Fillers
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1. What are fillers?
As we age, the soft tissue in our fast (especially the fat) starts to dissipate which can leave hollowing, grooving and fine lines. Fillers are substances that are closely modelled on our soft tissue and can be injected under the skin to recreate volume that has been lost. Fillers can be permanent or temporary and are created from 3 main compounds: collagen, hyaluronic acid and calcium hydroxyl apatite.
Fillers can be ‘xenogenic’ – from an animal – an example being bovine collagen, ‘allogenic’ – from a human, ‘synthetic’ – an example being hyaluronic acid which is produced by biosynthesis in the laboratory and ‘alloplastic’ – an example being calcium hydroxyapatite. The type best suited to you will depend on the area being treated and the desired longevity.
2. What are fillers composed of?
This depends on the type of filler used. Dr Macadam and her nurse injector use the following fillers:
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Juvederm (Allergan)
This was the first developed and commercially available hyaluronic acid filler. Hyaluronic acid exists normally within our skin and stimulates production of collagen. With age hyaluronic acid and collagen decrease leading to wrinkles and sagging of the skin. There are a number of products within the Juvederm line that have different bonding patterns and concentrations of hyaluronic acid making it a versatile filler that can be used to fill fine lines, deep lines and enhance facial contours such as the cheeks, lips and chin. This filler lasts 6-18 months depending on the product.
Belotero (Merz Aesthetics)
This is a synthetic (non animal origin, biodegradable) filler composed of hyaluronic acid. Hyaluronic acid exists normally within our skin and stimulates production of collagen. With age hyaluronic acid and collagen decrease leading to wrinkles and sagging of the skin. Similar to Juvederm, Belotero includes a number of products within the line that can be used for fine lines, deeper lines as well as facial contouring, especially for chin projection. This filler lasts 1-2 years.
Teosyal (Clarion)
This is a synthetic (non animal origin, biodegradable) filler composed of hyaluronic acid. Hyaluronic acid exists normally within our skin and stimulates production of collagen. With age, hyaluronic acid and collagen decrease leading to wrinkles and sagging of the skin. This line includes products specifically targeted to create volume (cheeks, lips, chin, jawline, temples), products targeted at deep lines (nasolabial folds, marionette lines), one product specific to the lips, and products aimed to fill fine lines and wrinkles by nourishing the skin from within. This filler lasts 6-18 months depending on the product and typically lasts a few months longer than Juvederm.
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This is an alloplastic filler composed of calcium hydroxyapatite. Calcium beads are suspended within a gel carrier composed of cellulose, glycerin and water. Radiesse is best used for deep grooves such as the grooves that run from the bottom of the nose to the outer lips (nasolabial), lip lines, acne scars and lines from the bottom of the corner of the mouth to the chin (marionette). This filler lasts up to 2 years.
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3. How long do fillers last?
These products have been extensively used by Dr Macadam and her nurse injectors. After a full facial analysis we will give you our opinion on the best product for your specific treatment area. This will depend on the area being injected, skin quality and thickness, the depth of injection required and your preference after you understand all of the options. In our hands, we have found that some fillers are better for specific areas (i.e. Bolotero for chin enhancement, Bolotero or Teosyal for tear trough and Juvederm for temples).
4. How do I choose the best filler?
The most common risk is swelling and bruising which will dissipate within a few days. Asymmetry may also occur and this may be addressed at a follow up visit. The most serious complication of filler injection is inadvertent injection into a blood vessel. In the worst case this can lead to death of the overlying skin. If you experience any pain or change in colour of the skin that was injected you must contact Dr Macadam or her nurse injector immediately as there is a product that is injected to dissolve the filler in this circumstance. This must be done immediately upon noticing symptoms of pain and colour change.
5. Are there any risks to using fillers?
With any filler treatment you will be assessed by Dr Macadam and her nurse injector. A white pencil will be used to mark the areas to be treated after a full facial analysis. Filler will then be injected into the target area which will then be massaged to ensure even distribution. Procedures normally take 15-60min with a 15-30min prep using numbing cream.
6. How does the treatment work?
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Discontinue blood thinners such as ASA and Ibuprofen
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Avoid alcohol for one day before, the day of and one day after treatment
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No vigorous exercise for 48 hours after treatment to minimize the risk of bruising and prevent diffusion in the case of Botox
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If you take medication for oral or facial herpes please consult Dr Macadam prior to treatment
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Avoid retinol for 2 days before and after treatment
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Avoid chemical peels for one month after treatment