Dermal fillers are made of various kinds of natural and man-made or synthetic materials that have been developed over the years for injection into the skin.


What are Dermal fillers and how do they work?

As the skin ages, 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. Material 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 dermis (middle layer of the skin - see diagram below) to help plump out fine to deep lines and wrinkles.

Dermal Fillers Skin Section

Background image provided courtesy of Q-med Limited.

 

Collagen treatment has been widely used to increase the size and volume of lips in women for a number of years, and this is still the most popular use for most dermal fillers.

However, 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 tip of the nose, 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 used alongside injections of botylinum toxin or Botox.

Some fillers can be used to treat larger skin defects in other areas of the body.

Depending on the area treated, and the depth of wrinkles or scars or sagginess of the skin, your practitioner may recommend that different combinations of types of fillers are used in order to achieve the best results.

What happens during Dermal Filler treatment and how long does it take to recovery?

During your first visit to a clinic, you should explain what you expect from a dermal filler treatment and how you would like to look afterwards. Your practitioner should discuss any potential problems connected with the treatment, such as allergies. You must discuss which filler is best for you and how much it will cost.

For instance, if bovine collagen is recommended, you will be advised to have a skin test where a small amount of collagen is injected into your forearm to see if you have an allergic response. This skin test is only currently recommended for products containing bovine collagen. Other dermal fillers can be used without a skin test. The area injected will be checked after 2 - 3 days and again after 4 weeks to see if there is any swelling or tenderness. Around 3% of people will have a positive skin test preventing them from having treatment with bovine collagen.

The practitioner should take a medical history to make sure that there are no reasons why you shouldn’t have the treatment. Then you will usually 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.

The consultation, skin test (if appropriate), or maybe even an initial treatment might happen in your first visit, if your skin suits the filler recommended and you are comfortable in going ahead with the treatment. If not, you will simply be given a second appointment to begin your procedure.

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 lignocaine (an anaesthetic like the ones used by dentists) is injected into the lip area to help to numb them prior to treatment.

Different injection techniques are used depending on the type of filler and the area being treated.

For filling out wrinkles, 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 employed.

Follow-up treatment

Depending on the type of filler used, and the area treated, top up treatments are usually required to maintain the effect.

Recovery time for Dermal Fillers
Depending on the area treated, and which filler is used, treatment times can vary from around 30 minutes to an hour, 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.
 

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