Overview of filler treatments to, Fill, shape, contour...
What are dermal fillers and how do they work?
As the skin ages, from the age of 30, it gradually loses some of its collagen and fat. These are the materials that prevent the skin from becoming saggy. Thus, as we age, our skin can become thinner and more wrinkled and lined. Dermal fillers help to restore our skin to its former youthful appearance. Filler is injected into the skin in areas where it needs to be plumped up again and made to look firmer. Fillers come in different thicknesses, and in general, the thicker the product, the deeper it is injected into the skin to help plump out fine to deep lines and wrinkles. Ranging from thin injectable skin hydration all the way to sculpting and volumising thicker filler. We only use high end brands at AB Medical UK.
What skin problems can dermal fillers treat?
These products are also very effective in both men and women in helping to fill out lines around the lips, the lines from the nose to the corners of the mouth (nasolabial lines), smile lines on the cheeks, as well as crow’s feet and forehead wrinkles. Thicker fillers can also be used to add volume to sunken cheeks and weak chins, reshape the nose, improve the jawline, the teartrough area, hands and so forth,as well as filling out deeper acne or other scars. In addition, fillers can be used to help reduce the appearance of veins and bones in aged hands with thin skin. Usually, if you need to have fillers in the upper part of your face for movement lines associated with expression i.e., crow’s feet, forehead and general wrinkle lines, it is usually recommended that the fillers are only used after injections of Botox. Depending on the area treated, and the depth of wrinkles or scars or sagginess of the skin, we may recommend that different combinations of types of fillers are used in order to achieve the best results.
What happens during dermal fillers treatment?
A medical history will be taken to make sure that there are no reasons why you shouldn’t have the treatment. Then you will be asked to read detailed information and sign a consent form which means that you have understood what the treatment may do, along with any potential side effects from the filler(s) being used. Photographs may also be taken by the practitioner for a “before and after” comparison of the treatment. For treatment of lines and wrinkles, an anaesthetic cream is sometimes applied to the area 20 minutes or so prior to injection. This helps to numb the area to be treated and reduces pain when the needle is inserted into the skin. Before injections in the lips, a dental or lip block may be used, where a small amount of lidocaine (an anaesthetic like the ones used by dentists) is injected into the lip area to help to numb them prior to treatment. However, as dermal filler products have developed in recent years, we now find that many hyaluronic acid based gels are available with the addition of 0.3% lidocaine combined with the gel in the syringe. This provides an instant relief from pain upon injection and removes the need for a separate nerve block or topical anaesthesia. Different injection techniques are used depending on the type of filler and the area being treated. For filling, the two main techniques are: linear threading technique, where the full length of the needle is inserted into the middle of the wrinkle and the material is then injected while pulling the needle slowly backwards; serial puncture technique, where several injections are made in a line along the wrinkle or fold to lift the wrinkle; for plumping out the face, or filling larger areas such as hollow cheeks, either a fan technique or cross hatching technique is used.
Depending on the type of filler used, and the area treated, how much correction is required, you will need top up treatments to maintain the effect.
How long will it take to recover from a dermal fillers treatment?
Depending on the area treated, and which filler is used, treatment times can vary from around 30-45 minutes and recovery time can be from a few hours to a few days. However, most people find that they can return straight back to work after treatment with dermal fillers. Remember a needle or cannula will have been inserted into your skin which cause tissue trauma, even if you cannot see any -it has definitely occured and needs time to heal.
Will I Bruise or Swell?
