cosmetic dermal filling

overview

Due to current government restrictions we cannot legally name any specific products, for more information on what each product has to offer please call the clinic and speak to one of our specialist cosmetic nurses.

Cosmetic Dermal Fillers, Softform and Fat are all substances used for the correction of wrinkles, scars and skin depressions, as well as for the enhancement of lips. These filling substances are injected or implanted into the skin to create volume which plumps out an area thereby rejuvenating and giving subtle and immediate results.

The skin is divided into sections, all of which have specific functions in maintaining a youthful appearance. The epidermis is the outer layer of skin, the dermis lies underneath the outer skin, and the subcutaneous layer of the skin is where fat is situated.

As we age the skin structure undergoes many changes. The epidermis thins causing the skin to become dry more easily. The dermal layer depletes in its supply of collagen making it less plump and the elastin fibers become less firm. All of these signs are minimal at first however over time when the fat cells of the subcutaneous layer get smaller, the wrinkles and sagging becomes more noticeable.

treatment options

Collagen – available in different forms has been used for many years in a variety of medical applications and was one of the first injectable substances for cosmetic purposes. Although this product is still reliable, many patients feel it is too restrictive, as it requires two test doses, two weeks apart prior to treatment to reduce the risk of an allergic reaction.

The newer Hyaluronic products are made of natural substances that can be found in all living tissue. There advantage is that treatment can be immediate as any risk of allergic reaction is rare which eliminates the testing period. As there are a variety of different products available, the most appropriate product for the patient can be specifically chosen for the particular area of concern.

Soft Form facial implant (ePTFE: expanded polytetrafluoroethylene) is a soft, synthetic material that is natural feeling and pliable. It is hollow and tubular and remains under the skin indefinitely, but may be removed if necessary.

Fat Transfer is procedure of removing fat from an area where there is too much fat (the donor site, often the abdomen), and placing it into areas where the fat has depleted. Fat transfer to the face is a useful treatment in facial rejuvenation.

the procedure

Collagen and Hyaluronic cosmetic filling substances are injected into the skin by a very fine needle. It is common to have a local anaesthetic injected in the area prior to treatment for the patients’ comfort.The procedure takes about 30 minutes and usually there will be some swelling post treatment. This generally settles with 24 to 48 hours and ice can be applied immediately after treatment to reduce any discomfort. Occasionally there may be minimal bruising, if so this usually settles within days of the treatment. The area will show immediate signs of fullness once any swelling settles.

The Soft Form procedure usually takes half an hour for each implant to be secured into place and generally only requires a local anaesthetic. The implant is fed under the skin with a rigid guide through two small incisions. The guide is removed, the implant cut to size and the incisions closed with a single stitch.

Fat Transfer is a relatively simple procedure where ‘tumescent solution’ (saline with dilute local anaesthetic) is infused into the donor area (fatty area) and then the fat is gently extracted by manual suction. A local anaesthetic is used to numb both the ‘donor site’ and the ‘implant site’ areas with sedation as an option if it is desired or necessary. The fat is then cleansed and re-injected into the areas requiring filling. Any unused fat may be stored frozen for 12 months or in some cases longer, for reinjection as needed.

recovery process

You can expect some swelling and bruising following all of these treatments, but this will settle in a matter of days. All the above cosmetic fillers are slowly broken down and later absorbed by the body over a period of time. It is necessary to have a ‘top up’ treatment to keep the new look.

Following the Soft Form implant, the stitches will need to be removed in about five days and there is often a feeling of tightness or swelling around the implant site for some days.

Following a Fat Transfer, both the donor site and the recipient site may be swollen and bruised for several days. It is usually necessary to wear a compression garment for a few weeks after fat has been harvested.

risks and complications

The most common side effect from any of these cosmetic injections is to have an allergic reaction to a product. This is most unlikely when the skin tests have been performed prior to treatment or when adequate history of any possible prior allergy experience has occurred. Most allergies exhibit as redness, itching or swelling and can be treated with medication to settle any problems.

With the Soft Form procedure, swelling is the most common reaction and should settle over time. It may be possible to feel the implant once it is in place, but this will become less obvious over time. In rare cases the implant may migrate out of position and may have to be removed.

Infection is a rare complication of the Fat Transfer procedure and this is minimised by the use of prophylactic antibiotics. Uneven or irregular results are usually avoided by using ultra fine cannulae. Research suggests that smokers are likely to have a less successful result when fat is used to fill out areas in the face.

faq’s

What fillers are available?

Dermal filling products range from highly purified bovine collagen (extract from cowhide) to simulated hyaluronic acid products (hyaluronic acid is a naturally occurring substance found in all body connective tissue). Soft Form, a soft synthetic material and the patients own fat can also used to add bulk and shape to many areas of the body.

Are dermal filling substances permanent?

Most dermal filling substances create an immediate improvement; however the result of the most commonly used filling agents is usually temporary. It is generally necessary to have ‘top up’ treatments to maintain the effects of the procedures. The effects from Collagen and Hyaluronic fillers can last from three months to two years depending on the chosen product and factors such as lifestyle, skin structure and age.

What areas can be treated with dermal fillers?

The most common areas selected for treatment with dermal fillers are: the enhancement of lips – adding volume or shape, lipstick lines (vertical lines above the top lip), lines from the nose to mouth grooves (naso labials), tear trough depressions, to enhance cheek elevation and acne pits.