with long-lasting effects. We tailor the treatment according to each patients’ personal requirements and pride ourselves on offering natural results with the highest quality HA based and approved products. Lip augmentation using fillers can provide:

- Volume

- Definition

- Improved Shape

- Hydration

- Symmetry

- Balance

- Rejuvenation

- Cleft palate/scarring reconstruction

 

Cheeks - Signs of facial ageing begin with volume loss and fat pad descent in the mid face, namely the cheek area. This leads to formation of other lines and jowling lower down in the face. In order to rejuvenate the face overall, midfacial volume replacement, structure creation as well as natural contour is a must. Equally in younger patients with no loss of volume, a similar approach can be used to add a degree of visible contour and shape in the cheek/ midface, further enhancing facial proportions/ ratios.

 

Smile Lines - The nasolabial fold, or smile lines, are the deep wrinkles or lines that run from either side of your nose downwards towards the corner of your mouth. They are extremely common, and you should feel reassured

that most people have them. The aim is never to remove the nasolabial fold, but to soften it. A series of small injections of hyaluronic acid dermal fillers are administered around the nasolabial folds to help reduce those

first signs of ageing. The injections are made just under the skin during a simple procedure that offers great results with limited downtime.

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Chin – Chin augmentation is popular amongst those with a weak, short or retracted chin. Augmenting the chin in the right candidate can add drastic improvements to overall facial harmony, and is a fantastic alternative to

surgical intervention. Female patients benefit from an enhanced chin to create a more feminine look with a heart-shaped face. Men can benefit from chin filler to give the appearance of a stronger more masculine chin. Both men & women undergo chin augmentation to reduce the appearance of a chin dimple, mental crease or improved definition to the lower face.

 

Jaw - Jawline filler is suitable for those wanting to improve the definition & prominence of their jawline. For both males and females, a more defined jaw is a desirable trait thought to improve a person’s overall attractiveness,

it can also help to balance other facial features, such as a weaker chin or side profile. The jawline augmentation is popular amongst those wishing to soften the appearance of jowls, or a weakened jawline secondary to ageing.

 

Earlobes –Fillers can rejuvenate an earlobe with volume loss & laxity secondary to the use of heavier earrings. This specialised treatment involves injecting filler directly into the lobe to volumize and reshape it, allowing jewellery to sit properly.

 

Non-surgical rhinoplasty - The non-surgical nose job is an incredible procedure which greatly differs from the surgical rhinoplasty due to the lessened invasiveness and downtime. By injecting hyaluronic acid (HA) based dermal fillers along the bridge of the nose we can reshape the nasal profile and mask the appearance of bumps, a drooping nasal tip, and asymmetry. Results last around 12 months and retain for longer with each additional treatment.

 

Tear trough - The tear trough is the area between your lower eyelid and cheek junction, and with ageing or genetics we can experience volume loss in this region causing a deep under eye hollowing & shadow. Fillers are

placed carefully using a cannula to restore volume and reduce the appearance of tired sunken eyes alongside fine lines and wrinkles. This treatment is carried out using a dermal filler that contains not only hyaluronic acid, but a cocktail of 14 essential nutrients naturally present in the skin (8 amino acids + 3 antioxidants + 2 minerals + 1 vitamin) to reduce the appearance of darkened under-eye circles.

 

Temples - As part of the ageing process, we all start to develop a degree of hollowing in our temples. This is due to muscle use in this area wearing down the bony tissue in this area leading to an older, more gaunt and bottom heavy appearance. As the temple area hollows the brow can also start to drop and become less shaped. This can become more apparent after we have treatments to fill and lift the mid or lower face from the cheeks or jowls for example. This corrective treatment allows us to fill this area and add youthful volume and structure back to the upper face and help balance out facial proportions and profile imbalances.

 

The Procedure

 

Your dermal filler treatment will firstly include an in-depth consultation with your Nurse Prescriber, who will assess your face and devise a treatment plan. A full comprehensive medical history will be taken, alongside any information regarding previous aesthetic treatments you have had. Your expectations and desires will be discussed alongside treatment suitability. The procedure itself takes around 45 minutes, and involves skin disinfection, marking up &  numbing. A topical numbing agent is applied 10- 15 minutes before injection to provide maximum comfort throughout the procedure. Full aftercare is given alongside an icepack to assist with any swelling or bruising.