Dermal fillers is a term which refers to using a gel based product to fill out lines and reshape the face. Most Dermal Filler agents have a manufactured Hyaluronic acid that the body will break down over time and can be dissolved if there are any problems.
Hyaluronic acid (HA) is our skin’s natural moisturiser, it binds water which moisturises the skin and provides tightness. Over time, as we get older our bodies stop producing collagen and elastin, both of which contribute to the youthful look. Most experts generally agree this occurs from the age of 25. Your collagen and elastin levels then decline at a rate of about 2% per year.
Hyaluronic Acid (HA)
Hyaluronic acid is a naturally occurring substance that is already found in your skin. It helps keep skin plump and hydrated. HA fillers are typically soft and gel-like. The results are temporary, lasting 6 to 12 months or longer before the body gradually and naturally absorbs the particles. Most HA fillers are infused with lidocaine to help minimize discomfort during and after treatment.
- Juvéderm products: VOLUMA, VOLBELLA, VOLIFT, VOLLUX
- Restylane products: Restylane Lyft, Restylane Refyne, and Restylane Defyne
- Belotero Balance, Volume, Intense and Soft
HA is advertised as an ingredient in anti-ageing day and night creams. However, truly speaking when it is applied to the skin (externally) as a cream or serum, the HA cannot penetrate through all layers of the skin.
For visible skin restoration and volume enhancement, HA needs to be injected into different layers of the skin by a qualified aesthetic practitioner or skin procedures or medical grade skin care should be used to stimulate fibroblasts to continue production.
Fillers aim restore lost volume to your face and plump areas, so that deep set lines are smoothed.
The History of Dermal Fillers
Fat transfer was first used over one hundred years ago, and a much refined version is available today. It is still a fairly time consuming and complex procedure with a fairly high failure rate but in the right hands can give good long lasting results. Liquid paraffin and silicone have both been used in the past but caused a lot of problems and thus they are not recommended any more.
Collagen injections were first used in 1976. However, collagen is derived from the skin of cattle and certainly no longer used so there was a significant demand for alternatives that were non animal sourced and longer lasting.
Modern Day Dermal Fillers/Facial Revolumisers
Products now contain manufactured hyaluronic acid such as Juverderm, Restylane and Belotero. Many others have become available over the last 5-6 years and have proved highly popular. Be wary of new fillers – The regulations at present are not very demanding so a product can be promoted after minimal testing.
Results depend on:
- The part of the face which is treated
- How much movement there is in the treated area
- The condition of the skin
- The experience and skill of the person performing the treatment. (This is the most important).
Dermal fillers should be administered by trained practitioners in a safe environment. Currently there is now a safety campaign to stop rogue practitioners from doing these types of procedures to make money.
Dermal fillers can be used to improve:
- Acne scars
- Depressions or pockmarks in the skin due to injury or disease, for example, chickenpox marks
- Unevenness in the skin after surgery or skin grafting
- Deep ‘smile lines’ which run from the side of the nose to the corners of the mouth
- ‘Crows feet’ at the corner of the eyes
- ‘Frown lines’ between the eyebrows
- ‘Smokers lines’ which are vertical lines on the top lip
- ‘Marionette lines’ at the corner of the mouth
- ‘Worry lines’ which run across the forehead
- The definition of the lip border
- Other facial lines.
Some defects can be difficult to improve with the first treatment and although you may notice some improvement, more treatments may be needed to get best results.
Treatment with dermal fillers is not going to be successful for every person, and results and duration are variable. For some people wanting treatment for deep facial fines other treatment may be required first, followed by ‘fine tuning’ with dermal fillers.
There are now over 60 dermal fillers on the UK market. The most obvious division between them being that some are temporary and some more long lasting. The BCAM and Dr Prasad would always recommend the more temporary solutions as they do have less problems and side effects. Please ensure that the doctor explains in full his choice of filler and it’s expected duration and side effects.
Below are three of the more common treatments.
