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All About Dermal Fillers

Written by: Kimberly A. Wenner, MD

Dermal fillers are products injected under the skin to help minimize wrinkles and increase volume. They are made of many components that the body breaks down over time. Different fillers perform unique functions, which is why we use them in separate parts of the face.

Types of Dermal Fillers

Some dermal fillers are firm and work better in the cheeks, while others are soft and pliable, working more effectively around the mouth or in the lips. Certain fillers last four to six months, while others can last for a year or more. Every filler can behave differently in different people, which is why the providers at Cascade Eye & Skin Centers complete a comprehensive assessment before treatment to discuss which fillers will give you the best look for your wishes, facial type, and budget.

What to Expect from Your Dermal Fillers

Have you ever seen someone who you can tell has had “work done” due to an unnatural-looking appearance? Our goal at Cascade Eye & Skin Centers is to help you achieve a refreshed, natural-looking appearance.

Everyone ages, but our objective is to revitalize the skin and achieve healthy aging.

Prior to Treatment

Before receiving dermal fillers, it is important to have proper expectations of the procedure. For example, certain areas of the face can be treated with one syringe of filler. Still, other times, multiple syringes are needed for complete correction, especially for patients who are receiving treatment for the first time.

If you require more than one syringe and have a limited budget, it may be optimal to wait to receive treatment. In these cases, one syringe may not lead to the results that you are anticipating.

In other cases, a dermal filler may not be an ideal treatment plan for you. Instead, corrections may be best made using surgical procedures, like eyelid surgery or a face or neck lift. Our providers at Cascade Eye & Skin Centers strive to achieve the best results for our patients and give you an honest assessment of what type of treatments will provide you with the best outcomes for your budget.

If dermal fillers are selected as your course of treatment, don’t forget to let us know if you have a history of cold sores. Injections around the mouth can occasionally reactivate cold sores, so we often prescribe medications such as Valtrex or Acyclovir to alleviate any adverse symptoms.

We may also prescribe Arnica Montana, which is a supplement that can decrease bruising from the procedure. To be effective, you should begin this medication two days before your procedure and continue for two days after. Arnica Montana is available both online and at our cosmetic center.

For ten days before treatment, you should avoid any blood thinners to minimize bruising, such as:

  • Aspirin
  • NSAIDs: Motrin, Advil, Ibuprofen, Naproxen
  • Gingko
  • Fish oil
  • Garlic
  • Vitamin E
  • Alcohol

After Treatment

Bruising occurs around 70% of the time after a filler procedure. However, it is often mild and may easily be concealed with makeup. Depending on your skin type and sensitivities, you may also experience more extensive bruising that could be noticeable for a few weeks.

If your bruising is bothersome, Cascade Eye & Skin Centers offer laser treatment to help clear away the bruising faster. If you have never had fillers before, it is ideal to obtain treatment at least four weeks before any important events to ensure that bruising is entirely healed.

Swelling is also very common after dermal fillers and can take up to four weeks to completely resolve. Fortunately, most swelling is gone within a few days, but it takes at least four weeks to determine if more filler is needed.

Once four to six weeks have passed, you may visit us for a re-evaluation or a touch-up appointment, especially if this is your first treatment. However, administering more filler before all swelling has resolved may lead to asymmetrical results.

In most cases, you will only need to apply ice packs to the affected region to decrease swelling. However, in severe reactions, please contact us to determine if you require a steroid to mitigate swelling. You should also make sure to refrain from using any blood thinners in the immediate days following dermal filler injections.

Potential Complications of Treatment

The most dangerous complication of dermal fillers – and one of the rarest – is arterial occlusion, when the blood vessels become partially or entirely blocked. This condition may cause sharp pain in the area of the injection, which differentiates from soreness. The area may also appear blue, mottled, or white, and the symptoms will usually be apparent immediately or soon after the filler is injected. This complication is treated by dissolving the filler as quickly as possible, usually within 48 hours of the occurrence, to restimulate blood flow.

Very rare cases of blindness have been reported upon dermal filler injections, but this has typically occurred when fillers are injected around the eyes or upper nose, which is a procedure that Cascade Eye & Skin Centers does not offer.

Occasionally, small lumps may occur underneath the skin after receiving fillers. Most are felt immediately after the fillers are injected and go away with massages or pressure. However, if lumps occur a few weeks after the injections, please contact us. Sometimes, they are the body’s reaction to the filler, or the lumps indicate an infection. Fortunately, there are successful treatments for both.

One type of treatment is hyaluronidase, which can dissolve fillers made of hyaluronic acid. Hyaluronidase can be used if the patient is not happy with the results or if the filler has lumps or other issues. Patients allergic to bee stings may also be allergic to this product, so please let us know if you have any history of this allergy before its application. This treatment is ineffective at dissolving all fillers, so it is essential to understand what fillers you have had in the past if you would like them to be dissolved.

Fillers like Radiesse and Bellafill cannot be dissolved, but they do naturally go away over time.

What to Expect at Your Appointment with Cascade

After you check in, we will allow you to relax with complimentary water or tea while our physicians prepare to see you. If you are not a member of our Alle or Aspire rewards program, we will help you enroll to make sure that you earn points for your treatment.

After enrolling in one of the rewards programs, one of our medical assistants will take you to one of our treatment rooms and gather a short medical history. They will discuss your concerns, past treatments, and any other information that you would like to relay to the doctor. Following your discussion, our medical assistant will take pre-treatment photographs.

When the doctor arrives, they will review your chart with you and address any of your concerns, past issues, and recommendations before beginning treatment. Once your treatment plan has been decided on, your doctor will clean your face of any dirt or makeup. Next, your doctor will apply ice packs to numb the skin and begin the procedure. Often, we use a vibrating “beauty bar” during treatment to further decrease pain.

Once the procedure is completed, we will show you the results in a mirror, ensure there is no bleeding, and clean you up. Post-treatment photographs may be taken as well and can be provided to you on request. In addition, we offer Finishing Touch-skin soothing treatments, sunscreen, and cover-up for post-procedure skin so you can leave feeling confident.

If this is your first treatment, or if you have any concerns, we often recommend coming back after two to three weeks to ensure that you are happy with your results and perform any additional treatments if needed. We will also send you home with a reusable ice pack to help with post-procedure swelling. You can use it for ten minutes every hour as needed in the first few days, but most patients only need it the first night. If you experience severe pain or any blue or mottled changes to your skin in the immediate hours following the injection, please call the clinic’s after-hours line as soon as possible.

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