What are the don'ts of dermal fillers?

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People are seeking treatments to smooth smile lines and crow’s feet and plump up their lips, cheeks, and hands. 

Injecting dermal fillers into the face and hands can improve the appearance of facial lines and volume loss caused by age or certain medical conditions. In studies of dermal fillers approved by the U.S. Food and Drug Administration, people generally report they are satisfied with their treatment results.

However, dermal fillers are not for everyone. Dermal fillers may not be appropriate for people with certain conditions, such as bleeding disorders or some allergies. If your health care provider confirms that dermal fillers are an option for you, know that all medical products have benefits and risks. The FDA advises you work with a licensed health care provider who is experienced in injecting dermal fillers, knowledgeable about fillers, anatomy, managing complications, and most importantly, tells you about the risks and benefits before receiving treatment.

What are dermal fillers?

Dermal fillers are gel-like substances injected under the skin. Dermal fillers are meant to create a smoother or fuller appearance, or both.
 
The FDA regulates dermal fillers as medical devices. As reported in clinical trials, the effects of most FDA-approved dermal fillers are temporary because they are made from materials that the body eventually breaks down and absorbs. The injection procedure may have to be repeated to maintain the desired effect.

Types of dermal fillers

Temporary fillers include the following materials:

• Hyaluronic acid, a sugar that is naturally found in the body
• Calcium hydroxylapatite, a mineral and a major component of bone
• Poly-L-lactic acid (PLLA), a biodegradable, synthetic material

There’s only one FDA-approved dermal filler that is not absorbed by the body. It is made with polymethylmethacrylate (PMMA) beads suspended in a solution that contains bovine (cow) collagen. PMMA beads are tiny round, smooth, plastic beads. 

FDA-approved uses of dermal fillers

Dermal fillers are approved for specific uses in people aged 22 and older. Those uses include:

• Correcting moderate-to-severe facial wrinkles and skin folds
• Increasing fullness of lips, cheeks, chin, under-eye hollows, jawline, and back of the hand
• Restoring facial fat loss in people with human immunodeficiency virus (HIV)
• Correcting acne scars on the cheek

FDA warnings about unapproved fillers

• The FDA has not approved injectable silicone or any injectable fillers for body contouring or enhancement. The FDA has warned against getting filler injected into the breasts, buttocks, or spaces between the muscles. Using injectable filler for large-scale body contouring or body enhancement can lead to serious injury, including long-term pain, infection, permanent scarring or disfigurement, and even death.

• The FDA has not approved needle-free devices for the injection of dermal fillers and warns against using them to inject hyaluronic acid or other lip and facial fillers. The injectors use high pressure and do not provide enough control over where filler will be placed. Serious injuries and in some cases, permanent harm to the skin, lips or eyes have occurred.

• The FDA also warns against buying or using lip or facial fillers that are sold directly to the public. They are not FDA approved and may be contaminated with chemicals and infectious organisms. The only FDA-approved dermal fillers are supplied by a prescription for injection by a licensed health care professional using a syringe with a needle or a cannula (a small flexible tubing with a blunt tip that is inserted under the skin).

Risks of FDA-approved fillers

As with any medical procedure, there are risks involved with the use of dermal fillers. Most side effects associated with dermal fillers, such as swelling and bruising occur shortly after injection and many resolve in a few days to weeks. In some cases, side effects may emerge weeks, months, or years later. 

Common risks include:

• Bruising
• Redness
• Swelling
• Pain
• Tenderness
• Itching
• Rash
• Difficulty in performing activities (only observed when injected into the back of the hand)

Less common risks include:

• Inflammation such as swelling or redness may develop near the dermal filler injection site following viral or bacterial illnesses or infections, vaccinations, or dental procedures 
• Raised bumps in or under the skin (nodules or granulomas) that may need to be treated with injections, oral antibiotics, or surgically removed
• Infection
• Open or draining wounds
• A sore at the injection site
• Allergic reaction
• Necrosis (tissue death)

People should be tested for allergies before receiving dermal fillers made with certain materials, especially materials derived from animals, such as collagen.

Unintended injection into blood vessels
The most serious risk associated with dermal fillers is accidental injection into a blood vessel.  Filler that enters a blood vessel can cause skin necrosis (death of tissue), stroke, or blindness. While the chances of this happening are low, if it does happen, the resulting complications can be serious and may be permanent. 

Removing Dermal Fillers
If you want to have fillers removed or reduced because of side effects, you may need additional procedures to reduce the filler or surgery to remove it. These procedures carry their own risks.  Be aware that it may be difficult or impossible to remove some filler materials.

For more Singfiller Dermal Fillerinformation, please contact us. We will provide professional answers.

Related links:
Dermal fillers: The good, the bad and the dangerous
The Ultimate Buyer's Guide for Purchasing Bi-phasic Dermal Filler
Botox vs Hyaluronic Acid Fillers: Here's Everything You ...

6 Tips for Consumers About Injectable Dermal Fillers

1. Do work with a licensed health care provider who has experience in the fields of dermatology or plastic surgery and is trained to inject dermal fillers. The provider should use properly labeled, sealed vials or pre-filled syringes of FDA-approved filler. 
2. Do request and read the patient labeling information on FDA-approved injectable dermal fillers from your licensed health care provider.
3. Do know the type of product to be injected and the possible risks. Know where each product you will be receiving is to be injected. Talk to your licensed health care provider if you have any questions.
4. Do not buy dermal fillers that are sold directly to the public. They may be fake, contaminated, or not approved for use in the U.S. FDA-approved dermal fillers are indicated for prescription use only.
5. Do not inject yourself with dermal fillers or with needle-free injection “pens.”
6. Do not get any type of filler or liquid silicone injected for body contouring. 