It's likely! As the skin has billions of large, medium and micro vessels throughout the skin. While Andrea will do as much as is practically possible to avoid a bruise, but there are a number of things you can do too:
1. Be realistic-a needle will be puncturing the skin.
2. Avoid all alcohol-it thins the blood and increases the risk of bruising
3. Avoid heat inducing activities-they flush the face bringing more blood to the treated area increasing risk
4. Avoid touching injected area-you will prevent the clotting process increasing the bruising
6. Avoid substances that thin the blood-thin blood = more bruises (fish oils/vitamin E/aspirin/NSAIDS
7.Apply a cool compress-this will reduce blood supply and swelling
8. Take oral arnica tablets-take them prior to and after treatments to help
9. Eat pineapple-it has a chemical called bromelain which is thought to reduce bruising
10. Avoid having an injectable treatments around important social events.
11. Concealer may be applied carefully to reduce the visability of bruising.
12. If you are excessively worried about bruising then these treatments are not for you.
How Many Syringes Will I Need?
This depends very much on how damaged or aged your skin is from either lifestyle issues, genetics, smoking, menopause, tooth loss, sun exposure, weight loss, stress and obviously how old you are. This also depends on the area needing treatment, for example an aged lip may need 2ml for the lip and wrinkles above and around it but a youthful lip may only need 0.5ml. We generally look at each individual to see how your face has aged and where structure, volume, lift and tightening is required. You will have some improvement after only 1ml or you may need a number of syringes over a period of time to achieve the look you want. You will be advised whether you need a mix of different treatments too.
What are the risks and potential complications of dermal fillers treatment?
Depending on the area injected and the type of filler or pain control used, patients may find the procedure relatively painless to mildly uncomfortable. Treatments around the nose or lip areas are usually more painful. The obvious immediate side effect is of slight bleeding after the needle has been inserted into the skin. Other risks include mild bruising, tenderness, redness and swelling that may also occur around the site of injection. These signs may take 2 - 3 days to vanish completely, especially around the lips where there is little flesh and the skin is tender. If you have a history of cold sores, in the treated area, filler injections may cause them to break out again. In these cases, your practitioner may recommend that you take an anti-viral medicine before treatment to help reduce the likelihood of an outbreak of cold sores. There is the serious risk of vessel occlusion which is where through either product being inadvertently inserted into a vessel or too much product inserted that it compresses a vessel which stops the normal blood supply. This is an emergency and treatment is given immediately at the clinic. Other side effects include granuloma and nodules which is where the body due to inflammation "walls off" the substance creating a firm lump. There is also a condition called biofilm infection which can occur many months after the treatment. If you are concerned of any side effects you would book a consultation and return to the clinic for treatment.
What should you do after dermal filler treatment?
It is important that you follow the advice of your practitioner carefully after dermal filler treatment. This will help you to gain maximum effect from the procedure and reduce the risk of complications.
Post-treatment advice may include:
• iced water soaks or ice packs to help to reduce swelling (although this is generally not required);
• massaging the filled area, however you will be advised if you need to do this,
• arnica (a homeopathic remedy) cream or tablets are sometimes recommended a few days before and a few days after treatment as there is some evidence that this can reduce bruising;
• bruising and swelling should go down between 2 to 10 days, but if you continue to experience very painful swelling and bruising after 7-14 days, or if any blistering occurs, you should contact us.
Who should not have dermal filler treatment?
As in any treatment to the skin, injections should be avoided in areas where the skin is swollen or where infections are present – e.g. active acne, impetigo, herpes simplex. This will reduce the risk of infection at the injection site after the treatment. If you have even the slightest allergic reaction to a particular filler, it cannot be used and you will need to use a different brand. Dermal fillers have not been tested in pregnant or breastfeeding women, so if you are pregnant or breast feeding we will not treat you.
Who can administer dermal fillers?
Dermal fillers are categorised by the UK medical authorities as medical devices. This means that practitioners, currently, do not need to write a prescription to use these treatments. Manufacturers recommend that only medically qualified practitioners should use dermal fillers. Thus you will find many nurses, as well as general practitioners, cosmetic doctors, dermatologists, plastic surgeons, and private dentists offering one or a range of dermal filler options. Manufacturers do not recommend that beauticians or any other person outside the medical profession administer these treatments. There is a legal challenge underway to change the cagegorisation of fillers to prescription only medicines to stop untrained members of the public from injecting fillers.
