DERMAL FILLER FAQ

FAQs of dermal fillers

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This page deals with the frequently asked questions on Korean Medical Aesthetic treatments. If you have more queries, feelfree to send it in.

FILLERS

Who can have Dermal Filler Injections?

Any adult who is clinically indicated and deemed fit to make an informed decision about the treatment and its associated risks.

Who can’t have Dermal Filler Injections?

Anyone with the following

  1. Previous allergic reaction to a Dermal Filler or someone with a allergy to Lidocaine
  2. Pregnant or breast feeding mothers
  3. Post plastic surgery patients, and those who havepermanent implants or fillers are also contraindicated for filler treatment.

What are the side effects?

  1. Short term side effects can include redness, swelling, pain, itching, bruising or tenderness at the injection site,
  2. These can be relieved with a cold compress, paracetamol and arnica if you have no allergies.
  3. There is no evidence to date of any long-term safety concerns associated with hyaluronic acid filler treatment, as the body naturally metabolises the product over time.

 

Are Dermal Fillers Safe?

  1. There are many Dermal Fillers in the market.
  2. It is vital to use trusted and reputable Hyaluronic acid Dermal Fillers.
  3. These are the most scientifically documented HA based dermal fillers in the world with comprehensive studies that support their safety and efficacy.

What is the evidence for fillers?

Fillers have level 1 evidence for safety and efficacy from randomised studies conducted since more than a decade ago. This is especially so for hyaluronic acid filers.

Of course fat grafting can also be done, but thats a surgical option.

Can I improve facial balance and symmetry with Fillers ( Restylane, Juvederm, Teosyal)?

Yes facial balance and symmetry can be improved with fillers. The key is finding an injector with a good eye for beauty in order to achieve a natural look, to bring out your best features. I recommend having a consultation with an expert injector.

I am Asian and have thin skin. Will I get lumpiness with fillers?

Asians have a unique facial anatomy, so filler treatment is more focused on the central T zone.

Lumpiness occurs when the area of injected lacks soft tissue volume. A combination of good placement technique in the right injection plane, appropriate filler type and amount would help you achieve good results.

Undereye is a delicate area, so a small volume of extra soft filler would help. Good choices include restylane vital light and redensity 2.

Marionette lines and nasolabial folds require more dynamic fillers. Good choices include Juvederm voluma and Perlane.

I must stress, it is not so much the brand of fillers, but more the injector’s technique, and amount injected, that would help PREVENT lumpiness.

What are the benefits of dermal fillers?

  1. A treatment with dermal fillers provides an easy way to enhance your looks.
  2. The result of a single treatment can be seen instantly and lasts around one year for facial treatments and around six months for the lips.
  3. With dermal fillers you will achieve a natural looking result that does not affect facial expression. Remember, your face changes over time, and treatments with dermal fillers allow you to control you looks naturally as you age.

What are dermal fillers?

  1. Dermal fillers are an injectable substance made from natural and synthetic material and have been developed for injection into the skin to restore its youthful appearance.
  2. Over 30 million people across the world have been successfully treated. The main type of dermal fillers in the market, are a soft gel consisting of stabilized, non-animal hyaluronic acid.
  3. The gel is tissue-friendly and closely resembles the hyaluronic acid that exists naturally in the body. It is long-lasting but not permanent.

Are longer lasting fillers any good?

Many people comment that hyaluronic acid fillers dont last, and they seek a more permanent soluntion. It is common to notice volumisation reduces as swelling subsides a few days after filler injection.

Historically, permament fillers have had a string of complications, from infection to nodules, granulomas etc

There is no antidote for these except surgical excision, leaving behind a permament scar.

It is best to stick to hyaluronic acid fillers as these can be reversed if needed.

What causes static fine lines, and  how can we treat static fine lines?

Static fine lines occur from collagen breakdown due to repeated muscle movement. They often exist around the mouth This is akin to bending a credit card, causing a crease to form from repeated movement.

Your options include filler injection and laser resurfacing.

Soft fillers will help to hydrate and plump up the lines and are your best choice. You can expect up to 75% correction.

What are granulomas and can they occur post fillers?

Granuloma is a delayed foreign body inflammatory condition, suggesting that your body had an adverse reaction to your fillers. It cannot be dissolved. It is not in your best interest to have further filler injections.

If you wish to remove the granulomas, surgical excision is an option, but that in itself is not without risks. Hence it may be better to just monitor it if it doesnt cause you any problems.

Concerned about filler result 3 days post treatment?

3 days is still too early to tell what your final result will be like. Tissue swelling is still present and can persist, depending on the volume and choice of filler. It is best to wait 14 days before doing anything to address your concern.