We offer a variety of dermal filler treatments in London which will give your skin a refreshed and more youthful look. At Faciem Dermatology London, we proudly use and recommend only 3 main fillers from 3 reputable companies that have been manufacturing dermal fillers for many years. These products have undergone rigorous testing and are CE marked. Dr Prasad mainly uses Juvederm Vycross range for its longevity and has undergone MD Codes training under Dr Mauricio De Maio of Allergan.
Unfortunately due to the rise in the aesthetic market over the last few years many more fillers from outside of EU and UK are being sourced and these are unregulated and not as safe For this reason Dr Prasad only offers dermal filler treatment at Faciem Dermatology London from 3 reputable companies Juvederm, Belotero and Restylane and these are only purchased direct from the companies themselves or reputable pharmacies such as Wigmore, Health Xchange, Church or Med Fx.
It is important to know that when considering replacement of significant volume of the face, 1ml of Dermal filler is often not enough and it is not unusual for 3-6 mls of product to be used either at one appointment or over serial appointments.
- VOLUMA, VOLBELLA, VOLIFT, VOLLUX
Juvéderm® is available in various formats to be used in different parts of the face. These are injected at different depths of injection, are of different consistency, lasting for different areas and suitable for different target areas.
- VOLUMA, VOLBELLA, VOLIFT, VOLLUX
The older range used to be Juvéderm® 3 and 4 Juvéderm® and Smile and has largely been replaced by Juvederm VOLUMA®, Volift and Volbella.
Why is Facial Volume so important?
A youthful face is characterised by smooth, round contours, high cheekbones, hollow jowls and a thin, well-defined jawline. These features together comprise the “triangle of beauty” or “heart of face”, with its base at the top and summit below. As we age, facial fat loss, gravity, and loss of the skin’s natural elasticity conspire to reverse this triangle’s composition, leading to a narrower, less youthful forehead and temple area, and a wider, heavier jawline.
Juvéderm® VOLUMA® can restore the face’s balance and heart-shaped proportions, revolumising facial hollows and lost volume and recontouring the cheeks, cheekbones, and nose for a fuller, softer, more youthful appearance. Juvéderm® VOLUMA® helps recapture the facial volume that age and weight loss can diminish.
What is Juvéderm® VOLUMA®?
Juvéderm® VOLUMA® is an injectable hyaluronic volumiser that provides long-lasting restoration for facial volumes through injection. The results are immediate, even, and very natural looking.
Juvéderm® VOLUMA® restores youthful volume to cheeks, cheekbones, and chin that have become hollow or thin due to weight loss or age-related facial fat loss. It can also rejuvenate the effects of a sagging facelift.
What exactly is hyaluronic acid?
Hyaluronic acid (HA) is a naturally occurring substance found in the body that helps to hydrate and add volume to our skin. Natural hyaluronic acid is broken down by the body in one or two days so is constantly replaced. As we age this replacement mechanism diminishes so the moisturising and plumping effects of hyaluronic acid decrease. The hyaluronic acid used in Voluma® is stabilised and cross linked to achieve safe, long lasting results.
At what age should I start treatment with Juvéderm® VOLUMA®?
Juvéderm® VOLUMA® is intended for use by adults. It is the ideal implant for remodelling facial volume and correcting a receding chin.
How long will the effects of treatment with Juvéderm® VOLUMA® last?
The average effect of treatment with Juvéderm® VOLUMA® lasts about 18 months. It may sometimes be shorter or longer depending on:
- your age
- your physiology
- your lifestyle (smoking and exposure to sun or UV rays may shorten the effect)
- the amount injected and the practitioner’s technique.
Will the treatment hurt?
Most Aesthetic doctor use the latest techniques to minimise any discomfort. These can include ice packs and skin vibration. At Faciem Dermatology London we use both. Patients do not need local anaesthetics and after the treatment any discomfort usually settles very quickly. Dr Prasad is a skilled practitioner and very light touched and the procedures are very tolerable.
