DERMAL FILLERS ADVANCED

Dermal fillers are gel-like substances made up of hyaluronic acid, which are injected beneath the skin. The aim is to restore lost volume, smooth lines and soften creases to create a smoother appearance. 

Dermal filler can be injected into different parts of your face, including the cheeks, around the mouth, into the chin and also the jawline, as well as lip fillers which are administered directly into the lip tissue. 

We do have a special section especially dedicated to lip augmentation so please look there for more information. 

The fillers used in my clinic are temporary as they are eventually absorbed by the body. Most dermal fillers today consist of hyaluronic acid, which is a naturally occurring polysaccharide that is present in our skin and cartilage. The effect lasts for approximately six months or up to 12 months if using the Vyross range. Successful results depend on the health of the skin and the type of filler used. Some people may need more than one injection to achieve the wrinkle-smoothing effect.

An In depth knowledge of how fillers work, the physical and the chemical properties of the products are vital within aesthetic practice. Having a sound knowledge of the molecular structure of a filler is so important, as it is certainly not a case of one filler suits all. The anatomy of the face, including the nerves and blood vessels are also essential to reduce the possibility of complications.

My favourite products are Juvederm fillers, which include the Vycross range and the Ultra range. These tend to last and are used by many top clinics. 

1. Improving the appearance of the nose to mouth lines; the Nasolabial folds:

Figure 1. Nasolabial folds

Deep nasolabial folds can be corrected with injections of dermal filler .The goal of nasolabial fold (NLF) injections is to even out the skin volume, leaving you with a smoother, refreshed-looking appearance.

NLF are common wrinkles that form alongside your inner cheeks. They stretch from the bottom of your nose to the corners of your mouth.

Everyone has these wrinkles to some degree, but they tend to get deeper with age, along with other factors that include sun damage, and smoking which are the biggest culprits of deepening nasolabial folds. The sun’s ultraviolet (UV) rays break down the collagen and elastin fibres in your skin, which are responsible for keeping it smooth and supported. 

Typical aging can also play a part, even without sun damage or smoking. As you age, the structure of your cheekbones flatten out, which can cause the skin of your cheeks to sag or droop downwards. Add to that years of gravity tugging on your skin and the natural decrease in collagen and elastin, and you have the perfect recipe for wrinkles, loose skin, and nasolabial folds.

2. Improving the lines from the corners of the mouth to the jawline; the Marionette lines.

Marionette lines are facial wrinkles that occur with natural aging. The lines run vertically between the corners of the mouth, and down to the chin. 

The lines are a common result of the natural aging process that includes a combination of depleting fat (and other facial tissue underneath the skin) with a loss of skin elasticity.

Genetics can also play a key role in the development of marionette lines and how prominent they become. In fact, genetically susceptible individuals can begin to develop some degree of marionette lines during their childhood.

If you already have fairly prominent marionette lines, these lines can be softened with the use of dermal fillers, and support can be added to improve the appearance. Juvederm can be used to restore lost volume for a plump and youthful appearance. Radiesse for the jawline will add definition to the jawline and thus support for the marionette lines, while instantly adding volume back into the skin , utilizing an ingredient that stimulates the production of collagen over time.

3. Creating definition to cheeks, or lifting the jowl area through cheek augmentation.

Over time the facial fat pads in the upper and mid face atrophy (waste away), while those in the lower face tend to become fuller (hypertrophy). As deeper fat pads decrease with age (for example deep in the cheeks) this reduces their support of the superficial fat pads, which can then begin to sag.Shallow cheekbones ultimately represent the aging effect of gravity.

By adding volume to the areas of the cheek that has lost volume, a lift can be created to the lower face, thus helping to reduce the sagging jowl area. 

High cheekbones are associated with youthfulness. SYMMETRY IS EVERYTHING: High cheekbones can be a sign of a more symmetrical face. Many of my clients achieve beautiful high cheekbones, with product placement in specific areas along the cheek. 

1ml to 2ml of Product may be required in order to achieve symmetry, lift or a chiselled/contoured look. 

4. Contouring the Chin to create a more youthful appearance.

 Whether you are troubled by a weak chin, a dimpled chin or a double chin, there are treatments that can be combined to redefine your chin to the prominence you desire.

Many of us by-pass the chin when we think about the beauty and definition of the face, focussing instead on lips, cheeks and eyes, yet the chin is a vital component which creates facial proportions that are considered optimal for beauty. 

Dermal fillers are used effectively in my clinic to create a little length, or definition to the chin. Any lines on the chin can be softened, and I have had great results for those clients who do not like the large crease or large single dimple along the contours of the chin, known as a cleft chin. 

5. Contouring the Jawline to create a more defined look, and improving the jowl area.

Jaw enhancement injections are a fast, non-surgical way to enhance the look of your jawline and decrease the appearance of jowls. By smoothing the contours of the jaw, it also increases the definition in this area. 

A strong chin and streamlined lower face are important elements of attractiveness, adding definition, creating symmetry, and bringing balance to facial features. 

For individuals who desire more definition in this area following dermal fillers. Other treatments can be used such as Deso fat dissolving injections, which can also be used to slim the double chin.  The use of neurotoxin can also be used to tighten the neck, for example the Nefertiti lift.  

6. Reducing the appearance of the lines around the lips, often called smokers lines, otherwise known as Perioral lines.

Perioral lines are the linear, vertical wrinkles that spread out from the border of the lips. These often start as very fine lines, but can become deeper and more pronounced over time.

The 'perioral' area of your face is the area immediately surrounding your mouth. This includes several features such as the upper lip area under the nose, and the corners of the mouth.

Dermal fillers are used in my clinic effectively to create smoothness and volume in this area. The results are a reduced appearance of lines. Often Botulinum toxin can be used in conjunction with fillers, to lessen the lines around the lips.  

7. Improving skin hydration, firmness and luminosity through Skin booster injections.

  Injectable moisturisers are intended to make your skin look and feel better, but don’t change the shape, volume or muscle movement of your face. Injectable skin boosters are becoming more and more popular for my clients of all ages, who are becoming more aware of the latest trend for Glass skin. Glass skin refers to a complexion that is plump and hydrated, with a glossy appeal. 

These treatments are injected into the skin to improve the appearance of your skin on your face, neck, décolletage and hands. The treatment involves administering tiny droplets of the product, which is directly injected under the skin. Numbing cream is generally applied as it can be a little sensitive at times. 

I love to use Juvéderm® HYDRATE which is part of the Juvéderm® ULTRA family of dermal fillers. It contains hyaluronic acid (HA) as well as the anti-oxidant, mannitol. 

Juvéderm® HYDRATE is designed to improve skin hydration and elasticity by replacing HA lost through ageing. It is not a traditional filler; instead it acts as a hydrating agent, attracting moisture, retaining it within the skin to maintain a head turning healthy glow. 

Benefits of skin boosters:  

    Smoother appearance around the décolletage (the delicate area around the neck)

    Improving the firmness of the skin around the mid face, including cheeks and lower face accordion areas.

    Creating a more even complexion.