Dermal fillers, often referred to simply as fillers, are an injectable treatment of either naturally occurring or synthetic material into the skin to restore volume, reduce visible signs of aging, sculpt, plump and shape. In contrast to the injectable neuromodulators that relax facial muscles, dermal fillers will fill in wrinkles, plump and volumize, with naturally occurring hyaluronic acid, autologous fat injections, collagen products or biostimulatory material such as calcium hydroxylapatite (CaHA). It is essential to master different kinds of filler as they are used for different procedures within your clinic. Having a great mastery of the ins and outs of dermal filler treatment will help you better educate your patients on the best course of treatment for their desired results. As with any cosmetic treatment, it is vital to remember that risks are possible, and results may vary. These include, but are not limited to bruising, infection, nodules and the most concerning vascular occlusion.
Mastering Filler for Lip Injections
Juvéderm, Revanesse and Teoxane are examples of hyaluronic acid-based injectables that are commonly used for lip injections. Hyaluronic acid (HA) is a naturally occurring substance in the body and can be injected to improve the volume and redefine the shape of the patients’ lips. The lips require a softer HA, which is applied with a needle or cannula for application. Often a topical numbing gel is applied prior to maximize comfort. A cannula is a long thin tube with a rounded tip that may reduce the risks of puncturing blood vessels but does present some disadvantages as well. For this reason, many practitioners prefer to use a needle. Results from HA lip injections are typically seen immediately after treatment. Swelling is very common and typically lasts one to two days. In addition, the treatment provides short to long-term results, with patients usually coming in for a touch-up at around six months. Results can vary, but lip filler typically will last the least time compared to filler treatment in other parts of the face.
Correcting Deep Folds in the Skin
Many clients will come to your clinic looking for a long-lasting solution for deeper signs of aging. Here you will benefit from using HA as well as other options including CaHA, a soft-tissue-based filler different from hyaluronic acid-based fillers. CaHA, commonly branded as Radiesse®, stimulates collagen production by injecting a gel containing calcium microspheres. Initially, the skin will appear plump, varying with the volume of gel injected. Then, as the microspheres are metabolized, collagen production becomes stimulated to provide long-term results. CaHA filler can be used in your clinic for hand rejuvenation treatments. Here, a cannula will be used to penetrate the skin deeper and deliver the product to the desired area of the skin.
Tear Trough and Temporal Filler
More advanced filler treatment techniques include tear trough and temporal filler. Both of these treatments require advanced application techniques by you as the physician. However, they can make an impressive difference in achieving optimal patient results. Tear troughs are the undereye area of the face which become more hollow as we age. By using specialized HA filler through a cannula method of application, you are able to plump the under eye area almost instantly, leaving patients rested and rejuvenated after just one treatment. This area of the face is extremely delicate. Therefore, it is crucial to have a detailed understanding of anatomy and extensive experience. Similarly, temporal filler treatment is an injection used on the temples to help reverse hollowing at the sides of the face. Here, a needle or cannula method can be used to navigate the tissue and reduce the risk of vascular occlusion. For both these treatments, specialized training and education on the different hyaluronic acid fillers will help ensure you provide patients with the necessary quality of care. Mastering each filler technique starts with education on the types of dermal fillers available and their best uses. Having experience in a variety of techniques will ensure you can meet patients desired medical aesthetic goals, whether it be plumper lips or restoring the natural fullness of the face. Overfilling can harm a patients’ face and increase complications and risks. When getting started with filler treatment, ensure you are properly educated, trained and aware of the risks so you can relay that information to your patients. With any of the treatments above, results vary, and serious risks are possible. Inform your patients so they can be confident in entrusting you with their dermal filler treatment.
Editor’s Note:
This article is intended for general information only and does not constitute medical education or training.
About the Author
Samuel Hetz, MD
Dr. Hetz is the owner and medical director of Concept Medical, an advanced clinic in Ottawa, Ontario, Canada. He completed his residency in Family Medicine at the University of Ottawa, followed by a fellowship in primary care skin conditions and office-based surgical procedures. As well as directing his practice, Dr. Hetz currently holds an academic appointment with the Faculty of Medicine at the University of Ottawa and regularly teaches fellow physicians and residents.
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