Dermal Fillers

Due to restrictions from the TGA, the actual name of the dermal fillers cannot be used here. This is because it is a prescription medication and it is illegal to advertise prescription medication directly to the public. 

 

What are Dermal Fillers?

As we age the face loses volume and changes shape. Typically a child or young adult will have full face with the cheek area or mid face being broader than the lower face. As we age, usually beginning in the thirties, we begin to lose volume in the cheek area. This causes flatness and a tired look. As this volume loss progresses there is loss of support for the lower face which exacerbates nasolabial lines (folds between the outer lower nose and the outer lip).  In addition, volume loss between the corners of the mouth and jaw leads to marionette lines and jowls. Volume loss also occurs in the temples, around the eyes and lips. All of these factors contribute to increased heaviness in the lower face and a more square shape as we age. In addition, loss of volume can also cause finer wrinkles in the facial skin generally. This has been likened to the look of a partially deflated balloon. Dermal fillers are injectable substances that can be used to address these issues.

There are a variety of dermal fillers available. By far the most common type of filler are those comprised of synthetic hyaluronic acid. Hyaluronic acid is a naturally occurring substance found in the body and is responsible for helping the skin remain hydrated and plump. The reason that hyaluronic acid fillers are the most popular is due to their natural look and feel as well as their excellent safety profile. Hylauronic acid fillers are temporary and, if necessary, can be dissolved away. Other fillers often last longer but have a much greater risk of side-effects and complications.

Hyaluronic acid fillers come in a variety of brands. Each brand has a range of products. These products vary in thickness or consistency between very soft and thick. Generally thicker products last longer but they have to be injected deeper into the skin and are only suitable for replacing lost volume rather than treating fine lines. Finer fillers are injected closer to the surface and are generally used for filling surface lines and wrinkles. Recently a company called Allergan has released a range of fillers with a new type of technology known as Vycross. The manufacturer claims that these fillers are softer and smoother than older products but with excellent longevity. Many of these fillers also contain a local anaesthetic, which is blended into the filler.  This helps reduce the pain associated with the procedure. 


Where Can Dermal Fillers be Used?

Dermal fillers can be used to replace volume loss that occurs with aging, helping restore a more youthful facial shape and appearance. They can also be used to treat finer lines, particularly around the lips and eyes. Some of the areas that dermal fillers are used for volume loss include:

  • Cheeks. Volume loss in the mid face leads to a tired, aged look. Replacing cheek volume is rejuvenating as well as providing support to the lower face.
  • Tear troughs. Loss of volume under the lower eyelids causes a tired look as well as exacerbating dark eye circles. Filler placed in this area is rejuvenation and can often reduce shadowing and therefore darkness.
  • Nasolabial Folds. These folds join the outer lower nose to the lip corners. Filler softens this fold by reducing the depth of the fold and restoring a more youthful contour to the face.
  • Marionette Lines. These folds appear between the outer lip and the jaw. As these folds increase they cause jowling. Filler can be injected in the corner of the mouth to elevate a downturn. As volume loss increases filler can be used to correct the volume deficit all the way to the jawline if necessary. Use of filler along the jawline reduces jowling and improves jawline definition.
  • Lips. Filler can be used to augment lip volume and help define lip edges and borders.
  • Eyebrow Shaping. As we age looseness in the skin tends to cause eyebrows to flatten and droop. Dermal filler can be used to revolumise and support this area to create a more youthful shape to the brow.
  • Hollow Temples. Hollowness in the temple occurs as we get older and can create an ageing appearance. Filler can be used here to correct the volume deficit and create a more youthful shaped face.
  • Fine lines. Fillers can be used to soften fine lines around the lips, below the cheeks (accordian lines) and around eyes or in the forehead and frown area. Often anti-wrinkle injections are a better choice in some of these areas or anti-wrinkle injections can be used in conjunction with fillers.

