What are Dermal Fillers?
Dermal fillers are injection based gel-like substance that help to restore volume in the face. There are multiple types of dermal filler products that are separated based on their chemical make up, longevity, and how they interact with your body. These include hyaluronic acid (ex Juvederm, Resylane), polymethyl-methacrylate –PMMA (ex. Bellafill), calcium hydroxylapatite (Radiesse), and polylactic acid (Sculptra). Some last up to 12 months and others are semi-permanent. Regarding being the most popular kind of dermal filler with the highest safety among all other fillers, hyaluronic acid is the go-to product. In our clinic and for this discussion, only hyaluronic acid will be discussed when dermal fillers are mentioned.
Hyaluronic acid is a natural occurring substance that is found all over our body from our skin tissues to the fluid in our joints. Because of this, allergic reactions are very uncommon and no allergy testing is required before use. Once injected, hyaluronic acid acts quickly to restore volume to the area of injection, increasing skin elasticity and smoothing out deep wrinkles and folds. Hyaluronic acid is extremely hydrophilic, meaning that it has the ability to draw in a lot of water, which helps to add volume to the depleted areas in a more natural way as compared to permanent implants.
What Areas Can Be Treated?
Temple hollowing
Under eye hollowing/Tear troughs
Volume loss at cheeks
Nasolabial folds
Volume loss at lips/Thin Lips
Downturn of the mouth/Marionette lines
Volume loss of jawline
Protruding fat at jawline/Prejowls sulcus
Receded chin
Photo Credit: RichmanHill Clinic
What to Expect
Before getting Fillers
Do your homework. Select a creditable injector with proper education, training, and certification. This may take time but will be worth it. Picking someone who is experienced with great outcomes should always trump pricing.
Discuss what you want to achieve with the treatment. Don't be shy to ask any questions or relay any concerns you may have; skin aging, types of fillers, longevity, techniques, pain, recovery, cost, etc. This time is yours to collect all the important information before making the decision.
Plan ahead and do not feel pressured to do the procedure on the same day as the consultation. If you feel rushed and pressured, stick with your gut and leave.
If you have a procedure scheduled
Make sure there are no big events in the week following your planned injection (in case there is any bruising or swelling). Your lips for example may be 30% larger than the final product in the week following injections. Don’t worry, this will go down.
If you are prone to getting cold sores, let the practitioner know ahead of time so they can treat you for it ahead of time to prevent another breakout.
Stay away from the following for the next week if possible: NSAIDs (such as aspirin, ibuprofen, Advil, naproxen etc), fish oil, vitamin E, John's Wort, ginseng, ginger, ginkgo biloba.
Avoid drinking alcohol 2-3 days prior to the procedure.
Take arnica supplements 3 days following to the procedure.
Lastly, BREATHE, and pat yourself on the back for stepping out of your comfort zone.
On the day
Wash your face with water and soap before leaving the house.
It is best to arrive without any make up on, however if that is not an option, you can take it off at the office.
We will go through your medical history to make sure that you are medically cleared (if not done so at the consultation). Because this is a medical procedure, it is important to get a thorough history. There will be consent forms that you will have review and sign.
PICTURE TIME: before images will be taken (only for your eyes and your practitioner's).
Your face will be cleansed with alcohol wipes to make sure the face is free of bacteria before the injection.
After the Injection
You will see immediate improvement (depending on the amount of filler used)!
You may see small bruises from the injection site which usually resolve the following days (within 2 weeks).
Some Do's:
Apply ice to the area to decrease bruising and swelling, being very careful not to apply any pressure.
Continue arnica cream for the next 3 days.
Stay hydrated.
Some Don'ts:
(Many enjoy this part) AVOID exercise or strenuous activities for the next 2-3 days.
Avoid massaging or applying any pressure to the treated areas for the next 24-48 hrs.
Avoid extreme temperatures like heat (sauna) or cold (skiing).
Avoid any skin care treatments (microdermabrasion, chemical peels, facials etc.) for one week.
Avoid extended UV exposure or direct sunlight until the redness/swelling subsides and sites are healed (use sunscreen that is SPF 30 or higher).
Laser (There is limited data on effects of laser treatment on filler treated areas).
What are the side effects?
Most common side effects:
Bruising
Redness
Swelling
Pain
Itching
Less common side effects:
Infections
Lumps and bumps
Discolouration or change in pigmentation
Rare but serious side effects:
scarring, blurred vision, partial vision loss, and blindness if the dermal filler is inadvertently injected into a blood vessel. It is recommended that health care providers take care to avoid injection into blood vessels (especially around the forehead, nose and eyes) for these reasons.
an allergic reaction that may lead to a severe reaction (anaphylactic shock) that requires emergency medical help.
Based on the list, you can see why it pays to do your research. Whether it is a common, less common or rare side effect, it is important to go to an experienced, medically trained practitioner who knows the steps to take to avoid it from happening or treat it if it arises.
Frequent Questions.
Who should not get dermal fillers (Hyaluronic Acid)?
Clients who are allergic (such as anaphylaxis or severe allergies) to hyaluronate or any components of the formulation in the filler.
Pregnancy/Breastfeeding and dermal fillers have not been studied so safety has not been established. It is unknown if the content in the filler crosses the placenta or to breast milk; therefore we don't give fillers or Botox during pregnancy or while breastfeeding.
Any active infections should be treated first before getting dermal fillers.
Will my face look overdone after dermal fillers?
This question is very injector dependent. This look can only be achieved by inexperienced injectors who have strayed too far from the natural look and using way too much product at once. Find an injector that takes their time to map out your face, make a conservative plan, and go slow. The look after the injection should be subtle and refreshed rather than overdone.
Will one syringe of filler be enough?
One syringe may be enough for adding volume to the lips but may not be enough to do a full face restoration. The amount of filler in a syringe is 1ml.
How long do dermal fillers last?
Depending on the type of filler, the brand and the treated area, Dermal fillers can last between 12 months or all the way up to 2 years.
How far in advance should I get dermal fillers before a big event?
Plan to meet the practitioner 2 to 3 months in advance to discuss treatment options to avoid side effects such as bruising or swelling and to receive the maximum effect of the product by the time your big day comes.
Are dermal fillers expensive?
Unfortunately, yes. To be able to find a product that is similar to what your body makes is not cheap. There are many fake products on the market so if it sounds too good to be true, it likely is too good to be true. We currently charge 625$ & 675$/ml of filler depending on brand. We’ve recently added 0.6 ml options for 475$.