Liquid lift with dermal fillers questions and treatment part 3 of 5
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Naruschka: So Sheramin, I understand that you’re interested in having some dermal filler treatments. Do you have any questions or concerns that you want to ask me about having a dermal filler treatment?
Sheramin: So, my big question is, what exactly is dermal filler?
Naruschka: Ok, so dermal filler is a hyaluronic acid. Hyaluronic acid is something that we have naturally within us, in our support structures, within our skin. But this is not human derived, it actually some from a plant and then it’s stabilised and then it’s prepackaged in a syringe in the form of a gel. And basically what happens is that when we inject the hyaluronic acid into the skin, or below the skin or where ever it is we need to place it, your body responds by making lots of collagen around it in a way to kind of isolate it and that encapsulates it and forms an implant. So it’s an injectable implant that we’re putting into your face.
Sheramin: Ok. So, how long will it last?
Naruschka: It’s different for different areas of the face. So areas where you move a lot, it will break down quicker because your muscles and your activities challenge the integrity of the filler more and then in other areas of the face you’ll find where there’s less activity the filler will last much longer. So, generally speaking, on actually all of the, you know, within a range you have different, different levels within the filler range. So different fillers are appropriate for different needs and they have different qualities in terms of thicknesses and, you know, how much hyaluronic acid there is in there per mil and also, you know, molecular size. And these affect the durability, the strength, and the lifting capacity and also how long it lasts. So all of these things affect how long a filler lasts in your face depending on where we put it. They all say six to twelve months but actually what we’re finding is that, you know, for example under your eyes anything up to two, two and a half years. You might find that, yes it’s gone down a bit perhaps, at six months. Especially in the early stages when you’re having your first treatment because it’s something very new to your body. Then it will go down just that little bit quicker. But everytime you maintain then it will last longer. Because every time you maintain you get new collagen which stays with you. And your body gets used to it so you’ll find your body will hold onto it for longer. And eventually, well, quite quickly, you’ll, you’ll, you know, you’ll go into a maintenance mode, but find that your maintenance treatments become further and further apart.
Sheramin: So when will I realistically need a maintenance treatment after I have this treatment now?
Naruschka: Ok. So, your first maintenance treatment between six and twelve months. So expect your filler to have gone down a bit, but not gone completely. And the idea is basically to maintain your look then you need to do a maintenance treatment when it has just gone down a bit instead of waiting for it to go back to, you know, completely back to zero. Otherwise what you’re doing then is really starting all over again. And not getting the actual correction because everytime you maintain and put filler on top of, you know, a previous treatment existing filler already in the face, you actually get more of a correction. So you get a, you know, further enhancement on top of what you’ve already achieved. And we want you to get into that mode.
Sheramin: Are there any side effects?
Naruschka: There are some side effects associated with dermal filler treatments. You have, you can be allergic to dermal filler. You can be, you know, worst case scenario you can have an anaphylaxis, which is an allergic reaction but it’s a life threatening type of allergic reaction. It’s very important that you know that. And, you know, you can also have problems with blood flow and vascularity that then lead to other issues. So that doesn’t just happen on its own, it happens for a very specific reason. So, you know, if too much filler is applied, if it’s not applied in a way that takes your anatomy into consideration, and by anatomy I’m talking about, you know, where your, your, blood vessels lie, and also even where nerves lie. You know, we can actually make it uncomfortable for you if we compress a nerve and also, you know, if we obstruct good blood flow, or inject directly into a vein we can create something called necrosis. Necrosis is when your blood supply to your given area of skin tissue isn’t received and so what happens is that skin tissue dies. And it happens very quickly. And there are signs that appear actually immediately that that, you know that would lead to that happening. So it can be picked up earlier on, so it’s very important to really sort of minimise the risks of that actually happening in the first place really, instead of just sort of arriving at that point and fire fighting, trying to put it right. So, I have limitations on how much filler I would do in one session, okay, so that we can treat you respectfully and be respectful to your tissue and to your facial structures. And, also as well I use different, you know, methods of delivery to make the treatment safer. So, for example, around your eyes I don’t use needles to do the treatment. I actually use cannulas. And a cannula is a long, thin reed type of instrument, it’s blunt so it can’t shear through structures, it can’t go into a vessel because I select a size of cannula that is, makes that harder to happen because it’s much thicker, because you have different widths of cannulas, so I work witha size that makes it much more difficult for that to actually happen. And that way I can, you know, minimise the risk of actually injecting directly into a vein and so that coupled with having the limitation of how much filler I do in a session significantly minimises the risk for harm. Unfortunately, I can’t guarantee that you will not have a problem with a filler treatment because these same problems that I just talked about can also lead to blindness. So there is a risk for blindness, there are 36 cases globally that have been reported where people have had, you know, blindness, that’s all different types of blindness. So blindness in both eyes, blindness in one eye, blind spot where they have site but there is an area that they can’t see and this has come about through filling type treatments. So not just hyaluronic acid but filling with fat as well to the face. In fact the majority of them have come through, have come from fat injections and the reason why we think that is to do with the force of the product, not the product the substance rather coming through into the face and also the type of instrument they use to do it heightens the risk as well for that damage to happen. However, there are cases that have derived from filler treatments and they tend to be for the most part associated with specific areas. So temples, glabellar filling which is this area between your eyebrows are very high risk areas and one of the other very high risk areas is actually around the mouth because it’s a highly vascular area so it’s easier to inject into a vein. So, unfortunately that risk will always exist and I can’t say it’s never going to happen. But what I can do is just try to do my best to make the treatment as safe as I can, you know, with all of that in mind.
Sheramin: Okay. Is it painful?
Naruschka: It’s, some treatments are more, I wouldn’t really say painful, but sensitive, than others. So have like a discomfort factor and, you know, it shouldn’t be painful because I have to say like, you know, true pain, that would worry me. So it’s not really something I associate generally with these treatments. It tends to be that it feels uncomfortable and then once you get the product going in, it has some pain relief in it, actually that numbs the area and then makes it much more comfortable for subsequent injections that come after that. With the eye area, the first part is always quite uncomfortable just sort of entering and positioning myself. And then after that once you, you know, get that bit of product through it really makes a huge difference. And most people, nearly all, say that it’s, it’s not painful, there’s just a sort of like an irritation factor and it feels a bit strange at the beginning. I do have a couple of people that, you know, with all the pain relief in the world they might say actually, you know, it was just really, really, really uncomfortable. But, never anything beyond that.
Sheramin: How long does it take?
Naruschka: Not long, I mean today we’ll be doing multiple treatments so it will take longer than if I was doing one treatment on its own. So, for your eyes it will probably take about twenty to twenty five minutes to do both eyes, and then working on your lower face probably about fifteen minutes to do. So that combined altogether, and then, you know, to actually do the treatment, but you’ll probably, what makes it longer really is you sort of waiting for your topical anaesthetic to take effect. Because before you have the treatment I would put the topical, so it’s a cream anaesthetic on your face and let that numb the skin and that, you know, that helps greatly.