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Fillers

Dermal fillers are substances designed to be injected beneath the skin to restore facial volume including plumping cheeks and reducing shallow or deep line.

It is also used to volumize chins, to give more definition to jawlines, to fill groove in temples and to give more volume to thin lips. Depending on the type of filler used, the results may last from 6 months to 3 years. 

Dermal fillers are often used in combination with Botox to give the overall refreshed appearance.

Time

40 ~ 60 min

Anesthesia

Topical Cream

Hospital care

None

Downtime

None

Recommended for

  • Who wants to get facial volume enhancement 

  • Who wants to reduce the presence of wrinkles 

  • Who wants softer and smoother skin appearance 

Types of Dermal Filler

  •  Hyaluronic acid

Brand such as Juvederm, Restylane, or Belotero 

 

Hyaluronic acid (HA) is naturally found in many types of body tissues, including skin, connective tissue and joints. Among its many biological functions, HA is important in tissue hydration, joint lubrication, immune response, and tissue repair. In the skin, it is a major component of the natural skin barrier. HA is a humectant, which means that it can hold moisture which can bind up to 1000 times its volume in water. This contributes to its effectiveness as a dermal filler as it pulls and retains water, enhancing the volumizing effect while also adding hydration. The physical and chemical properties of HA can be altered by manufacturers to influence their products’ performance and outcomes. The modifications include the particle size of the HA used, degree of cross-linking between molecules, the concentration of HA, and the consistency and viscosity of the gel. These variations account for differences in the effectiveness, longevity, and appropriate injection sites of different HA dermal fillers. HA fillers are made from biodegradable, non animal and stabilized HA so it gives very natural appearance

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  • Polymethyl-methacrylate microspheres (PMMA)

Brand such as Bellafill​

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Bellafill is dermal filler composed of biocompatible PMMA microspheres with collagen base. When Bellafill is injected, your body absorbs the collagen and the microspheres remain in place. It works to provide continued support after the collagen has been absorbed by your body and replaced with your own. PMMA is considered a semi-permanent filler as results can last up to 5 years. It can be used to correct smile lines and certain types of depressed acne scars.

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  • Polylactic acid (PLLA)

Brand such as Sculptra 

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Filler that composed of Poly-L-Lactic acid is a synthetic filler. This type of filler works slightly differently as its polymer result in an irritation of the skin which subsequently increase fibroblastic activity thereby stimulating the body to produce new natural collagen in the treatment area. This can add to the filling effect and produce long-lasting results for up to two years. 

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  • Calcium Hydroxyapatite

Brand such as Radiesse

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Calcium hydroxylapatite is a mineral-like compound found in bone. This type of dermal filler works similar to Sculptra in the sense that they stimulates production of collagen within the skin, although they differ from Sculptra fillers as they can also be molded and shaped to provide improved definition or contour to the face. It is used for the correction of moderate-to-severe facial wrinkles, to add volume to the cheeks and jawline,

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Side effects

Dermal fillers are quite safe and most side effects are mild and resolve without treatment

  • Redness, swelling and bruising due to minor tissue trauma

  • Discomfort that can be reduced by using a filler with lidocaine or a topical anesthetic

  • Mild itching and/or rash

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More serious side effects that may require treatment are rare; these include:

  • Infections at the site of injection

  • Nodules from local tissue reaction

  • Filler migration or poor aesthetics 

  • Injury to blood vessels if accidentally injected into a blood vessel. This can lead to tissue death (gangrene) or blindness if a clot forms and move to the vessels that supply the eyes

Before your filler treatment 

  • The most common side effect is bruising and swelling. It is NOT advisable to have injections less than 2 weeks before the big event.

  • To avoid bruising, it is best not to take any pain relievers or any anti-inflammatory that are blood thinners like ibuprofen and aspirin (Aleve, Advil, Motrin). Take acetaminophen instead: Tylenol.  Please consult your physician if you are taking Aspirin or any other blood thinning medicine for medical reasons! 

  • Avoid certain supplements including St. Johns Wort, ginko biloba, primrose oil, fish oil, omega 3, ginger, ginseng, garlic pills and Vitamin E for 1 week. They are all blood thinners. 

  • Avoid alcohol prior to treatment and for a few days after treatment since it helps blood circulation and act like blood thinner. 

  • Sunburned skin is difficult to treat so avoid exposure to the sun.

  • Avoid waxing, bleaching, tweezing, or hair removal cream on the area to be treated for 3 days prior.

  • Avoid topical products such as Tretinoin (Retin-A), Retinols, Retinoids, Glycolic Acid, or alpha hydroxy acids higher than 10% for 3 days prior to the day of treatment.

  • Inform the doctor if you have a history of perioral herpes or facial sores to receive advice on antiviral therapy prior to treatment. 

  • Always inform your doctor of all medications you may be taking as well as your medical history.

  • Do not use dermal fillers if you are pregnant or breastfeeding, are allergic to any ingredients, or suffer from neurological disorders. Please inform us if you have any questions about this prior to your treatment.

Post care after filler procedure

  • Do not rub or stimulate the site of injection

  • Avoid the sauna for one week after the procedure

  • Avoid smoking or drinking

  • It is advised that treatment with the homeopathic oral medication, Arnica Montana, begin the day before treatment to help promote healing and minimize bruising and swelling. Arnica is available at health food super markets such as Whole Foods.

  • Take Bromelain. Bromelain, a supplement derived from pineapple stems, may reduce bruising and swelling by breaking down blood proteins.

  • Incorporate foods abundant in bioflavonoids into your diet. Bioflavonoids help to strengthen your blood vessels and connective tissue. Foods rich in bioflavonoids include oranges, berries, grapes and green beans.

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