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Dermal fillers are an accepted and popular method of treating unwanted facial lines. A number of different products exist for this purpose, most claiming to be better than the next! The commonest filler used in my practice is Restylane. This is made from non-animal hyaluronic acid and is in the form of a clear gel which smoothes wrinkles and folds. The gel binds water within the wrinkle or fold, and as the gel breaks down, water takes its place. The treatment is used for lines on the forehead, between the eyebrows, around the eyes, in the lines around the mouth and to add volume to the lips. The effect of Restylane lasts up to six months but this may be less in areas of excess muscle activity (eg the lips).
The clear gel is injected into the skin in small amounts with a very thin needle. A local anaesthetic cream may be applied to the treatment area 30 minutes to numb the area. For very sensitive areas, such as the lips, a local anaesthetic injection is given under the lips (similar to that given by your dentist). I use lignocaine (xylocaine) injection which acts as a nerve block to numb the treatment areas. Please mention any allergies to lignocaine or any previous problems with dental injections. On occasions I will advice you to massage the area treated but full advice on aftercare will be provided at the time of your treatment.
Some common injection related reactions might occur such as swelling, redness, pain, itching, discoloration and tenderness at the implant site. Other types of reactions are very rare, but about 1 in 2,000 treated patients have experienced localised reactions thought to be due to hypersensitivity. These have usually consisted of swelling at the implant site, sometimes affecting the surrounding tissues.
Redness, tenderness and rarely acne-like reactions have also been reported. These reactions have either started a few days after injection or after a delay of 2-4 weeks and have been described as mild to moderate and are self-limiting.
Although Restylane has not been shown to have any serious complications, it is advisable to avoid treatment if you are pregnant or breastfeeding.
Depending on the site of treatment, I also use other hyaluronic acid based products related to Restylane. These include Perlane and SubQ where more bulk filling is required, or Evolence. These tend to last longer – approximately 9 months. Where even more bulk is required, eg in very sunken cheeks, I use a permanent filler called BioAlcamid.
Please do not hesitate to ask any questions about these treatments both before and after injection.
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