Dermal Fillers

WHAT IS AN IDEAL DERMAL FILLER?

A safe and effective dermal filler treatment must possess the following features:
1. Easy to obtain, inject and store
2. Non-antigenic and non-inflammatory
3. Long- lasting but biodegradable
4. Natural looking and not too expensive
5. Non-migratory and stable
6. Non-toxic, non-carcinogenic
7. No risk of inducing allergic/hypersensitive reaction
8. It must produce pleasing cosmetic results
9. Minimal side effects

WHO CAN GET A DERMAL FILLER TREATMENT DONE?

Patients with the following indications can opt for cosmetic dermal filler treatments in Chandigarh:
1. Depressed scars

• Post surgical.
• Traumatic.
• Resulting from acne or other diseases.

2. Wrinkles and creases caused by facial movements and ageing
3. Lip sculpting
4. Dermal atrophy from disease or injection of steroids
5. Under-eye dark circles and sunken eyes

WHO SHOULD AVOID A DERMAL FILLER TREATMENT?

1. Patients with autoimmune diseases
2. Patients with hypersensitivity to products
3. Patients with history of serious anaphylactic reaction in the past
4. Patients with active local disease like acne
5. Patients with keloidal tendency
6. Patients having unrealistic expectations.

WHAT ALL CONDITIONS REQUIRE CAUTION DURING FILLER TREATMENT?

1. History of facial herpes simplex
2. History of atopy
3. History of bleeding disorder or use of anticoagulants
4. Current or long term use of immunosuppressive therapy

WHICH ARE COMMONLY USED DERMAL FILLERS?

Bovine collagen, hyaluronic acid derivative implant and human derived collagen are the most popular implant material used today. Out of all, Hyaluronic Acid (HA) derivative is the most-widely used dermal filler at present in India.

HOW DO WE PREPARE A PATIENT FOR A DERMAL FILLER TREATMENT?

1. Avoidance of aspirin, NSAID's, anticoagulants, vitamin E and green tea for 7-10 days prior to the treatment to reduce chances of bruising.
2. Counselling with regards to making the patient feel comfortable about the treatment. Discussions intended to calm him/her down, information about the choice of fillers, expectations and product limitation are essential. The cost of getting a dermal filler treatment done in Chandigarh is also talked about during counselling.
3. Photographic documentation.
4. Written informed consent.
5. Removal of make-up from treatment site.

WHAT IS THE BEST PROCEDURE FOR DERMAL FILLERS?

1. Preparation of the area to be treated.
2. Topical anesthesia may be used 1-2 hours prior to injection.
3. Local anesthesia is required for upper lips and in cases of non-cooperative patients.
4. Patient is to be treated under proper lighting in upright position for gravity to maximize wrinkles.
5. All dermal fillers come with pre-filled syringes and desired gauge needle (26-32G) depending on particle size. The needle should be screwed carefully onto the syringe to avoid any waste of material.
6. The material is injected in serial puncture, liner threading, fan or cross hatching technique.
7. The defect fills up immediately.
8. Treated area is massaged lightly to mould the material appropriately and avoid lump formation.

WHAT ARE POST PROCEDURE INSTRUCTIONS FOR A DERMAL FILLER PATIENT?

1. Area should not be touched for 6 hours after the treatment.
2. Make-up should be avoided for 72 hours.
3. Patients should avoid extreme heat, cold or UV radiation.
4. Sauna bath should be avoided for 2 weeks.
5. Chemical peels, laser treatment etc. should not be spaced out for at least 2 weeks to avoid inflammatory reaction.

WHAT ARE THE ADVANTAGES OF DERMAL FILLERS?

1. Instant results. No down time.
2. Easy technique compared to other procedures for scar or wrinkle correction like punch excision, punch graft replacement etc.
3. Does not require special surgical expertise.
4. Simple, OPD procedure.
5. Large area/multiple lesions can be treated in one sitting.

WHAT ARE THE COMPLICATIONS OF DERMAL FILLERS?

a) Bruising, erythema, pain, itching, discolouration.
b) Intermittent swelling: Treatment sites may swell up intermittently, often precipitated in few individuals by alcohol consumption, heat or sun exposure, exercise or caffeine ingestion.
c) Local necrosis.
d) Local infection.