How to treat superior sulcus hollowing?

Superior sulcus hollowing occurs due to volume loss.

You are right to suggest that your options include filler and fat grafting.

Filler is a non surgical option and is effective with results lasting up to a year. There is a risk of blindness, so it is best to find an expert filler injector who is well versed with the microcannula technique to reduce your risk.

Fat grafting is operator dependent and carries other risks. Results will be more lasting.

Is there a filler that can fill my cheeks, lips and nasolabial fold together?

Fillers vary in density and propensity to attract water. Hence, there is no one size fits all filler that can be used throughout the face.

Cheeks and nasolabial folds respond well to denser fillers.

Lips are a delicate area, so a softer more dynamic filler is advisable to avoid an overdone look.

IMHO, I would suggest going slow and focusing on your top area of concern first to give yourself the best result there, rather than using one type of filler in 3 areas.

Bumps > 3 weeks after filler injection?

Based on the time course, this is not common. Your filler must have been placed superficially.  It is best to seek a formal review with your injector. A small measured amount of carefully placed hyluronidase can clear the bumps quickly.

How to achieve a heart shaped face?

A heart shaped face is a common request here in Asia.

The key is having a beautiful chin, slim jawline and apple cheeks.

What are my treatment options for facial sagginess, flat midface, sunken cheeks?

Midface can be sunken from bone and soft tissue depletion, and that accounts for your sagginess.

Your options include hyaluronic acid filler, collagen stimulators and fat grafting.

Hyaluronic acid fillers have the strongest evidence for safety and efficacy, with several level 1 evidence studies conducted. Of which, Voluma is FDA approved for the midface, with longevity of 18 months on average.

Collagen stimulators, for example radiesse, sculptra take time to achieve peak results and possess mainly level 2 evidence to support its use.

Fat grating is a surgical measure, but is operator dependent.

For a straightforward treatment, I would suggest hyaluronic acid fillers.

2 weeks after volumisation, if you still notice saggy skin, then you may opt for midface thread lift to give your face the extra bit of lift.

How to correct indentation from hyaluronidase?

It is best to wait 2 weeks to see your final result. Then, you may opt for fillers to fill up your indentation, which is essentially an area of volume loss.

I hope this helps.

I am stressed. How can I correct my facial asymmetry?

Most of us have a certain degree of facial asymmetry, and that is what makes us unique.

Your options include seeing a craniofacial surgeon vs an Aesthetic Physician. In addition, it is good to focus on ways to handle stress and build on your positivity.

After mastering the above, you can then consider simple measures, for example lip fillers to lift your left mouth corner and botox to your left masseter to improve the fullness over your left jaw.

Why is chin filler some common in Asians?

​​In Asia, chin fillers is a commonly performed treatment as Asians tend to have a small chin.

Commonly, our chin is small and would benefit from enhancement to increase both the vertical and anterior projection to give us a more defined, 3D look.

Options include a chin implant and chin fillers.

I would start with fillers, then if you like the result, you can move on to a more permanent solution ( implant).

Chin fillers and botox for v shaping?

​In Asia, chin fillers is a commonly performed treatment for V face shaping.

I often combine it with botox to the mentalis to relax the muscle for 3 main reasons.

1. To smoothen the chin

2. To reduce appearance of the mental crease

3. To increase longevity and shape of the chin filler by reducing uneven muscle pull

It is difficult to comment on your case without pictures, so I hope the above helps!

Can I go under the sun after filler injection?

Generally excess sun will not have a major effect on your fillers. However, for good wound healing and recovery, it is best to wait until your swelling subsides, which can range from 48 to 72 hours depending on the amount and choice of filler.

What is hyaluronic acid?

  1. Hyaluronic acid is a naturally occurring substance found in the body that helps to hydrate and add volume to our skin.
  2. Natural hyaluronic acid is broken down by the body in one or two days so is constantly replaced.
  3. As we age this replacement mechanism diminishes so the moisturising and plumping effects of hyaluronic acid decrease. Hyaluronic acid is used for aesthetic treatments, and has also been used for injection into arthritic joints to aid movement as well as eye surgery.

How long is the treatment?

  1. The injection process takes 15-30 minutes.

What areas can be treated with dermal fillers?

Dermal fillers can be used to smooth away facial lines and wrinkles, create fuller lips, shape facial contours and revitalise the skin. The most common areas treated are:

  1. The nose to mouth lines (Nasolabial fold).
  2. Lines around the mouth (Perioral lines and mouth corners).
  3. Natural lip enhancement and definition of the border.
  4. Natural cheek augmentation.
  5. Nose and chin enhancement.
  6. Also can be used for replacing soft tissue volume loss and scar corrections.

