What the Heck are “Dermal Fillers”??
By: Christine Dale, BSN-RN, CLHRP
“Under Eye Troughs”
….the list goes on and ON!
It’s 2017, and our health and cosmetic needs and regimens have changed DRASTICALLY, from previous generations! We now have injectable options that bridge the gap between the relaxing facial and cosmetic surgery!
These injectable products are an attractive option for our health-conscious clients, who have little time for recovery or down-time, without breaking the bank!
(We want it safe, affordable, comfortable, and NOW!)
Let’s Talk Volume Loss…
Like it or not, we all age! Starting about your mid 20’s, we start experiencing the effects of aging (slowing of collagen production, decrease in oil production, slower skin cell turnover rate), that begins to become visible in our late 20’s-early 30’s.
One aspect of the aging process is loss of volume from the face!
(And, you thought your teenage acne was bad!)
As we lose volume from various parts of the face:
The lips become more shriveled.
The corners of the mouth turn down.
The eye sockets start to look hollow.
We start noticing lines going down our cheeks, when we smile.
We notice the deepening of “nasolabial folds” (smile lines).
We start noticing the weight from the mid-face becoming a burden on lower areas (think jowls and jawline droopiness!)
Got your attention??? It’s all like a bad horror movie….And, BONUS!!! These changes are not limited to the face-Lucky us!
(The woman in these pictures is NOT having a fun time, ya’ll!)
(Reminds me of the movie scene where the Wicked Witch of the West melts away!)
Grandma’s night cream-while cheap, will not tackle this issue! To plump our puckers back up and re-round out our apples, we need a substance that can be placed directly in the area of need (via injection) and thick enough to make visible, but natural-looking results!
Enter dermal fillers….
The Options are Overwhelming...
Juvederm©, Restylane©, Prevelle©, Beletero Balance©, Elevess©, Radiesse©, and on, and on, and ON!....
Assuming you have correctly self-identified the need for volume restoration, now comes the daunting task of choosing the best dermal filler option, and the right health care provider to administer it!
These soft tissue fillers can be classified by material (see handy-dandy FDA chart, by clicking on the link below!)
There are a lot of questions you need to ask, in order to get the results you are looking for (at the very least…):
1. How long does it last?
Each product can last up to a different amount of time. Some hyaluronic acid fillers, such as Juvederm© and Restylane© last up to one year. Radiesse©, which is made of hydroxylapatite (aka calcium microspheres), can last around the 12-18 month mark. Sculptra Aesthetic© (which is actually classified as a bioactive injectable), can provide results that last up to 2 years. With most dermal fillers, you will be able to see some immediate improvement to the area injected, with “final results” being achieved at about the 10-14 day mark.
2. What’s it made of?
Products such as the Juvederm© family and Restylane© family, are generally made of hyaluronic acid (HA). In short, HA works to keep skin safeguarded and continually renewed. It also has the ability to attract and hold significant amounts of hydration for the skin.
(Incredibly, just 0.03 ounces of HA can hold as much as 6 liters of water!)
The bioactive injectable, Sculptra Aesthetic©, works a little differently from a traditional filler, in that the poly-L-lactic Acid (PLLA) that is injected into the tissue, causes significant collagen production, bearing results after about the fourth week, post-procedurally. Poly-L-lactic Acid has been around for quite some time, and is favored for its biodegradable properties (think, body-friendly!) In fact, its versatile properties have even been in the creation of some types of coronary (heart) stents!
3. How experienced is my injector?
None of your research will matter, if you choose an injector who is not experience, skillful, or does not offer the product of your choice! Look for these qualities, in the skilled professional you choose:
• Education-How much experience do they have injecting? What did their training consist of? How familiar are they with the anatomy of the face? Am I comfortable with them? Do they have a plan, in case of a complication? (Yes, I said it-COMPLICATION…While no one PLANS to have one, if it happens, and you have NO PLAN at all, you could experience a lot of unnecessary stress and suffering-to say the least!)
• Artistic Ability- Believe it, or not, administering dermal fillers is the perfect marriage between science and art! Our faces are not symmetrical! The ability of the health care professional to address the imperfections of the face, lies in both their raw artistic talent and in the knowledge of how that specific product can be expected to perform. (Ask for before and after pictures.)
• Product Availability-It takes a lot of time and practice to become fluent in multiple dermal fillers. Many times, a health care practitioner will only offer one or two products (keeping overhead down, familiarity with a product, product preference, etc.). Be open to discussing what needs your technician can address with each product offered, and don’t be afraid to inquire about their willingness or experience with a product not offered!
(Maybe your technician is offering you one product over another, because it’s cheaper for you; find out!)
*Note: some injectors are trained in the use of BONTA’s (Botox©, Dysport©, etc.), in combination with fillers, to help in achieving your desire results-lucky you, if that’s your technician!
4. What’s the cost?
Generally, fillers are priced per syringe. The exception is Sculptra Aesthetic©, which is priced by the vial or by the kit (2 vials in a kit). Prevelle© runs around $400, for a 0.75 mL syringe, while Juvederm Ultra XC© can be in the neighborhood of $700, for a 1 mL syringe. From the Restylane© family, Restylane Lyft© can be purchased for approximately $600, for a 1mL syringe. (Some companies offer half-syringes, in their products, as well.) Each area may need a different amount of product. For example, to perform one session of lip augmentation, for increased volume, may take 1-1.5 mL of product (depending on the product), or more. Be prepared to need a follow up session, with more product being injected, depending on how much correction you desire. (Helpful tip: sign up on the company’s rewards program! Most filler companies now offer these!)
5. What’s the maintenance?
Nothing lasts forever, unfortunately, and filler is no exception! Think of fillers as a process. Each session should put you closer to where you want to be. Each person metabolizes differently, and therefore, will biodegrade fillers at different rates. (This is where that established trust in your technician will really shine!) Ask your injector about a maintenance plan. Since, we know, up front, that these results will need to be maintained, it pays to be proactive in this department! Ask about upcoming events and sales that could be used in planning your follow up sessions.
5. Let’s talk pain!
The number one question on everybody’s mind is “will it hurt”???.....
The bad new-YES!
The good news-this can be minimized!
-Look for an injector who changes needles throughout the procedure. The sharper the needle, the less pain and bruising!
-Ask about numbing agents! (Some products contain lidocaine pre-mixed!)
-Request assistive devices! The Vibrata© was designed to vibrate the area to be injected, and goes a long way in preventing pain!
-Relax! The more relaxed you are, the less uncomfortable it will be!
-Ice is NICE! Chill the area with ice, before-hand. Cold skin is numb skin!
-Take a break! An experienced injector goes a long way in techniques to reduce discomfort!
The level and amount of discomfort experienced is subjective, and varies, from person to person! Getting cheek filler is typically minimally uncomfortable, while lip injections may be more uncomfortable.
(Another interesting fact, is that many fillers are being used on the body, as well! Backs of hands are being injected for volume loss! Pads of feet are being injected, for high-heel connoisseurs! Ear lobes that have deflated are being plumped back up! Upper breast/chest areas are being targeted to get rid of the dreaded “cleavage wrinkle”! Butts are receiving much-needed attention in the form of injections, to promote lifting, smoothing, and cosmetic contouring!)
Christine Dale, BSN-RN, CLHRP, is a Master-Level Cosmetic Injector, practicing at Simply Beautiful Medical Spa, in Gassville, Arkansas. Christine is renowned for her talent in cosmetic injectable procedures, often traveling to other states, to perform and educate on dermal fillers. Her clients often marvel at the fact, that she does her own facial injections!