Frequently asked questions about fillers

Immediately after the treatment there may be slight redness, swelling, tenderness and an itching sensation in the treated area. For most patients, swelling subsides overnight. However, a small proportion of patients (5%), have additional swelling that may last for up to 5-days. Light concealer make-up can be applied even 5-minutes after treatment. Avoid touching or massaging the treated area for 6 hours after the treatment. The area can be gently washed with soap and water.

Until the initial swelling and redness have resolved, do not expose the treated area to intense heat (e.g. solarium and sunbathing) or extreme cold. If you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another eruption of cold sores. If you have a cold sore, treat as normal with topical acyclovir ointment.

Avoid taking aspirin or any similar medication, unless medically indicated, for two days to minimise bruising, as these medications may increase bruising and bleeding at the injection site.

Dermal fillers can be made from different materials. At The Harley Street Face Clinic, we only use fillers that have the ‘Gold-Standard’ level of safety (Termed FDA approval). These fillers are made from hyaluronic acid (termed HA fillers). HA is a naturally occurring sugar that exists in our skin, joints and nerve tissue. Hyaluronic acid in fillers is manufactured and contains no animal products, hence allergies and reactions to the filler are very rare.

We use different hyaluronic acid fillers in separate parts of the face, as each has unique characteristics that favour specific areas. For example, some fillers have ‘Water-Loving’ (termed hydrophilic) properties and are best suited to areas around the cheeks. However, they would not be suitable for around the eyes. Fillers we advocate include: Restylane, Juvederm, Voluma, Volbella, Princess and Volift.

One of the advantages of filler treatment with dermal fillers is that results are relatively instant, and can be seen at the end of the treatment.

Treatment length is dependent on several factors including:

1. Type of filler
2. Technique of filler application
3. Location of Filler
4. Lifestyle.

Newer generation fillers are made to last longer and have scientifically been proven to last 18-24 months. The technique of filler application can help the filler to last longer when it is placed deeper down with a cannula technique at the level of the natural cheek bone. Fillers in certain areas of the face last for much longer. Around the eyes (we have had patients maintain filler for 4 years), and the nose tends to maintain fillers for a long time.

There are also genetic and lifestyle factors that influence the duration of results. Excessive aerobic exercise may influence filler duration. On average filler last for between 12-18 months.

Most non-surgical techniques take between 45-60 minutes to complete the procedure. Each treatment includes a full consultation to ensure we understand the look you’re trying to achieve.

We use a combination of techniques to minimise discomfort, including:

– a powerful numbing local anaesthetic cream that is specially made for The Harley Street Face Clinic.

– the state-of-the-art no-needle cannula technique

– the fillers we use include anaesthetic in their ingredients

– we use additional numbing and vibration devices that utilize the Nobel Prize-winning research on ‘The Gate Control Theory of Pain”

At The Harley Street Face Clinic, we take the above measures to ensure patients are comfortable at all times.

With time the hyaluronic acid (a type of sugar) is broken down naturally and reabsorbed by the skin. This means that over time your results will slowly fade but the occasional top-up treatment at The Harley Street Face Clinic will maintain your appearance.

Although hyaluronic acid filler enhances appearance, once they dissolve, the natural soft tissues will remain. As a normal part of ageing each year there is some natural loss of fat volume, some effects of gravity and loss of natural skin elasticity.

At The Harley Street Face Clinic we believe that it is of paramount importance to practice ‘safe treatment’ with fillers, and we would advise against undergoing treatment if you are pregnant or breastfeeding. There are no scientific studies that show that it is or is not dangerous for pregnant or breastfeeding mothers to use dermal fillers. However, we would not advise undergoing treatment until you have completed breastfeeding your baby.

We are committed to providing our patients with ‘safe treatment’. We administer fillers consistent with UK regulations and guidelines that have been developed to support patient welfare. At this time, we would not advise or perform filler treatment on any individual under the age of 18.

Restylane is a type of hyaluronic acid filler that treats wrinkles and lines. It is a crystal-clear gel manufactured from a type of sugar called hyaluronic acid and water. The gel is a biotechnologically produced version of hyaluronic acid, a tissue friendly substance that occurs naturally in the body. Restylane is not made from any animal products and is not a Botox.