Treatment with dermal fillers sometimes does take more than one session to get the best results. The first treatment lays the foundation for the subsequent treatments. The best long term results are usually achieved by regular sessions of smaller amounts of filler. This way the impact of the treatment is lessened, the cost becomes more manageable and adjustments can be made. 


What is the Best Dermal Filler for me?

There are a variety of dermal fillers on the market. Years ago collagen was the most popular dermal filler but it is rarely used these days. Dr Wassall uses a variety of dermal fillers at Skin Integrity. They all consist of a synthetic form of a naturally occurring substance found in the skin and many other areas of the body. They are classified as temporary fillers with results lasting between 3 months and 18 months depending on the product used and the area treated. With repeated treatments results can often last longer. Various viscosities are available for different applications and the thicker products tend to last longer. One of the great advantages of temporary fillers is that they can be dissolved if the patient has an adverse result such as the formation of a lump or if the product is visible under the skin.

Some products are more suitable for injecting close to the surface of the skin for treating fine wrinkles whilst others are designed to be injected deeply to address volume loss and deeper folds and wrinkles. They can all be used for lip rejuvenation with slightly different outcomes.

There is no single "best" dermal filler. The choice of filler needs to be matched to the clients needs and expectations.

There are a variety of dermal fillers on the market which claim to have a life span of many years or decades. Whilst this may sound attractive, they are associated with greater risks. These risks include ongoing lumps, infection and ulceration. These products are firmer to touch than temporary fillers and not suitable for fine lines. Dr Wassall does not use these products in his practice.

Risks

Every procedure involves a certain amount of risk, and it is important that you understand the risks involved. An individual’s choice to undergo a procedure is based on the comparison of the risk to potential benefit. Although the majority of patients do not experience complications, each client need to understand the risks, potential complications, and consequences of dermal filler injections.

  • Redness, swelling and tenderness – This is to be expected in the first few hours following treatment and can be alleviated with ice and cold compresses. Occasionally (less than 10% of patients) swelling and tenderness can be more prolonged. Some cases of swelling have lasted up to 2 weeks but this is rare.
  • Bruising – Bruising may be evident following injection at the site of this procedure.
  • Infection - Infection is unusual but if it occurs may require antibiotic treatment.
  • Lumps – Some lumpiness may develop at the injection area. Once swelling has subsided these can be gently massaged. Occasionally lumps may persist but will eventually resolve when the dermal fiiller has disappeared. If necessary, these lumps can be dissolved by injecting a substance known as hyaluronidase.
  • Product visible under skin – Occasionally a faint blue line may be visible where the dermal filler was injected. This occurs when the dermal filler is injected too close to the skin surface.  It can be concealed with make-up and will resolve when the dermal filler disappears. If necessary, these lines can be dissolved by injecting a substance known as hyaluronidase.
  • Necrosis – This is a very rare complication and is thought t be caused by injection of product directly into an artery. If untreated it can lead to significant ulceration and scarring. If detected early it can be treated by injection of hyaluronidase.  Persistent pain, swelling, redness, whiteness or blistering in or around the treated area requires immediate review.
  • Unsatisfactory result  - There is the possibility of an unsatisfactory result from the procedure.  Minor degrees of asymmetry can often be corrected with additional injections of dermal filler.  

SKIN INTEGRITY OFFERS COSMETIC CLIENTS THE FOLLOWING BENEFITS
  • SAFETY: A genuine medical clinic offering safety, discretion, hygiene, sterility and the ability to deal with emergencies. These standards are not available in Beauty Salons with visiting practitioners.
  • VALUE: The best prices for injectable cosmetic treatments performed by a doctor on the Central Coast.
  • EXPERIENCE: Dr Wassall has been practising Cosmetic Medicine since 2002 and has performed over 10 000 procedures.
  • REWARDS: Cosmetic clients of Skin Integrity will also have the option of receiving access to Special Offers and Promotions. These include discounts on anti-wrinkle injections and dermal fillers.