HYALURONIC ACID DERMAL FILLERS

Dermal fillers are hyaluronic acid (HA) gels. You may have heard of this in adverts for skin creams and such. HA is actually produced naturally by the human body and is a kind of sugar molecule that attracts 1000 x its weight in water. This gives it the wonderful property of retaining moisture and plumpness in the skin, as well as the eyes and connective tissues. 

There are lots of things which lower your natural levels of HA. The biggest avoidable factor is UV radiation! If you're an avid sun seeker, there's nothing I recommend more than a good quality sunscreen such as those provided by Obagi Medical Skincare. This will protect your HA levels as the years go on and prevent that leathery look you may spot on a sun bed enthusiast after many years! Now I'm not here to nag, but the second big factor is smoking. I don't need to run through all of the many poor health side effects of smoking, but lets add a marked reduction in HA synthesis and quality to the list! May I recommend a stylish carrot stick to hang from the lip instead? 

Now there are some things you can't help. All organs age over time, so skin is no exception. Hormonal changes such as the reduction in oestrogen and progesterone production from your mid 20s, and more markedly during the menopause, also ​causes a drop in your HA levels. As the HA drops, so too does the moisture, and in turn your collagen and elastin fibres become drier and more brittle. This results in drier, saggier skin with wrinkles.

HA gels should be considered a 'gel implant'. When I say 'implant', I mean a substance placed strategically under the skin to change the shape of the face. Unlike a traditional implant, this does not need a scalpel or stitches to be secured in place. The gel can be injected into the desired position to act in 3 ways: 

1. The gel fills out the space it is injected in
2. Once placed, HA attracts a tonne of moisture
3. Over the long term, HA stimulates your own cells to produce more collagen and elastin

These 3 mechanisms work together to add volume in the desired place, improve the quality of skin and hydration in the area, and act to stimulate your own body's anti-ageing mechanisms over time.

There are lots of different kinds of HA gel fillers available on the market. The main difference between different HA fillers is the degree of cross linking of the gel. This relates to how stiff of soft they are, and makes different fillers more suitable for different parts of the face or body.   

HA fillers are NOT permanent. All HA fillers get broken down by your body's natural metabolic processes over time. Depending on how firm the filler is, they can last anywhere from 6 months to 24 months. The softer the filler, the faster it's broken down. This doesn't mean we can put a stiff filler anywhere, just because it lasts longer. Thick fillers are only used deep on the bone where they change the structure of your face  more. Softer fillers are needed in dynamic and superficial areas such as the lips or the tear troughs. Some people find their filler wears off faster than 6 months. This can be true for people with very fast metabolisms, people who exercise a lot, or get a lot of sun or heat exposure. Sometimes filler is broken down on purpose by an injector. An enzyme called hyalase may be injected into filler to dissolve it for a number of reasons. Sometimes this is to get rid of old filler which can't be corrected by adding more filler. In the event that there is a complication during the procedure, hyalase may be used to dissolve and reverse the complication.

As much as I like to think that HA is a magic potion sent from the gods, it isn't quite that. During a consultation, I want to know exactly what you want- this stage is almost more important than the procedure itself! Most people want a natural enhancement. They want to look like themselves but just better! Some people have a phone gallery full of heavily edited Instagram model and celebrity photos and want a 'copy and paste' procedure. Now the fact is, even those models and celebrities do not look like their own photos. Fillers can only enhance what is already your face. It is my job to help show you what is possible and realistic, and to advise you as to whether what you desire is doable. Filler is fantastic at tweaking your proportions, but anatomy is very complicated, and if a drastic change is what you desire, it may call for an adjustment in your expectations, or a plastic surgeon!

The concept of 'non-surgical' treatments such as fillers has become increasingly popular as a safe way to enhance yourself without going under the knife, and at a lower cost than plastic surgery. ​ It should however be treated more seriously, and not as frivolously as getting your eyebrows threaded! Your beautician may indeed have an artistic eye, but it's one hell of a risk to take! In the wrong hands, life changing complications can occur during routine procedures. It is imperative to see a medical professional with the proper training, knowledge and experience to first recognise a complication, and then safely and swiftly treat it. It is heartbreaking to see serious complications such as dead rotting skin, scarring, need for skin grafting, blindness and even occasionally death! I wouldn't wish these horrific events on anyone. Invest in your health and don't take that risk! ​​

As with any procedure, there is always an element of risk involved. The risk of an adverse event happening is greatly reduced by seeing a qualified medical practitioner. Possible risks include but are not limited to:

• Post treatment discomfort and pain, swelling, redness, bruising, and discolouration of skin
• Post treatment infection
• Allergic reactions
• Reactivation of herpes (cold sores)
• Lumpiness, visible yellow or white patches
• Granuloma (delayed reaction and lump) formation
• Localised skin or tissue loss and necrosis due to blockage of a blood vessel by injected product, and/or sloughing, with scab and/or without scab and asymmetry, and in extremely rare cases blindness.
• Haematoma- a blood filled blister. If small, these heal themselves but if a significant size, may need further treatment

Complications can occur, but make sure you see someone well equipped to manage them! 

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