These are injectable products used to add volume or definition and contouring to areas of the face and can produce immediate rejuvenation with very little down time.
Fillers can be semi-permanent or reversible. Semi-permanent fillers last longer but have a higher incidence of reaction which cannot be reversed and, if severe, may need surgical removal. They can be useful in cases of severe volume loss.
In Australia, 90% of fillers are Hyaluronic Acid (HA), which can be reversed with a substance called Hyaluronidase. HA’s occur naturally in our bodies but the HA’s in fillers are crosslinked or bonded together -the degree of crosslinking determines the thickness and longevity of the product. Thicker fillers are used to volumise areas such as cheeks or temples and thin fillers are used in more delicate areas such as lips. How long the filler remains therefore varies with the type used, but recent studies using MRI have found traces of filler can remain much longer than initially thought.
Talk to your treating doctor about ongoing treatments using filler – you may need annual review.
Fillers can be injected via needle or catheter depending on the treatment site and low volumes are usually used. Common side effects are bruising and some swelling or lumpiness. This can be minimised by ceasing all oral vitamins, glucosamine, fish oils etc a week prior to treatment- these all have antiplatelet activity which causes oozing at the time and increases bruising. Drinking more water over the next 24-48 hours helps with hydration of the skin and ice packs may be useful. Lumpiness can occur and is usually short lived and improved with gentle massage. If any other concerns arise, it is important to contact our clinic for review.
Two important issues with dermal fillers to know about that are very uncommon but important are ulcer formation or skin necrosis and the extremely rare complication of blindness. If a small artery is injected directly with a bolus of filler this may block that artery and deprive the area of skin it is supplying of oxygen. This produces an incredibly painful sensation and you may see redness and small blisters or pustules appearing on the skin. This is an emergency and you need to see your treating doctor ASAP. It can potentially be reversed by a liberal injection of Hyaluronidase into the affected area. Despite these measures, some breakdown of the skin and ulcer formation can occur which will be slow to heal and produce a scar. The use of blunt tip catheters can help minimise this risk. The same bolus of filler into an artery may travel up into the arteries supplying the back of the eye and produce blindness, usually irreversible and requires immediate intervention from your treating Doctor and Eye Specialists. Unfortunately this has occurred around the world in a small number of people. However, fillers have been around for more than 20 years and are generally very safe and are used every day by a huge number of people.
