Dermal Fillers

A GUIDE TO DERMAL FILLERS

There aren’t so many things that go up but never come down. Your age undoubtedly belongs to this exclusive club, and while there may be nothing you can do about your age going up, there are things that could be done to many of what it does to you. Aging is famous for the many changes it brings to your body and wrinkles are certainly one of the changes no one likes.

Many wish they could let their age go up as much as it likes, as long as it doesn’t take the skin with it. Sadly, this wish would not come true if you do not act. Dermal fillers are one of the ways by which you can prevent wrinkles from stealing your beauty. If you are still in doubt about whether they are appropriate for you or not, here is a comprehensive guide that would aid your decision making.

History of dermal fillers

Man has been on an age-long quest to maintain a youthful appearance. Many drugs, techniques, and technologies have been experimented, albeit with varying results. The invention of the syringe sometimes in the 19th Century also marked a turning point in the evolution of methods used for correcting wrinkles. Direct injections into the face were possible and surgeons were not afraid to explore this technique.

Today’s success story in the field of dermal fillers is by no means an easy ride. Historical records show paraffin is the first substance injected to be injected as a dermal filler, but it was abandoned due to the multiple complications arising from its use. Silicone is another example of a material that has been widely experimented but its use was also discontinued due to safety concerns. Research into the field continued and a major breakthrough was made with the discovery of bovine collagen.

First used I 1976, bovine collagen injections displayed amazing results but short duration of action and animal origin proved major limitations to its use. More recently, many products have been developed to help solve the limitations of collagen.

The products usually contain hyaluronic acid as a supplement and examples include Restylane, Juvederm, Perlane etc. Current British regulations on dermal fillers are not very stringent and many of the products being advertised have only undergone minimal testing. You should, therefore, be careful and only go for dermal filling at rusted centres.

What are Dermal Fillers?

The term ‘dermal fillers’ is broadly used to refer to any material or substance that is used or has previously been used for the purpose of removing wrinkles or filling out lines on the face or other areas in the body. Dermal fillers are administered as injections into the skin and most of them only act for a short duration because they end up being absorbed into the body. The need for maintenance and repeat injection, therefore, arises. Full wrinkle-smoothening effect may not be seen in some people until after multiple injections while others may experience almost immediate results with dermal fillers.

Various substances have been used as dermal fillers and varying results have been obtained but products containing hyaluronic acid have come to be the mainstay of dermal fillers today. Also, known as soft tissue fillers, dermal fillers are specially administered for diminishing facial lines, and restoration of volume, as well as fullness. Asides Hyaluronic acid dermal fillers, synthetic wrinkle fillers e.g. Sculptra, collagen wrinkle fillers and autologous wrinkle fillers are also in use

Different Types of Dermal Filler Treatments

Lip Volume/Augmentation

Any cosmetic procedure designed to improve the appearance of the lips by making it plumper and fuller is referred to as lip augmentation. Although different techniques have been employed for lip augmentation, the use of dermal fillers has become the most effective and reliable method and is widely adopted.

Dermal fillers for lips are mainly Hyaluronic acid fillers and they work by improving water retention and consequently, the volume of the lips. They are injected directly into the lips and also in the neighbouring area around the mouth. The use of collagen as dermal fillers for the lips has become less popular due to other long-lasting alternatives. Fat injections have also been used but they have been associated with more side effects and less consistent results.

Dermal fillers for lip augmentation are capable of improving the appearance of the lips by correcting shape, structure and volume depletion. As generally observed for dermal fillers, the lip augmenting effect of dermal fillers injected into the lips tend to last for an average of 6 months. After this period, maintenance injections would be needed to ensure the volume of the lips is kept intact. Sometimes, there may be a need for gradual administration of the injection and your physician may fix many appointments for you.

Non-surgical rhinoplasty

The many complications that could arise as a result of surgical rhinoplasty has made the use of dermal fillers popular. Injection of dermal fillers into the nose for a nose job is much less difficult and comes with fewer risks. The patient also experiences minimum comfort and the procedure takes much less time, requiring a local anaesthetic agent instead of the general anaesthetic that the surgery requires.

Hyaluronic acid fillers are injected directly into the nose to restore the shape or structure. As with all dermal filler treatments, it is non-permanent and would require maintenance injections after a period of time. Fillers such as Restylane or Juve ‘derm are commonly used and the procedure usually takes about one hour or less.

As said earlier, a local anaesthetic agent is used, therefore, there is no recovery period as with the surgical treatments. Also, there are no permanent scars since there is no knife cut and the procedure poses minimal discomfort overall. The results from nose treatments with dermal fillers are seen immediately, the procedure is less expensive and equally effective.

