Dermal Fillers in London UK

For a non-surgical way of combating wrinkles in facial skin as it ages, people are increasingly turning to dermal fillers as a safe and relatively non-invasive procedure. The popularity of dermal fillers comes partly because of their speed of effect and safety and efficacy record but also due to the modern understanding of how the face in particular, ages.

Aside from the surface damage caused by environmental factors such as sunlight, exposure to the world at large with all its pollutants and also very importantly cigarette smoke, the major factor in causing sagging of the skin and an aged appearance is depletion of the larger fat deposits contained within the layers of the skin and beneath. Lack of moisture within the skin itself and depletion of collagen may also have an adverse effect of the way the skin "shines".

Dermal fillers are used for facial tissue augmentation, and are injected into the skin to plump it up and make it firmer. Effects are instant, resulting in deep lines being smoothed away and the natural volume of the face and its radiance beng replenished. There are a number of different forms of fillers and the common and safest ones are based on a natural component of human skin tissue, hyaluronic acid. In the main there are two major brands, Juvederm and Restylane and each comes in a range of different types which are useful in different areas of the face and body.

Dermal fillers can be used on any area, but are most suitable for :
o    Reducing lines or grooves between the nose and mouth, and around the lips.
o    Plumping up the lips.   
o    Volumising cheeks.
o    Redefining chin area.    
o    Improving contour of the bridge of the nose.  
o    Reducing the appearance of acne pits or scarring.  
o    Improving the appearance of depressions or pockmarks due to injury or disease, for example, chickenpox blemishes.
o    unevenness in the skin after surgery or skin grafting
o    supplementing the use of laser treatments to the chest area which is particularly prone to sun damage through the years.

In the 1970’s, dermal fillers contained substances such as silicone and bovine collagen implants, but research has greatly improved the active ingredients. Now Freedomhealth’s Aesthetic Nurse, Lee Garrett, favours the use of one of the most tested and widely-used products.

Restylane is based on hyaluronic acid, a complex sugar which is present in skin and cartilage and exists naturally in the body to carry and bind water. Restylane is a man-made version but almost identical to the human hyaluronic acid, differing by only 1%. Consequently the body accommodates it relatively easily, and no pre-treatment test is usually required.

A recent study reported that fillers like Restylane could actually promote collagen growth without increasing collagen breakdown. The study by Wang in Arch Dermatol 2007 Feb compared injections of restylane and injections of saline into alternate arms of a number of volunteers. The study showed a 100 fold increase in the amount of collagen produced by the restylane injections compared with saline, suggesting that the formation of collagen was not just a stretching effect produced by injection of fluid or the effect of the needle being introduced into the skin but as a direct result of the interaction of the modified hyaluronic acid on the skin texture.

The Procedure – what to expect :

Firstly, the treatment area is numbed with a cream containing local anaesthetic. The dermal filler is then applied via injection directly into the treated skin. The process takes about 30 minutes, and people should expect a little discomfort, especially during deep injections to the cheek area, but not more unpleasant than a mild bee sting. Restylane contains the local anaesthetic lidocaine and after the very first injection will numb up the area quite swiftly. Occasionally a nerve block will be used to ensure the patient’s comfort.

Results are immediate as hyaluronic acid delivers nutrients and hydrates the skin to plump a targeted area and temporarily remove wrinkles.

Possible side effects :

Treatment with injected fillers in most people results in localised redness, slight swelling and minor discomfort, though these should fade away within a few days. Minor bruising may occur. Bruising can be minimised by using arnica tablets for the few days prior and after the procedure. In addition, if patients are taking drugs such as ibuprofen, aspirin, plavix, warfarin etc they should discuss these with their dermal filler injecting clinician. These drugs are not absolute no-no’s in terms of who can be treated but they do carry extra risks of bruising particularly, making it all the more important to have a medically qualified clinician consult with and inject the patient. This always happens at Freedomhealth.

Patients should avoid putting any undue pressure on the area for at least two days to give the injected gel time to set. High heat should also be avoided for a short period, especially excessive sun exposure, sauna’s and steam rooms etc.

People with a history of cold sores may experience a recurrence after treatment, although this can be minimised by the use of antiviral medicines.

Anyone who experiences severe skin allergies may not be suitable for injections, especially those who have ever experienced anaphylactic shock. Anaphylaxis with hyaluronic acid products made by reputable suppliers such as the Restylane company Q-Med aesthetics and also the company making Juvederm is extremely unlikely.  Existing problems with allergies of any type should be discussed in depth with a Doctor first.

How long do injectable fillers last?

Injectable fillers will usually last from six months to a year before being broken down inside the body. Semi-permanent fillers can last up to two years, while permanent fillers can last up to ten years or more.

At the end of that time the fillers do not simply disappear but there is a gradual fading of the effect. This is usually apparent to the patient and a further top up can be useful in terms of restoring the original effect.

Specialist Nurse Lee Garrett is expert at injecting both male and female clients. He attends and contributes to many teaching courses for doctors and nurses around the UK and Europe and is used by the Restylane manufacturer to demonstrate best practice injection technique.