Introduction to Cosmetic Injectables
A cosmetic Injectable is a non-surgical cosmetic procedure which uses the botulinum toxin to induce muscle paralysis and make lines and wrinkles less obvious. Results are usually seen within 3-5 days.
What are Cosmetic Injectables?
A Cosmetic Injectable is a non-surgical cosmetic procedure which uses the botulinum toxin to induce muscle paralysis and make lines and wrinkles less obvious. Results are usually seen within 3-5 days and only the treated muscles will be affected by treatment. Unaffected fascial muscles will work as before to allow normal expression of the face.
Which is the best dermal filler?
Dermal fillers can be biocompatible or synthetic and offer many treatment options. The best filler will be the one that is most appropriate for the area treated and your requirements.
What can dermal fillers be used for?
Fillers are used to fill hollows that may result due to ageing or weight loss, deep lines and wrinkles and can also be used to add volume to the cheeks and lips and in non-surgical nose jobs.
Fillers may be required and used in conjunction with Botox; when it has not reduced deep wrinkles sufficiently.
Dermal fillers can also add volume to:
- Cheeks, to create the appearance of higher, more defined cheekbones
- Lips, to create fuller lips with more volume or shape.
- Jawline and Temples
- Recessed scars can also be filled in to make them less noticeable
Non-surgical rhinoplasty also uses fillers to smooth out bumps and create more definition to the nose and tip if required.
What are the different types of dermal fillers?
1. Calcium hydroxylapatite based fillers
Brand names include:
Calcium hydroxylapatite, is a mineral-like compound found in bones and stimulates collagen production. The effects last between 12 to 18 months.
2. Hyaluronic acid wrinkle fillers
Brand names include:
- Prevelle Silk
Hyaluronic acid is present in the body and adds volume to the skin.
The treatment area will impact how long the results last. Fillers containing Hyaluronic acid will last a maximum of 18 months. In areas of the face where there is a lot of movement, such as the lips, the results will not last as long.
3. Collagen-based dermal fillers
Brand names include:
New methods of processing natural collagen and synthetic collagens
have reduced the risks and complications previously associated with collagen injections. Collagen injections are reported to last up to 5 years.
4. Synthetic wrinkle fillers Polylactic acid or Polymethyl-methacrylate microspheres (PMMA)
Brand names include:
Synthetic wrinkle fillers stimulate the skin to make more collagen and can last up to two years, although maintenance injections, after one year may be required.
5. Autologous (fat) Filler
Fat can be purified after being removed from another area such as the abdomen, thighs or buttocks. The fat can then be injected into the area you want treated, to smooth out lines and wrinkles or add volume. You will likely need more than one treatment with multiple injections. The effects can be permanent, although your skin can also reabsorb the fat.
6. Platelet-rich plasma injections
Platelet-rich plasma can be retrieved from your blood and injected into the face to smooth out wrinkles and deep lines. Results will last between 12 to 18 months.
7. Silicone Injections
Liquid silicone is not permitted to be injected into the skin in the UK or USA, although it is used in both France and Italy. There are high risks of inflammation and migration which often leads to additional surgery and can result in permanent deformities.
What can I expect prior to receiving cosmetic injectables?
A topical anaesthetic is applied 20-30 minutes beforehand to numb the area.
What happens during the procedure?
Multiple injections of dermal filler will be used dependent on the area treated and the amount of difference in shape and volume you require. This can feel uncomfortable and may sting. Once the injections are complete the filler may then be manipulated by your treatment provider, to improve the shape of the area treated.
How long will it take to recover after dermal injections?
Normally you will notice some stinging and swelling in the area that has been treated. This will normally only last a few hours although may persist for up to two days. Most patients go back to work or other daily activities immediately.
It is essential to avoid touching or pressing the areas where the filler has been injected. Occasionally you may be advised to massage the area if any lumps appear or the filler starts to feel firmer. You must follow all instructions carefully to prevent impacting the results.
To help prevent infection you must not shower or use any skin products and make up, for a minimum of six hours to prevent infection. To help prevent changes in the pigments of the skin, you should apply sunscreen every day. You must not wear heavy glasses or sunglasses for a minimum of two weeks.
What are the risks and complications of dermal filler?
Dermal fillers are considered to be safe but side effects can occur.
The most common risks and problems include:
- Feeling the filler beneath the skin
- Lumps and/or granulomas
- Skin rashes
- Swelling and bruising,
- Mild bleeding
- Local edema (fluid build-up) and/or erythema (reddening of the skin)
- Infection, and, or scarring
Serious complications can result in:
- Decreased vision and blindness
- A severe infection or bleeding
- Death of skin cells (necrosis)
What happens if I am not happy with my dermal filler?
Multiple treatments may be needed to give you the volume or fullness you desire. Lumps and bumps can normally be manipulated by your treatment provider. You may also be shown how to do this yourself, to smooth them, if they occur.
When you want volume or fullness reduced it may be possible to remove some or all of the filler, however, the majority are not easily removable. You also need to allow time for the results to settle down.
How long will dermal filler last?
The length of the results will depend on your physiology, the type of filler selected, the area treated and how many treatments you have had previously. The majority of fillers will last between 6 to 12 months, although some claim to last up to two years or have permanent results.
Should injectable fillers and Botox be given by a surgeon?
It is highly advisable to use a plastic surgeon who has the training and skills to help to prevent complications occurring.
Registered nurses can also receive specialised training in injectables, always ask to see their certificates to prove they have had appropriate training and are qualified.
Questions to ask prior to treatment with fillers
- Why have you recommended this treatment, type of injectable?
- When will I see the results?
- Will I need multiple treatments?
- Will the results improve over time and how long will it take for the full effect to be apparent?
- How long will the results last?
- What are the risks and complications associated with this type of filler/Botox injection?
- How many patients you have treated in the past 12 months have had complications?
- Did any of your patients need surgery following a complication?