What is the average cost of a dermal filler treatment?
Costs vary depending mostly on the type of dermal filler used and the degree of filling to the skin required. Generally prices for fillers are based upon the estimated number of syringes needed to obtain the required result. Deeper lines and wrinkles tend to require more filler than shallow lines. Fillers used more for facial sculpting; contouring and addition of volume will tend to me more expensive than those just used for treating single lines. A combination of fillers may also be recommended, and for certain areas additional treatments with other agents such as Botox may also be suggested, (especially for lines in the upper part of the face).
In addition, different filler brands such as Restylane, Perlane, Radiesse and Juvederm differ in price to clinics and practitoners who purchase them from the respective manufacturers. Prices may vary from £180 to over £750 per treatment session.
Remember, using less filler than is actually required to fill out a line or improve the contour of the face properly will generally produce a less pleasing and less long lasting effect than opting for a proper (and more expensive) treatment.
WHAT ARE UNREALISTIC EXPECTATIONS?
It is entirely appropriate to have certain expectations when you book for a treatment. Now you have had the opportunity to read all the advice and information about this treatment, we need to be assured that your expectations are realistic.
Some clients due to certain mental health issues or personality disorders or clients who are misinformed may, have expectations that will never be fulfilled. This can be disappointing to both the client and the medical practitioner when this occurs.
If you are concerned you may be becoming obsessed over a certain facial feature or "addicted" to treatments, please go to the downloads page and complete our confidential body dysmorphia screening tool. You can also speak candidly to Andrea who will advise you too. If your expectations are unrealistic, Andrea may discharge you from the clinic until you receive further assessment.
UNREALISTIC EXPECTATIONS CAN INCLUDE:
1. Expecting dramatic or instant results from treatments,
2. Never being happy or content with how you look or how treatment results appear,
3. Wanting to appear more than 5-10 years younger than your actual age,
4. Not accepting that all treatments have limitations on what they can achieve, excessive sagging of the skin, continuing smoking, excessive sun damage & premature ageing can be difficult to repair, if at all.
5. Not following the pre treatment or aftercare advice, but still expecting the treatment to give perfect results would be unrealistic.
6. To expect not to have any bruises when needles are being used in your skin,
7. To expect the treatment results to last longer than what the manufacturer advises,
8. Expecting a treatment to give you the effect of a different treatment i.e. toxin to give a filler result,
9. Expecting the treatment results of a multi treatment procedure or a more expensive treatment given over a period of time, from only one treatment.
10. Expecting bruises, swelling or other side effects to resolve within unrealistic healing time frames.
11. Expecting to look like your favourite celebrity is unrealistic.
12. Wanting to look like a filtered, digitally enhanced, social media picture of yourself or someone else.
13. Expecting out of hours emails to be answered, or sending excessive amounts of emails about already provided information. Although this is not an absolute unrealistic expectation, or contraindication, unfortunately, AB medical do not have the human resources to provide this level of client support. If you feel you want this level of support, please find an alternative clinic who have the capacity and resources to accommodate you.
14. If after having treatments you worry excessively or lose sleep, you may not be suitable to have treatments. Treatments should enhance how you feel, not contribute to feelings of anxiety.
15. Expecting "bargain basement prices" when you are receiving premium brands, available on the market, performed by a regulated health professional who is an expert in aesthetics and other areas at AB Medical.
This is not an exhaustive list but gives an indicator to whether treatments are for you and whether you are suitable to be a client of AB Medical. If Andrea feels that you are not suitable, no further appointments will be booked for you until you have had further assessment.
Teosyal, Restylane, Perlane, Juvederm 0.5ml £180
Teosyal, Restylane, Perlane, Juvederm 1ml £250
Juvederm Vycross Range, Voluma, Volbella, Volift 1ml £250