Fillers: The Dos And Don’ts collagen stimulation
People are going bananas for non-surgical treatments to enhance their lips and jawlines. However, too much injectable tweakments are not good either, say aNuMe Medical experts Dr Hugo Santos Garcia and aesthetic nurse Sharon Hough
When it comes to lip and cheek filler, too much of a good thing can be bad. These medical substances, which are injected into the face, have been helping people to hold back the years for two decades. While they were available as early as 40 years ago, it was only in the early 2000s when hyaluronic acid fillers were approved, that dermal fillers became more accessible to the wider public. Buyer beware applies to anything you will inject into your face and the fundamental rules about checking the qualifications of your injector plus the quality of product being used are well-known. However, there are many other dos and don’ts to make your treatments safer, last longer and look better. Here, Dr Hugo Santos Garcia and Sharon Hogan, an aesthetic nurse at aNuMe Medical, share their expert knowledge.
According to Sharon, even though filler remains a popular minimally invasive procedure for those seeking instant results, there has been a 57% increase in filler reversals between 2020 and 2021 (findings from the American Academy of Facial Plastic and Reconstructive Surgery).
She explains: “Since Kylie Jenner and Molly Mae Hague dissolved their filler there has been a drop-off in people looking for the very big lips. They still want healthy and hydrated lips with good definition, but not as big as before. There are options for those wanting lip volume without going for filler all the time. One thing filler is great for is balancing uneven lips, Hugo does a lot of asymmetry work.”
When it comes to making any cosmetic changes to your appearance, it most definitely pays to be picky when choosing who to trust. Hugo stresses the importance of asking your practitioner questions such as what their qualifications are and what brand filler they are using.
He explained: “It is very important for us to know if a person had filler before and which type was used, because some fillers cause lumps. So if we are applying new filler and need to dissolve some old filler, we need to know what we are dealing with.
“It’s vital that you go to someone who is fully trained so that they will be able to recognise any complications and will check not only your lips but the rest of your face because the filler may have migrated. Most people only train on fillers – they don’t train on complications. Fillers aren’t on prescription, but what is required to dissolve them is prescription-only so most clinics can’t dissolve them unless they are doctor-led. It’s vital to check if there is anything old there before attempting to top-up.”
Filler migration
Filler migration happens when filler injected to one area of the face moves to another area leaving you with facial fullness where you hadn’t expected it to be. This tends to happen in areas where the skin is thinner such as under the eyes or just over your lips. Sharon said there is medical research to prove that filler can last up to eight years in the face!
She added: “A lot of people may go for lip filler every six months, but what they may not realise is that while the filler may be gone from the lips it has migrated somewhere else. The more
Our doctors assess the patient and will give them only what they need
you get filler, the greater the chances that it can migrate to different areas.”
Another term being discussed at aesthetics conferences these days is “filler fatigue,” which describes undesirable consequences of overuse of dermal fillers. In other words, when filler is over-applied it creates a swollen look rather than the sculptured look that was intended. Sharon added: “Filler fatigue is the new thing that everyone is talking about in America. It means the more you get it, the greater the chance of you getting a swollen, puffy look. A lot of clinics charge per syringe, for example 1ml is €199, 2ml is €299. If they don’t use it all they put it somewhere else in the face rather than waste it, but you end up with too much filler and a puffy look.
“Our doctors assess the patient and they will give them only what they need, so they don’t have to take a full syringe or two syringes.” According to Hugo, not all fillers are the same, and different types of fillers are needed for
different areas of the face. He said: “It’s not a good idea to put lip filler into the cheek because some filler is to make more volume, while another is to soften superficial lines. A filler for the lip that adds volume shouldn’t be used to fill superficial lines.”
quality v quantity
There is also a fixation on mls in Ireland when it comes to filler.
“People come in to us and say they want 1mls in the lips, but they are only asking for this, because their friend had it,” revealed Hugo. “They may not need 1ml, faces are different shapes and sizes and not everyone needs the same amount of filler.
“I have never done more than 0.8 and people have always been happy with the look. We prefer to go slowly and decide what is best for the patient. It is always best to do it in two steps because there will be a little swelling, which should completely subside within four to five days. We review the treatment after two weeks. We can keep the filler for four weeks, but I prefer to keep it for only three. So after two weeks if the patient wants more volume, they can get it. It is only on very rare occasions that I have injected more because most people are happy with the initial result.”
When too much filler is injected, the natural appearance is distorted and can end up looking totally out of proportion. The issue then is you can’t remove just some of it – it all has be dissolved. Sharon explained: “You have to remove it all and then the problem is that you can end up getting skin laxity from deflating the lips and that could cause its own problems. Best practice is to undertreat rather than overtreat and to try to combine with other treatments. I was at a conference in Slovenia recently where they said the next treatment is going to be reproducing collagen to tighten the stretched skin from overfilling. As you age you are losing your own collagen and elasticity in your lips which will require more filler which will lead to skin laxity also. To avoid this, the industry is looking at lasers now to try to protect skin on the lips that have been overfilled. To avoid damaging your lips, we recommend a lip laser to stimulate your own collagen and you can combine this with lip filler if you wish. Fillers are still one of the most popular treatments, but particularly as you age you should combine them with other treatments to protect the lips.”
Sharon recommends a HydraFacial treatment which is all about hydration and uses a type of vacuum to add serum to the lips. The Fotona LipLase – which uses heat pulses on and around the lips to stimulate collagen production – is another option. She said: “It’s super for creating fuller lips without injectables. You can go right inside the mouth with that to restimulate the collagen. You can laser on the vermilion border to shape and define the lips. Laser isn’t instant, it’s a three- to four-month process because you will be regenerating your own collagen.
“PRP (platelet-rich plasma) is also another option with the growth factors stimulating your own collagen production, improving the skin texture and definition. These treatments that stimulate your body’s own collagen require a series of three costing €600 in total and should be repeated every 12 to 18 months. Lasers and fillers work well together because if you have hyaluronic acid in your lips, it is way more hydrated making the laser work better.”
Hugo is all for the combined approach. He continued: “Many of these other treatments prolong the lifespan of the injectables. The injectables are instant too so they work well together. With long term use of injectables like Botulinum toxin, the results don’t last as long. Patients who come to us for a treatment like EMFACE, which enhances tone, definition, and firmness of the face, find they need less Botox because it lasts longer and it works better. This is especially the case with people who have been using Botox for a long time.”
Finding the right physician to perform your non-invasive procedure is key. Both Sharon and Hugo recommend a full consultation before any treatment and they agree that slowly and safely is the best route for any aesthetic journey.
■ anumemedicalclinic.com ■ @anume_medical_clinic