Why Juvéderm® VOLUMA® and not a wrinkle filler?
Juvéderm® VOLUMA® has been specifically developed to restore lost facial volume e.g. in the cheeks, cheekbones, and chin. While wrinkle fillers like Juvéderm® ULTRA offer excellent results when applied to fine lines and wrinkles around the mouth, nose, and eyes, Juvéderm® 4 and Juvéderm® VOLUMA® are often better suited to larger scale facial volumising.
When can I return to work and resume my social life?
The aesthetic results are immediate and very natural looking. You can return to work and resume your social life immediately.
Are there any side effects?
Following injection, you may experience redness, slight swelling, or bruising at the injected area. Your doctor will inform you about this. These side effects will not last and can easily be covered up with your usual makeup.
What about contraindications?
These do exist. They are not specifically related to Juvéderm® VOLUMA®, but to this type of treatment. This is why it is important to tell your doctor about any previous history of pathologies such as auto-immune diseases, allergies, known hypersensitivity to hyaluronic acid, any tendency to develop hypertrophic scars, immunotherapeutic treatment, inflammatory or infectious complaints (acne or cold sores) at injection sites, if you are pregnant or breast-feeding, any previous aesthetic treatment, particularly the use of permanent products.
Juvederm Volite is a wonderful skin booster for the neck and décolletage, please read the Brochure below
How does Belotero work?
Belotero adds volume and fullness to the skin to correct moderate to severe facial wrinkles and folds, such as the lines from your nose to the corners of your mouth (nasolabial folds). Again it works immediately by adding volume to smooth away wrinkles. A clear gel formulation of hyaluronic acid and again it is specifically formulated to act like your body’s own hyaluronic acid.
There are at least 4 main types of formulations
- Belotero Volume for restoration of facial volume usually used in cheeks/chin
- Belotero Balance for correction of moderate lines such as Nose to mouth lines, glabellar lines, moderate peri-oral lines and lip contouring
- Belotero Intense for the correction of deeper lines such as deep nose to mouth lines, intense lip volume and Belotero soft for correction of fine lines around the face and décolletage
How does Restylane work?
Restylane adds volume and fullness to the skin to correct moderate to severe facial wrinkles and folds, such as the lines from your nose to the corners of your mouth (nasolabial folds). Restylane works immediately by adding volume to smooth away wrinkles. A clear gel formulation of hyaluronic acid, Restylane is specifically formulated to act like your body’s own hyaluronic acid. So, you can use Restylane to visibly reduce moderate to severe facial wrinkles and folds.
Biocompatible with the human body, Restylane is eventually broken down naturally to water and carbon dioxide.
There are different formulations of Restylane for different areas and results. Restylane is available again with added lignocaine to reduce injection discomfort.
Is there anything I should know before I have the treatment?
Do not take aspirin for at least three days before the injection session. During the injection, risk of bruising (haematoma) and swelling will be higher for patients under anti-coagulant treatment or taking aspirin.
This is minimised by judicious use of topical anaesthesia.
What can I expect to happen at a treatment session?
- Your Aesthetic doctor will answer all of your questions and prepare you for the treatment
- Anaesthesia for the treatment area will be provided
- The area where the injections will be given will be cleaned with an antiseptic
- Multiple injections will be needed
- An ice pack should be applied to the treatment area to help reduce swelling.
After the treatment session, the area should be thoroughly massaged to distribute the product evenly.
Questions you should ask your doctor prior to any dermal filler treatment.
- What are your qualifications?
- How long have you been doing fillers?
- How many patients have you treated?
- Which fillers do you use and why?
- Are there any alternatives that I should consider?
- How often have your patients had “problems”?
- Is the is filler dangerous?
- What problems can occur?
- Do you audit your results and patient satisfaction?
- What do I do if there is a problem with my treatment?
- Do you routinely follow up the result?
- Do you have any patients who you have previously treated whom I could speak to?
- How much does it cost? (this is the least important question).