Restylane is a non-surgical treatment that can be repeated as often as you like. Most patients choose to have a follow-up treatment 6 to 12 months after their initial treatment. A touch-up treatment within 2-4 weeks after the initial treatment may be necessary to achieve an optimal correction. Clinical experience indicates that follow-up treatment normally requires a smaller amount of the product.

Juvéderm Voluma is an FDA-approved injectable hyaluronic acid volumiser that recontours the face to restore volume to the chin, cheeks, and cheekbones that have become hollow or thin due to weight loss or age-related facial fat loss. Immediately after treatment with Juvéderm Voluma, you should notice that your facial contours appear fuller and rounder, giving your face a softer, more youthful appearance. Voluma is an innovation because the gel offers a substantially longer effect up to 18 months.

Juvéderm is a type of hyaluronic acid that is used in facial tissue to smooth wrinkles and folds, especially around the nose and mouth. Hyaluronic acid is a naturally occurring sugar found in the human body. The role of hyaluronic acid in the skin is to deliver nutrients, hydrate the skin by holding in water, and act as a cushioning agent.

Juvéderm has ‘Water-Loving’ (termed hydrophilic) properties and these are best suited to areas around the cheeks and lips. However, it would not be suitable around your eyes.

n a US clinical study, 146 subjects were followed for 24 weeks after injection with Juvéderm SMILE injectable gel in one nasolabial fold (NLF) and ZYPLAST® dermal filler (bovine-based collagen) in the other.

Injection-site responses were similar in duration and frequency for the Juvéderm SMILE injectable gel and ZYPLAST®. Side-effects were mild or moderate in severity, did not require intervention, and lasted 7 days or less. However, Juvéderm SMILE injectable gel was found to provide a more persistent wrinkle correction than ZYPLAST® dermal filler over the 24-week course of the study.

The percentage of subjects who maintained improvement with Juvéderm SMILE injectable gel at 24 weeks was 88% compared to 36% with ZYPLAST® dermal filler. At the conclusion of the study, 129 (88%) of the 146 subjects expressed a preference for Juvéderm SMILE injectable gel, while only 8 (5%) expressed a preference for ZYPLAST® dermal filler, and 9 (6%) had no preference.

Subjects who completed the 24-week study were invited to return for a complimentary repeat treatment. Subjects returned at their (or their doctor’s) convenience, rather than at a prescribed time point. Of the 146 subjects, 116 (79%) returned for repeat treatment, on average at 9 months after their last injection. Forty-eight (48) subjects returned more than 36 weeks (9 months) after their last injection: the percentage of those subjects who had maintained improvement with Juvéderm SMILE injectable gel was 75%.

At multiple time points in the clinical study, subjects’ nasolabial folds were rated on a scale from 0 to 4: 0 none, 1 mild, 2 moderate, 3 severe, 4 extremes. Using this 5-point wrinkle assessment scale, the mean improvement since baseline was 1.9 at 2 weeks, 1.4 at 24 weeks, and 1.1 beyond 36 weeks after treatment.

A subset of these subjects enrolled in a second study that followed subjects for 24 to 48 weeks after repeat treatment. Twenty-four (24) subjects were enrolled in the study. Twenty-three (23) were evaluated at 24 weeks (6 months) after repeat treatment with 87% maintaining improvement. Nine (9) subjects returned for evaluation 48 weeks (1 year) after repeat treatment: the percentage of those subjects who had maintained improvement with Juvéderm SMILE injectable gel was 78%. The mean improvement since baseline at different time points after repeat treatment was 1.4 at 24 weeks and 1.3 at 48 weeks after repeat treatment.

Be sure to report any redness and/or visible swelling that lasts for more than a few days, or any other symptoms that cause you concern, to your doctor.

The treated areas must not be exposed to intense heat or extreme cold for the first few days after treatment. This is to avoid the risk of inflammation since the area has been disturbed. The gel will not harden or soften as outside temperatures change. Saunas and steam rooms should also be avoided for the first few days after Treatment.

Feeling good about how one looks is important for self-esteem and confidence. It helps create a sense of well-being. Many women, and an increasing number of men, want to maintain and enhance their looks in a subtle and natural way, without going to the extremes of a surgical facelift or more invasive techniques. Hyaluronic Acid fillers make this possible and help hold back the years. There is no need to feel guilty about feeling good!