Following on our previous article, Clinical applications of Botox, is the other very trending topic of dermal fillers.

One of the most frequent query that clients present to the aesthetic practitioner, is requesting to understand the difference between Botox and dermal fillers. It is a probably the most common question posed to our clinic. This may be the result of a many new clients becoming more aware of the availability of aesthetic treatments and at times younger population seeking aesthetic treatment options.

The main difference between the two, is that Botox is used to reduce the lines and wrinkles that are formed as a result movement /muscle activity. Botox is used to “paralyze” these muscles of expression, thus reducing wrinkles associated its action.

Dermal fillers are usually composed of hyaluronic acid – this is essentially a sugar (polysaccharide) that is present in the skin and cartilage. Dermal fillers are injected into the skin to increase / restore lost volume on the face and assist in smoothing out lines and wrinkles.

Dermal fillers usually vary in consistency or viscosity, with the thicker more viscous fillers being used in areas that require a high lifting or sculpting effect (eg, mid face /cheeks, jawline and chin). The area of the lips and eyes require a much thinner filler, that allows for greater pliability / moulding of the dermal filler, to achieve desired results.

Fillers are usually a temporary treatment with longevity varying from 6-18 months on average. Lip filler tends to wear out faster than fillers done on the nasolabial area. Lifestyle factors such as excessive smoking, consuming of alcohol or excessive exercise can also hasten the degradation of the product and reduce longevity of the product.

The most popular areas treated usually include, mid face / cheeks, nasolabial folds, tear trough (under eye area) and lips. In more recent times, there has been an increasing number of requests to perform filler augmentation in the following areas:

  • jawline and chin augmentation
  • non- surgical rhinoplasty (using dermal fillers only)
  • eyebrow lifts

Fillers usually take about two week to settle in before one sees optimal results. Should a client feel that they require a top up or are dissatisfied with the appearance, they should reassess only after this time period.

Especially for those new to aesthetics, there are often questions relating to the do’s and don’t’s before having dermal filler injections.

It is usually recommended that at least 1 week prior to  treatment, that clients stop medication such as aspirin, ibuprofen or similar, avoid fish oils, ginkgo biloba and Vitamin E. This is suggested to decrease the possibility of bruising that may occur after using injectables.

It is exceptionally important to choose your aesthetic practitioner wisely. Always ensure that all your necessary questions have been answered. Even more important, is to ensure that both yourself and the practitioner share the same expectation of the desired treatment. This will ensure patient satisfaction. Also be mindful of any aesthetic advice issued by the practitioner. Often clients need to be assisted, advised and guided as to best desired outcome – this is often determined by a variety of factors including age of patient, skin condition and anatomy of the face.

Whilst we often highlight the aesthetic aspect of dermal fillers, it is important to remember that injecting a substance into the face is ultimately a medical procedure and as such, the necessary precautions need to be considered.

The ultimate goal of injecting dermal fillers is to achieve an aesthetically pleasing result. However a client may experience certain side effects. Common “side effects “ include redness, swelling, bruising and bleeding. Clients can also occasionally experience a skin rash, itching or pimples. Occasionally clients can also experience numbness.

It is important to note that there may be “initial side effects“ that should  resolve over time . For example, a client may have an initial overfilled appearance. There might also be palpable lumps / hard areas over the injection sites. These will settle over time.

A frequent question amongst clients new to aesthetic medicine is “what is the best age to get dermal fillers injected?” The exact answer to this question varies depending on several factors:

  • Determining factors often include skin condition / texture
  • Past and present exposure to sun damage
  • Personal preference.

It is an increasing trend to adopt a prophylactic approach to aging, with many clients starting to use both Botox and dermal fillers in smaller doses to help prevent or combat the signs of aging. Clients often also compliment injectables with a good skincare regimen and other adjunctive aesthetic treatments such as face peels, lasers and thread lifts.

Another huge concern is the safety profile of dermal fillers. Manufactures have reported great advancements in dermal fillers over the last two decades. Whilst they boast a huge safety record, it must be noted to clients during a consultation that there are occasions where clients have developed lumps / granulomas, rashes etc. A practitioner should always try his / her best to limit such complications. A thorough history, an adequate “refill / top-up “ period, using of similar / same products as previously injected and using a  good quality product, can help limit or decrease the sensitivity to the development of granulomas.

Practitioners are commonly questioned about the longevity / permanence of dermal fillers. There are both temporary and permanent dermal fillers. Temporary dermal fillers contain hyaluronic acid and lasts between 6-18 months depending on type of filler, area injected and lifestyle factors of the patient. These are the most widely used type of dermal fillers. The result is usually obtained from their hydrophilic (ability to attract water) effect resulting in a more natural appearance. Permanent fillers are used very infrequently, as one of the biggest challenges associated with them is their inability to adjust to the skin and bone changes that occur as we age.

Overall, dermal fillers have allowed for significant improvements to the facial structures, assisting  with the signs of aging and to achieve a more aesthetically pleasing result. There is an overwhelming trend to adopt a non surgical approach to facial aesthetics and this has resulted in a phenomenal increase in the use of dermal fillers to achieve amazing facial transformations without undergoing surgery!