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Frequently asked questions about fillers

What do I need to do before filler treatment?

Notify your clinician of any allergies or medications Pregnancy and breastfeeding are contra-indications to treatment. Alcohol intake should be reduced at least 24 hours before treatment. Medication such as aspirin may cause bruising as will high doses of vitamin E are best avoided before having treatment for up to two weeks Sunbeds, waxing, electrolysis, and laser should be avoided at least 48 hours before treatment. Pain sensitivity may be heightened at certain times (pre-menstrual or following excessive alcohol intake). Risk of cold sores may be reduced by the use of acyclovir (Zovirax®) tablets.

What do I need to do after filler treatment?

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 smaller 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 and light make-up can be Applied.

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, be aware that these medications may increase the bruising and bleeding at the injection site.

What are dermal fillers made from and how do they work?

Dermal filler 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 manufactured from hyaluronic acid (termed HA fillers). HA fillers are a naturally occurring sugar that exists in our skin, joints and nerve tissue. Hyaluronic acid is manufactured, it contains no animal products, hence allergies and reactions to the filler are very rare.

What products do you use?

At The Harley Street Face Clinic we only used fillers that have the ‘Gold-Standard’ level of safety (Termed FDA approval), these fillers are manufactured from hyaluronic acid (termed HA fillers). We use different HA fillers in different parts of the face, as each has unique characteristics that favour specific areas. For example, some fillers have ‘Water-Loving’ (termed hydrophilic) properties, that are best suited to areas around the cheeks, however, would not be suitable around your eyes. Fillers we advocate include: Restylane, Juvaderm, Voluma, Volbella, Princess and Volift.

How long does it take to see the results?

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

How long will I expect to see the results last for?

Treatment length is dependent on several factors

  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. Technique of filler application can aid longer duration when the filler 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, in the eyes (we have had patients maintained filler for 4 years, and the nose tend to maintain fillers for 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.

How long will my filler enhancement procedure take?

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

Will I experience any discomfort or pain?

We use a combination of treatments to minimise discomfort, these include the use of a powerful numbing local anaesthetic cream that is specially made for The Harley Street Face Clinic. We use state-of-the-art no-needle cannula technique to minimise discomfort. We use fillers that have incorporated anaesthetic into the injectable fillers to increase patient comfort.

At The Harley Street Face Clinic we use additional numbing and vibration devices that use the Nobel Prize-winning research on ‘The Gate Control Theory of Pain” to minimise Discomfort.

At The Harley Street Face Clinic, we take the above measures to ensure most patients only experience minor discomfort.

What happens to the dermal filler in my cheeks over time?

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 and occasional top-up treatment at The Harley Street Face Clinic will maintain your appearance. When the results fade, will my appearance be worse than before?

Although hyaluronic acid filler enhances appearance, once they resolve, 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.

I’m pregnant or breastfeeding, can I still have my cheeks done?

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 to use dermal fillers with pregnant or breastfeeding mothers, however, we would not advise undergoing treating until you have completed breastfeeding your baby.

I am a teenager can I have lip fillers?

At The Harley Street Face Clinic we believe that it is of paramount importance to practice ‘safe-treatment’ with fillers that are consistent with UK regulation and guidelines developed to support patient welfare. At this time we would not advise or complete fillers to any individual under the age of 18.

What is Restylane?

Restylane is a type of hyaluronic acid filler that treats wrinkles and lines. They contain 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 can be repeated as often as you like. Most patients choose to have a follow-up treatment 6 to 12 months after 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 require a smaller amount of the product.

What is Juvéderm Voluma?

Juvéderm Voluma is an FDA-approved injectable hyaluronic acid volumiser that recontours the face to restore volume to 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 should notice that your facial contours appear fuller and rounder, giving your face a softer, more youthful appearance. Voluma was an innovation in that the gel offers a substantially longer effect which has been shown to last up to 18 months.

What is Juvéderm?

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 to act as a cushioning agent. Juvaderm has ‘Water-Loving’ (termed hydrophilic) properties, these are best suited to areas around the cheeks and lips, however, would not be suitable around your eyes.

What did the Juvéderm clinical study show?

In 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® dermal filler treated sides, were usually mild or moderate in severity, did not require intervention, and lasted 7 days or less. 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 extreme. 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.

When should I notify my doctor?

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.

What happens to my treated skin in the sun or in the cold?

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.

How can I justify spending money on my looks?

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 and makes this possible and helps hold back the years. There is no need to feel guilty about feeling good!

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