Injectable fillers are substances used in aesthetic medicine to treat the following conditions:
- Volume loss such as sunken cheeks, aged lips, smokers lines, tear trough and dark circles the under eyes, nasolabial folds, marionette lines (lines at the corners of the mouth), temporal wasting. A volume restoration provides a visible and natural face lifting effect and improves facial contour. If lines and wrinkles are present in the area of the volume loss (which is common in older patients) they appear much smoother or disappear completely.
- The appearance of indented hypotrophic scars and acne scars can be improved.
- Fillers may be used on the face and body (hand rejuvenation)
- Injectable fillers improve the skin’s texture and hydration levels, making it looks more supple, smooth and healthy.
- Correction of facial contour: fuller cheek bones, eyebrow lifting and reshaping, fuller lips, correction of the shape of the chin and nose.
- Hyaluronic acid (for example, Juvederm ultra, Voluma, Volbela, Restilane, Perlane, SuQ, Teosial, XHA)
- Calcium HA (Radiesse),
- Calcium TriphosPhate
- Collagen (Evolence)
- Poly-L-Lactic Acid (Sculptra)
- Non- Resorbable
One of the most widely used types of injectable fillers is made of hyaluronic acid (HA).
What is Hyaluronic acid?
Hyaluronic acid is a smooth gel like substance that is normally present in the human body. Hyaluronic acid is found in high concentrations in specific body locations: in bones and cartilage, tendons and ligaments, scalp tissue and hair follicles, in the lips and eyes, in gum tissue, and in the skin. When we are young, large amounts of HA are present in the deeper layer of the skin – the dermis. HA has a great capacity to bind water molecules – up to 1000 times its volume. The water binding capacity of HA largely contributes to skin volume and its good level of hydration.
As a result of the normal ageing process the amount of HA in the skin decreases over time, and that contributes to the overall loss of volume of the skin and appearance of lines, wrinkles and sagginess. Along with degradation of HA, skin also loses its water reservoir and becomes dehydrated and dull.
Fortunately, modern aesthetic medicine can restore the HA supply in the skin due to the use of HA containing injectable fillers. HA fillers are made of synthetic Hyaluronic acid that is produced in different thickness/concentration and can be injected in the skin at different depths or in some cases under the skin depending on the conditions treated.
Treatment with HA fillers is a fast and non–surgical alternative to facial and body rejuvenation with an immediate visual improvement in the appearance of the lines, folds and wrinkles and restoration of the lost volume in the treated area. Shortly after the treatment, clients can appreciate the improvement in skin hydration and texture (smooth skin, smaller pores), more radiant complexion. Injectable HA fillers have minimal or no downtime (i.e. healing time).
About the procedure
On average an appointment for injectable fillers takes from 30 minutes to an hour, depending on the number of areas being treated. It starts with a consultation/discussion with the doctor, a medical history is taken and a written informed consent is signed by the client. The procedure is well tolerated by most people.
Topical anaesthetic is often applied to make the injections more comfortable. Some filler brands, like Juvederm (Allergan) have a built in 0.3% lidocaine to provide local anaesthesia. Based on the areas to be treated, additional injections of lidocaine may be administered for full local anaesthesia.
To achieve patients’ maximum satisfaction, fillers are often combined with other treatments (not in the same session) like Botox, laser, mesotherapy, chemical peels, etc. Your aesthetics doctor will advise you on the best course of treatment to suit your needs.
One week prior to fillers injection, it is advisable not to use alcohol, garlic, lidocaine and aspirin, or any other non-steroidal anti-inflammatory drugs for pain, swelling and/or fever, such as medicines containing diclofenac, mefaenamic acid, indomethacin or ibuprofen. Following these precautions will significantly reduce the risk of bruising or bleeding at the point of injection.
There is minimal recovery time. For the first 24 hours following the treatment please avoid strenuous exercise and alcohol consumption. It is advisable not to apply make up for 12 hours. Avoid extreme sun and/or heat exposure, UV light, freezing temperatures and saunas for 2 weeks after the treatment.
How long will the results of the treatment last?
Similar to skins natural hyaluronic acid, HA fillers will be slowly degraded by the body. Depending on the thickness of the fillers they generally last from 8 up to 18 months, with an average of a year. For example, lip fillers are thin and start deteriorating after 8 months, whereas the thick fillers used for volume restoration in cheek bones last up to 18 months.
Injectable Fillers will last longer in younger patients, and in patients that lead a healthy life style.
The results last longer if large quantities of fillers are injected.
As our body metabolizes out the HA fillers, it simultaneously produces new collagen and elastin. Thus fillers also have a long term rejuvenating effect on the skin. Because the fillers stimulate collagen synthesis the patient will notice that a year later, when most filler may be gone, the skin is in much better condition than initially, before the treatment.
What happens after the treatment?
As described above, immediately after the treatment with injectable fillers, the appearance of lines, wrinkles and volume loss is visibly improved.
During the next two weeks post procedure, the injected fillers absorb water and expand in volume thus; the maximum effect will be achieved in 3 weeks’ time.
It is expected to have mild redness and swelling at the injection points, which usually subsides within a few hours and is easy to camouflage with makeup. More sensitive areas of the face, like lips and the area under the eyes may retain swelling for longer.
In most patients a follow–up appointment is scheduled 2 – 4 weeks from the initial treatment with the purpose to correct/optimise the results and extend the life span of the fillers.
What are the side effects of injectable fillers?
One of the most common side effects of Injectable Fillers is bruising. It is temporary and usually clears within 4 -14 days.
To minimize chances for bruising it is advisable to avoid alcohol, lidocaine, aspirin and other blood thinning substances a week prior to filler injections.
Allergic reactions to fillers may occur, but they are rare. If during the consultation the doctor suspects the possibility of an allergic reaction, a small test injection will be done first in the hidden area of the body.
Most Injectable fillers contain lidocaine (local anaesthetic), that may produce a positive result in anti-doping testing.
There are some very rare complications that have been described: abscess formation, granulomas (small bumps), discoloration at injection sites, and necrosis (tissue death). Should any painful hardening develop after filler injections it must be reported to your medical aesthetician as soon as possible.
Contraindications for injectable fillers
- As a precaution, fillers cannot be injected during pregnancy and breast feeding
- Abnormal wound healing (predisposition to keloids)
- Allergy to HA
- Patients with known allergy to local anaesthetics must avoid fillers containing lidocaine
- Blood clotting disorders
- Concurrent acute skin infection in the area of injection
- The combination of HA fillers with certain drugs may reduce or inhibit liver metabolism, and is not advisable
- Uncontrolled Epilepsy
- The use of steroids may elevate the risk of developing infection at injection sites
HA fillers have been used in millions of patients for more than 10 years worldwide, with a very low incidence of side effects and they are considered as being very safe.
For more information please go to www.juvederm.co.za.