DERMAL FILLER

As with all our treatments, each client has individualized needs, and the treatment plan and cost will be determined and discussed with each patient prior to injection.  For full face correction, it is anticipated that each client will need one syringe of HA filler per decade of life to replace lost volume.  Although that may seem like a lot, each syringe of dermal filler contains only 1/5th of a tablespoon of product.

A thorough consultation, assessment and education will be provided by your injector during your first visit.  Your long-term goals, expectations, desired results & treatment plan will be discussed.  Our goal is to provide the most comfortable, painless experience possible for our clients.  Prior to your injection, anesthetic numbing cream is applied to the anticipated treatment areas.  Anesthetic injections may also be conducted for complete numbing in highly sensitive areas.  

Typically, dermal filler injections take between 1 - 2hours.  Each patient brings a unique canvas to our studio.  We ensure adequate procedure time for each client to ensure we are achieving symmetry and balance to facial structures.  

Make sure to schedule dermal filler injections at least TWO WEEKS prior to special events as bruising and swelling is common and may persist for up to 14 days.  

PRIOR to injections we ask that you avoid the following:

• Avoid blood-thinning medications such as aspirin 10-14 days prior to your procedure.  If you are prescribed anticoagulants by your cardiologist, medical clearance is required to stop these medications.  Your risk of significant bruising is much higher with anticoagulation therapy.
• Please avoid NSAID’s (Ibuprofen, Motrin, Naproxen, etc.) 24 hours prior to injections.  Tylenol may be taken, and is the preferred analgesic prior to your appointment.
• Avoiding Vitamin E, ginseng, ginkgo and garlic supplements 5 days prior to your procedure can also help minimize bruising.
• Please refrain from alcohol 24 hours before your procedure.  
• To minimize risk of infection, it is MANDATORY that you avoid all dental work, including cleanings, TWO WEEKS before and after your dermal filler injections
• Notify your provider if you have a history of cold sores.  Lip filler may trigger an outbreak, and prophylactic antiviral medications may be prescribed prior to your appointment.

NOTE: Some studies have shown Arnica tablets may also be effective in preventing or reducing bruising after injections.  You may take Arnica tablets 7-10 days prior to your appointment.  

A noticeable lift, fullness and softening of folds and wrinkles in the areas of injection will be noticeable immediately.  Tissue bruising and swelling are very common, and may persist up to TWO WEEKS.  The final results of your injections will occur between 4-6 weeks, as bruising and swelling have subsided and the filler integrates with your normal tissue. 

Some clients may feel that their injections didn’t work after the swelling subsides and volume decreased slightly.  That is not the case!  Expect 25% of the volume to dissipate after the first two weeks.  It may be that you desire a fuller, plumper look and need additional filler to achieve effect you are seeking.  

Dermal filler injections have virtually no down-time, and most activities can be resumed after injection. The following guidelines will provide the best outcome after your procedure:

AFTER INJECTIONS:

• Avoid vigorous exercise for 48 hours to help minimize bruising and swelling.
• Keep head elevated while sleeping as much as possible for the first 48 hours to help decrease swelling.
• Avoid saunas, or hot tubs for 24 hours.
• Avoid sun exposure, or NSAID’s (Ibuprofen, Motrin, Naproxen, Aspirin) while bruising is present.  Tylenol is preferred for analgesia during this time. 
• Do not massage or manipulate the area for 24 hours after your injection.  You may wash your face  gently and apply makeup as usual the next day.
• Avoid any facial procedures for two weeks after your injection.  This includes toxin, lasers, Ultherapy, facials, etc.  The first two weeks, dermal filler remains very malleable.  As noted, it can take 4-6 weeks for the filler to integrate with your normal tissue. 

All FDA approved dermal fillers are considered safe because most are temporary and are made from materials the body breaks down and absorbs naturally.  As they are temporary, injections will have to be repeated as the substance is metabolized to maintain the desired effect.  

Temporary fillers include the following materials:

• Hyaluronic acid: a sugar naturally found in the body
• Calcium hydroxylapatite (Radiesse): a mineral and a major component of natural bone
• Poly-L-lactic acid (PLLA)(Sculptra): biodegradable, synthetic material
• PMMA (Bellafill) is the only permanent dermal filler that is not absorbed by the body.  It is made of PMMA beads suspended in bovine (cow) collagen. 

Even though dermal fillers have an excellent safety profile, side effects can occur.  Common side effects include:

• Swelling, 
• Bruising, 
• Tenderness, 
• Pain at injection sites
• Itching or rash.  
• A rare but serious side effect is unintended injection into blood vessels, leading to vascular occlusion.  This side effect is rare and can be reversed with temporary (reversible fillers) by dissolving the offending agent.  

A note for your safety: Always ask and ensure you are receiving an FDA approved, properly labeled, sealed, brand name filler provided by a licensed practitioner.  Catastrophic events can occur with black market products, from unlicensed providers.  Do not buy dermal fillers sold directly to the public – they may contain silicone, be fake and/or contaminated.  Serious illness and death can occur.