Cheek bone augmentation

As we age, there is an increased tendency of the fat pads making up the cheek to droop downwards. This would, in turn, make the folds around the nose and mouth region more obvious and this is worsened by the resorption that occurs to the cheek bones as a normal component of the aging process. The overall result is an apparent loss of volume the cheeks that give the face an unbalanced appearance.

Using dermal fillers for cheekbone augmentation corrects this unbalanced structure. Dermal fillers act by restoring cheek volume and consequently, cheek and facial proportions. Surgical treatments involving insertion of cheek implants have also been used for this purpose but dermal fillers are now preferred as they are equally as effective (if not more) and pose much fewer risks.

Dermal filler injections are administered directly into the cheek and the amount required would depend on the level of augmentation needed for the individual. The type of filler used would determine the period of time the volume will stay restored. Some dermal fillers tend to last longer than the other, and although these may be initially expensive, they tend to give more value later on as fewer maintenance visits would be required.

Chin augmentation

Dermal fillers are also injected into specific sites in the chin to reverse anomalies or imbalance in projection, width or length of the chin. The risks inherent in surgery, which is the traditional method of chin augmentation makes dermal filler injections preferable. The patient also experiences much less pain and discomfort and since no anaesthesia is used, the procedure takes only minutes and you can resume work the same day. Surgical implants also come with the risk of movement or infection but this is absent with dermal fillers. All that is required is the prick of a needle and the injected substance becomes a part of your body.

Artefill is a chin implant that is usually described as permanent because it becomes embedded in the skin and even when your face undergoes further changes, Artefill would also conform with the change and your natural look is never lost.

Marionette lines

Nasolabial folds or marionette lines are one of the most worrisome signs of ageing. Even more than wrinkles, they sort of distort your face and make you look very old. Botox injection does not work well for all types of Marionette lines and its effectiveness depends wholly on how you place your face while at rest or smiling.

Dermal fillers, however, have been tested and proven to be an effective treatment for Marionette lines. Sometimes, there may be a need to combine both Botox injections and dermal fillers to achieve total correction of Marionette lines. This situation often occurs when the Marionette lines appear as horizontal and vertical lines on the face. Dermal fillers are best for horizontal lines while Botox works well for vertical lines.

Hands rejuvenation

Your hand is another body part that will lose significant volume while you age. Exposure to the sun and constant use also contributes to the bony and old appearance your hand assumes as you grow older. Due to the loss of volume underlying the skin, your veins would become more prominent and your tendons could start showing. Concentrating all efforts on your face and neck while completely neglecting your hands could render your efforts at achieving a youthful appearance fruitless.

Dermal fillers such as Radiesse and Voluma are preferred by doctors for restoration of volume on the hands. Voluma is longer lasting and its effects typically last for about a year. Radiesse is calcium based while Voluma contains hyaluronic acid but both produce fantastic effects and are capable of giving your hands the plump and pretty look of yesteryears.

You are unlikely to feel any pain at all as both Radiesse and Voluma come with lidocaine, a local anaesthetic. If your physician would be using a product that is not preformulated with lidocaine, a numbing cream should be applied and you would end up not feeling anything. The effects are seen almost immediately and would get better in the few days following the injection, as the dermal fillers blend with your skin.

How do dermal fillers work?

The natural process of aging is accompanied by various anatomical and physiological changes. Subcutaneous fat underlying the face is gradually lost and the facial muscles thus come in close proximity to the skin. This leads to the appearance of obvious smile lines, crow’s feet when the facial muscles are worked.

Aging also makes the facial skin lose some of its elasticity thereby stretching slightly and making the loss of facial volume more apparent. Heredity, lifestyle, and exposure to the sun are also partly responsible for the loss of facial volume and shape.

Different classes of dermal fillers have different ways of helping restore this volume and shape. Skin boosters are dermal fillers that act by improving water retention at the dermal layer, thereby increasing the suppleness of the skin and its overall texture and quality. Hyaluronic acid fillers work by complementing the depleted hyaluronic acid production by the skin. Hyaluronic acid has a high affinity for water. It, therefore, helps in improving internal hydration and overall smoothness, texture, and quality of the facial skin.

Yet another class of dermal fillers, known as synthetic fillers work by stimulating the natural process of collagen formation in the dermal layer of the skin. These are very effective and tend to last longer while requiring much fewer maintenance visits to the physician. Synthetic fillers, however, cost more than other types of dermal fillers.

Dermal fillers vs Botox

Although the major aims of both dermal fillers and Botox is to reduce appearance of wrinkles majorly as a sign of aging, the mechanisms of action of both interventions are quite different. While Botox as a muscle relaxer aims to decrease the appearance of wrinkles by paralyzing the muscles responsible, dermal fillers are injected to fill the line or crease in the face. This results in a near complete disappearance of the wrinkle hence making it a better option than Botox injections.

