Dermal & Lip Fillers

Hyaluronic Acid Dermal Fillers 

Dermal/soft tissue fillers are made from hyaluronic acid (HA); a safe and naturally occurring substance (sugar molecule) which exists in the human body.

HA fillers are manufactured by cross linking hyaluronic acid and binding with a liquid agent proven for its safety, stability and biodegradability, known as 1,4-butandiol diglycidylether (BDDA). This stabilises the filler and ensures its long lasting effects.  Fillers work by augmenting or replacing lost volume at the point of injection in the dermis.  In addition, hyaluronic acid is excellent at attracting and retaining water, thus providing a hydrated, smoother and more youthful appearance.

Fillers are used to fill out fine, moderate and deep lines, wrinkles and folds, provide definition, enhancement and volume or to correct contour or feature deficiencies, including asymmetry and scarring.

Treatment Areas

Typical treatment areas include lips, upper and mid face/cheeks, nose labial lines, marionette lines, oral commissures, forehead lines, chin (mentalis crease), jawline, tear troughs and pre-jowl/jowl areas. 

Practitioner Level

Dermal fillers should only be administered by an aesthetics practitioner who is a qualified, registered and insured healthcare professional.  It is recommended that the injecting practitioner is also a prescriber, so that they can respond quickly to any clinical complications, should they arise. Although complications are rare, they do happen from time to time and require urgent clinical intervention to resolve.

Brands

Popular brands used by Skin&Spirit include Belotero®, Juvederm®, Restylane® and Teosyal®.  If you have a preferred brand of filler, Skin&Spirit will be able to order this in for you, as long as it is appropriately CE marked and supported with published, valid clinical and safety data.

Downtime

You can expect some redness and swelling at and around the injection points and potentially some bruising, which may not appear until a day or two after the procedure.  

Most redness and bruising can be covered with make up and general swelling typically reduces after 2-3 days.

Before Treatment

An initial consultation is required for all new clients, during which a medical history and clinical assessment will be undertaken.  You will be provided with a full explanation of the procedure, its clinical/aesthetic benefits, the risks, aftercare and the consent process and you can ask as many questions as you need to make an informed decision.  We recommend that you go away and think carefully about the information you have been provided and conduct your own research before consenting to treatment.  

After the initial consultation has taken place (or a review consultation for existing clients), the treatment time itself takes approximately 30 - 60 minutes, depending on the number of areas treated and whether local anaesthetic is required.

You should arrive at the Skin&Spirit clinic 10 minutes prior to your appointment time, ideally with a make up free face (but we can remove this for you if not) and having not drank any alcohol or taken any non steroidal anti inflammatory drugs (eg. aspirin, ibuprofen) in the previous 24 hours.

If you have been prescribed some topical anaesthetic (numbing cream), you will have been given instructions on how and when to apply before arriving at the clinic for your procedure.  Please do not remove it before seeing the practitioner.

During Treatment

If local anaesthetic (injectable) has been agreed upon as part of your consultation, this will be administered after cleaning and preparing your skin.  If you have been prescribed a topical anaesthetic (numbing cream), you will have already applied this at home (as it needs to be on your skin for up to one hour) and your practitioner will remove this for you in clinic.

After preparing your skin, you will receive injections of HA filler, either via cannula or needle at your chosen sites of treatment.  

If you have opted not to have any anaesthetic, you can expect a little discomfort due to the injection (the needle is larger than the needle used for anti ageing injections to allow the filler to flow through); the more injection points, the more discomfort.  However, most clients cope very well and there is generally no residual pain.  Cannula injections are particularly well tolerated as there is usually only one needle injection point per area.  

Some clients experience a little bleeding at the point of the injection; this is quite normal and to be expected.  Redness and swelling is a common immediate side effect.

After Treatment

The results from receiving dermal fillers are immediate, ie. you will see lines, wrinkles and folds immediately filled.  The overall aesthetic result for each person will vary and depends on the severity of their lines and wrinkles before treatment and the amount of filler opted for.  The best aesthetic result is typically seen at least 2 weeks post treatment when any residual swelling, redness and bruising has settled and thereafter. 

A follow up appointment is offered to all clients 2 weeks post treatment to ensure there are no complications.  

Fillers are temporary but long lasting at approximately 12-18 months, although every person is unique and we all metabolise at different rates.  However, in and around the lips, fillers last up to 6 months, because the peri-oral area is more active due to eating and talking.  As hyaluronic acid naturally draws in moisture, in addition to plumping out lines, you may also notice that the skin around the areas of injection is generally improved and appears more hydrated and youthful.

Risks and Complications

Published clinical data provides compelling evidence of the aesthetics/client benefits and safety profile of hyaluronic acid as the main ingredient of dermal fillers.  Evidence shows that the main risks and complications associated with dermal fillers are either due to aesthetic practitioners and clinics choosing to use a brand and type of filler which does not have sufficient published clinical and safety data; or risks associated with the injection process.

Complications and adverse reactions that can arise from receiving dermal fillers include an allergic/sensitive reaction to hyaluronic acid, other filler ingredients or drugs/products used throughout the process, eg. topical anaesthetic; triggering a new episode of dormant herpes simplex type 1 (known also as cold sores) due to trauma to the peri-oral area; bacterial infection; delayed onset of nodules (when filler clumps together and forms a hard lump, some time after the original treatment); or a haematoma forming (a swelling of clotted blood).  All of these risks are generally reversible or treatable (assuming your aesthetics practitioner is also a prescriber). 

However, the most serious risk associated with dermal filler treatments is that of vascular occlusion (VO); where some of the filler product is inadvertently injected into a nearby blood vessel, causing restriction of blood flow to surrounding tissues.  The likelihood of this happening to you is very rare, but it does happen.  Skin&Spirit follows a strict clinical protocol to reduce the chances of a VO occurring in the first place, such as ensuring accurate knowledge of facial anatomy, proper injection technique (drawing back prior to slow and steady injection), the use of cannula rather than needle for high risk areas and monitoring clients for 10 minutes after treatment to check for good blood circulation and capillary refill times.  However, in the unlikely event that a VO did occur, Skin&Spirit would dissolve the hyaluronic acid filler using a prescription only drug called hyaluronidase, which melts the filler almost immediately, so you can be assured that you would be in safe hands, should this rarity occur.  

This is why it is critical that your aesthetics practitioner is a qualified healthcare professional who can also prescribe for and manage any clinical complications.  Also, be extremely wary of clinics and practitioners offering cut price filler treatments.  Ask specifically for the brand and name of filler at your consultation and then do your research!  In the aesthetics industry, you really do get what you pay for.  

Clinical complications arising as a result of treatment received at Skin&Spirit are managed with no cost to the client.  Note that dissatisfaction with the aesthetic result is not a clinical complication.  However, in this event, Skin&Spirit would endeavour to work with the client to resolve any aesthetic concerns.