Does dermal fillers treatment need pain relief? Will the procedure hurt?

  1. Generally, pain relief is not necessary when injecting into the skin to correct lines and wrinkles. Some people may experience the treatment as a mild discomfort.
  2. A local anaesthetic spray can be applied to the area for a more comfortable treatment experience.
  3. Dermal fillers are also available with the local anaesthetic 0.3% lidocaine included for a more comfortable experience.
  4. Our practitioner will be able to advise you on suitable anaesthesia for your treatment.

Will I notice the difference right away?

  1. Yes, the aesthetic results are immediate. You’ll see the results as soon as your appointment is over—and no one else needs to know!

Will I need to take time off work?

Nope! You can have an appointment in your lunch hour then get right back to your normal routine.

Are there any risks or side effects with dermal filler treatments?

  1. Millions of treatments have been performed with dermal fillers in the past.
  2. Product related reactions are rare.
  3. These reactions include redness, swelling, pain, itching, bruising or tenderness at the injection site. All skin injection procedures carry a small risk of infection.

How long will the effects of dermal fillers treatment last?

One of the great advantages of dermal fillers is that the effects are long lasting but not permanent. The length of the treatment depends on a number of factors including

  1. The area you have had treated
  2. Quantity of dermal filler injected
  3. Quality of skin
  4. Age+ Lifestyle + Health
  5. However, the range of dermal fillers in the market, are proven to last up to one year in (laugh lines) nasolabial lines and six months in the lips.
  6. After the initial treatment, follow-up sessions are normally recommended around every six to twelve months depending on the individual and the treatment.

Is there anything I need to know before I have the treatment?

  1. We advise you to avoid using aspirin or other non-steroidal anti-inflammatory drugs, omega fish oil a couple of days before your treatment (unless they are taken for chronic medical conditions).
  2. Avoiding these medications will reduce the risk of bruising and bleeding at the point of injection.
  3. Ask our practitioner if you have any concerns.

What do dermal fillers treatments involve?

  1. Before treatment
    1. Start by making an appointment with our practitioner. During consultation be prepared to discuss your treatment expectations. After discussion, our practitioner will recommend which treatment is most suitable for you.
    2. After the consultation, and if you are happy to proceed, your practitioner will help you complete a medical assessment and you will need to sign a consent form before treatment can progress.
  2. During treatment
    1. The dermal filler is injected into the skin in small amounts using a very fine needle.
    2. The gel provides natural volume to smooth away the appearance of lines and wrinkles, enhance facial shape, or create fuller lips. Dermal fillers improve the elasticity and texture of skin, restoring and maintaining the skins hydro balance.
    3. The treatment is quick, typically taking about 15-30 minutes. Treatments with dermal fillers do not affect facial expression and the benefits can normally be seen instantly.
  3. After treatment
    1. Dermal fillers are biodegradable, which means they will naturally disappear in the body.
    2. To ensure an optimal and long lasting result, a top-up treatment is recommended six to twelve months after your initial dermal filler treatment. This will discuss during the consultation with our practitioner. And a follow-up appointment can be arranged.
    3. After a treatment some reactions might occur, these include; are slight redness, swelling, itching, bruising, pain and tenderness. The reactions are generally mild to moderate and usually disappear shortly after injection. They typically resolve spontaneously within one or two days, but for some treatments they may last longer.

Can everybody use dermal fillers?

  1. DO: Most people can benefit from dermal fillers treatment. If you wish to reduce lines and wrinkles, create more defined or fuller lips, define the contours of your face, or boost your skin’s vitality, for a healthier more hydrated skin tone.
  2. AVOID: Dermal fillers have not been tested in pregnant or breast-feeding women, Individuals with medical conditions that lower the body’s immune response or individuals undergoing therapy that is immunosuppressive may be more prone to infection by a skin injection procedure.
  3. During your consultation, our practitioner will carry out a full medical assessment and discuss your needs for treatment.

Are there different dermal fillers products?

  1. There is a range of different dermal fillers designed to be used at different levels in the skin to meet your treatment needs and maximise your treatment results.
  2. Discuss with our practitioner during your consultation what type of products suits your needs best.

Do I need to take a skin test?

  1. No skin test is required as hyaluronic acid dermal fillers do not contain any animal-derived ingredients.

Can dermal fillers be used if I have had laser treatment or a chemical peel?

  1. If you have recently had a light laser or chemical peel treatment, so long as there is no skin wound, you are good to go.

When will I need another injection?

  1. Many patients like to book touch-up injections as well as repeat injections to maintain the effects of treatment.

 

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