Skin laxity and tear trough are age-related changes, and these changes can be treated with an injection of hyaluronic acid. Its therapeutic modality for violaceous appearance (little or no subcutaneous fat) restores the volume underneath the eyelids.
Dermal fillers are used for filling the nasojugal fold with hyaluronic acid. Hyaluronic acid is an essential component of the cellular matrix found in all tissues; it can retain water to provide hydration and turgor to the skin. It is a polysaccharide with a gelatinous consistency, formed by several interlinked units of disaccharide containing glucuronic acid and N-acetyl glycoasaminoglycan. It can be extracted from tissue or biosynthesized by bacteria through fermentation.
WHO SHOULD AVOID DERMAL FILLER TREATMENT?
- Patients with autoimmune diseases
- Hypersensitivity to products
- History of serious anaphylactic reaction in the past
- Active local disease like acne
- Keloidal tendency
- Unrealistic expectations.
WHICH CONDITIONS REQUIRE CAUTION DURING FILLER TREATMENT?
- History of facial herpes simplex
- History of atopy
- Any past reference of bleeding disorder or use of anticoagulants
- Long term use of immuno-suppressive 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 are the best dermal fillers used in Chandigarh at present and are freely available all over India.
HOW DO WE PREPARE A PATIENT FOR DERMAL FILLERS ?
- Avoidance of aspirin, NSAID's, anticoagulants, vitamin E and green tea for 7- 10 days prior to the treatment to reduce chances of bruising.
- Counselling with regards to calming down the patient, choice of fillers, expectations and product limitation and dermal fillers cost in Chandigarh is essential.
- Photographic documentation.
- Written informed consent consent.
- Removal of make-up from treatment site.
WHAT IS THE PROCEDURE FOR DERMAL FILLERS ?
- Cosmetic dermal fillers treatment requires preparation of the area to be treated.
- Topical anesthetic like prilox may be used 1-2 hours prior to the injection.
- Local anesthesia is required in case of an uncooperative patient
- Patient is to be treated under proper lighting in upright position for gravity to maximize wrinkles.
- All cosmetic dermal fillers treatment 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 waste of material.
- The material is injected in serial puncture, liner threading, fan or cross hatching technique.
- The defect fills up immediately.
- Treated area is massaged lightly to mould the material appropriately and avoid lump formation.
WHAT ARE POST PROCEDURE INSTRUCTIONS FOR A DERMAL FILLER PATIENT?
- Area should not be touched for 6 hours after the treatment.
- Make-up should be avoided for 72 hours.
- Patients should avoid extremes of heat, cold or UV radiation.
- Sauna bath should be avoided for 2 weeks.
- 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?
- Instant result. No down time.
- Easy technique for scar or wrinkle correction i.e punch excision, punch graft replacement etc.
- Does not require special surgical expertise.
- Simple OPD procedure.
- Large area/multiple lesions covered in one sitting.
WHAT ARE THE COMPLICATIONS OF DERMAL FILLERS?
- Bruising, erythema, pain, itching, discolouration.
- Intermittent swelling: Treatment sites may swell up intermittently, often precipitated in few individuals because of alcohol consumption, heat or sun exposure, exercise or caffeine ingestion.
- Local infection.