Dermal fillers also provide a longer lasting solution to facial wrinkles as they could last for a year or two before they are fully absorbed by the skin. Botox injections on the other hand only last for an average of six to eight months.

The differences cited above does not imply that both interventions are mutually exclusive. Botox injections are said to be ideal for ‘expression lines’ while dermal fillers are ideal for ‘static lines’. AT some point in time, distinction between expression and static lines may prove difficult as expression lines tend to evolve into static lines. Thus, some individuals may need to combine both Botox injections and dermal fillers to achieve the best results.

How long does the procedure take?

Dermal filler injections can be administered in very little time. Once you have had a previous consultation with the physician and an appointment has been made, getting your dermal filler injection would only take an average of 15 to 30 minutes. Unlike Botox injections which may need about 2 weeks before the effects are seen, the face-lifting effects of dermal filler injections are seen right after the injection. You also are likely to experience slight swelling and sometimes, light bruising on your head.

Do dermal filler injections hurt?

Like all other invasive (involving the use of injections) procedures, the possibility of pain cannot be totally eliminated. The pain experienced from dermal filler injection should under normal circumstances be slight and should only arise from the piercing of the needle. Multiple injections are usually required; thus, you might feel the piercing pain multiple times. Individuals may also experience different levels of pain due to varying thresholds of pain sensation. It is, however, highly unlikely to experience severe pain due to dermal filler injections.

Thankfully, many dermal filler solutions available today are pre-formulated with lidocaine, a potent local anaesthetic agent. This makes it possible for you to get a dermal filler injection without feeling any pain at all. If your physician is using a product that doesn’t contain a local anaesthetic, a numbing cream may be used. The cream is rubbed on your face some minutes before the injection and it guarantees a completely painless procedure. The cost of treatment may increase significantly if a numbing cream is to be used.

How soon after the treatment will I see results?

Perhaps, one of the best things about dermal fillers is the immediate results they produce. Typically, you would see significant changes immediately after injection of dermal fillers into any part of your body for any purpose whatsoever. This result usually gets better with time and optimum results should be achieved in a few days when the injected solution is fully blended with your skin.

How Long Will the results last after dermal filler injections?

One of the shortcomings (albeit negligible) of dermal fillers is that the results are non-permanent. While a lot of progress has been made on increasing the duration of effects (collagen lasts for about 3 months while hyaluronic acid based fillers could last for up to a year), average dermal filler treatments tend to last for six to eight months. This period depends on the substance injected and also to some extent, the part of the body that was injected. You should talk with your physician about how long the injection is expected to last and when you need to come back for maintenance injections.

Risks and Contraindications (are dermal fillers safe?)

Overall, dermal fillers are considered safe but the possibility of side effects cannot be completely ruled out, as with any medical procedure. Most of the side effects associated with dermal fillers are short-term side effects, occurring almost immediately after the injection and resolving in less than no time. Some permanent side effects have, however, been reported although rare.

If your physician wants to use collagen based fillers or fillers made from any other animal product, it is important you are first tested for allergies. Allergic reactions to these substances may be fatal and should be treated as an emergency. Common side effects that have been reported from the use of dermal fillers include bruising, swelling, slight itching or rash, pain, tenderness and an initial difficulty in undertaking otherwise simple tasks (common with hand fillers).

Nodules under the skin, necrosis, draining wounds and sores at the injection site are less common and more severe side effects that have been reported from the use of dermal fillers. Much severe side effects such as anaphylactic shocks, migration, rupture, formation of permanent nodules, blockage of blood vessels, stroke etc. have also been reported but these are extremely uncommon.

Aftercare instructions

Tenderness, bruising, redness or swelling may be experienced sequel to receiving a dermal filler injection. You should not scratch or massage the injection site no matter the discomfort you may experience. Your physician should provide ice to ease the pain and swelling and a topical cream may also be added. An over-the counter drug such as paracetamol may be given to manage the pain. You should avoid any activity that might exert a strain on the injection site. Furthermore, you should also avoid exposure of the area to intense heat which may arise from tanning, sauna, hot tubs etc.

If any of the side effects remain persistent even after about three weeks post treatment, you should contact your healthcare provider.

Different types and brands of dermal fillers

Various brands of dermal fillers are available and they differ in composition and consequently, effects and duration of effects. Some of the popular brands include

  1. JUVEDERM
  2. SCULPTRA
  3. RESTYLANE
  4. RADIESSE
  5. ARTEFILL
  6. PREVELLE
  7. CAPTIQUE
  8. HYLAFORM

How much do dermal fillers cost?

The cost of dermal filler treatment would depend on many factors including the area injected, amount of filler used, the brand of filler used and the extent of restructuring required and the cost of the services of the provider. In the UK, dermal filler treatments could range from £150-£2000.

You should talk to your provider about treatment costs before signing up and you should also ensure you know the potential costs of maintenance visits before making a decision.