Dermal Fillers and Botulinum Toxin Products

The FDA also has approved botulinum toxin products such as Botox, Dysport, Xeomin and Jeuveau to treat facial wrinkles. These products are not dermal fillers. They are injectable drugs that work by keeping muscles from tightening, so the wrinkles don’t show as much. The safe use of dermal fillers in combination with Botox and other treatments has not been evaluated in clinical studies.

Although botulinum toxin products are derived from the same bacteria that cause botulism, the amounts used for cosmetic purposes are purified and many orders of magnitude smaller. 
  
The FDA has approved these injectable drugs for the temporary improvement in the appearance of one, or perhaps several types of facial lines, including frown lines, forehead lines, and crow’s feet.

Side effects reported in clinical trials include facial weakness, eyelid drooping, and brow drooping. Other adverse events included localized pain, swelling, reddening, and bruising at the injection site. In rare cases, injections have resulted in double vision, dry eyes, or difficulty swallowing or breathing. The injection of botulinum toxin products for cosmetic purposes is not recommended for use while pregnant or lactating.

Additional Information

If you have experienced a problem with a dermal filler product or other product regulated by the FDA, you can voluntarily report it to MedWatch, the FDA safety information and adverse event reporting program.

 

Dermal fillers have been a popular part of cosmetic dermatology for a while. Over the years, injectable fillers have gotten more advanced. When done properly by a qualified practitioner, fillers can look absolutely natural. Patients who want to smooth out lines and wrinkles can have a convenient and easy procedure done to refresh their looks without anybody noticing they’ve “had work done.” But to make sure you get the most out of your procedure, follow these dermal fillers’ dos and don’ts.

DO Educate and Prepare Yourself Before Getting Dermal Fillers

Whether or not you are just starting to think about cosmetic injectables or you have already made the decision to get dermal fillers, you should prepare yourself before you go in for a consultation or procedure. There is a lot of information on cosmetic dermatology out there, and a lot of it is important to consider. If you feel overwhelmed by the amount of information available, then focus on the following things:

• Only get fillers from a qualified and experienced injector. Everyone ages differently, and everyone’s face is different. It takes time and training for a person to know the right amount of filler to use and exactly where it should be injected for the best individual results. We recommend going through a dermatologist’s office to get cosmetic procedures like this done to ensure you get a highly qualified injector.

• Research the different types of fillers available so you can have an informed discussion with your provider during your consultation.

• Don’t give in to pressure to have the fillers done the same day as your consultation. Especially if you have not had fillers before, you might want to take some time to think about it. Some aesthetics clinics will waive their consultation fee if you get the procedure the same day, but if you aren’t properly prepared (see the dos and don’ts below), there can be complications. Only get the fillers when you feel like you are ready.

• If you have a history of facial cold sores, then needle punctures can increase the chances of an outbreak. Talk to your provider about the risks.

• Pregnant and breastfeeding women should not get dermal fillers.
• People with allergies to ingredients in the fillers should not get them either, so be sure you ask about the ingredients and share concerns with your provider.

DON’T Take Over the Counter Pain Killers Before the Procedure

You should discontinue the use of any over-the-counter pain relievers at least a week before you get dermal fillers. Blood-thinning drugs like ibuprofen (Advil & Motrin), aspirin, and Aleve can increase the chances of bleeding, bruising, and complications during and after the injections.

DO Follow Instructions about Skincare and Supplements Prior to the Injections

• Don’t wax, tweeze, bleach, or use hair removal products on the treatment area for at least two days before the treatment.
• Do not use topical products for at least two days before the procedure. Treatments to avoid include Retinol, Retin-A, Retinoids, glycolic acid, and anything labeled “anti-aging”
• Stop taking supplements one week prior. Your provider can give you a list to avoid, which might include St John’s Wort, vitamin E, ginseng, Gingko Biloba, Primrose oil, and garlic.

DON’T Drink Alcohol for at Least 48-72 Hours Before the Procedure

Just like over-the-counter pain relievers, alcohol has a blood-thinning effect. This can lead to bruising and inflammation. It’s also a good idea not to drink for a day or so after the procedure to avoid inflammation and possible dehydration.

DO Follow Aftercare Instructions

• Follow instructions given to you by your injector about ointments, like an Arnica ointment, to take care of the skin and reduce bruising after the appointment.

• Ask your injector about icing the treatment area off and on throughout the day. Often, it is a recommended part of aftercare, but some treatments are best left without it.

• Don’t exercise for a few days after you get the injections. You will probably feel fine and able to exercise, but the increase in blood flow and movement can “nudge” the fillers out of place.

• Don’t touch, massage, or rub the area treated to avoid moving the fillers out of place. Wait at least 24 hours to put any kind of pressure on the affected skin.

• Don’t expose yourself to direct sunlight for at least 24-48 hours after the injections. The skin will be sensitive and sun exposure, especially if you get a sunburn, can cause damage.

• Don’t wear makeup for at least 24 hours after the procedure. The skin needs time to heal before it is covered by makeup products.

• Staying hydrated will not only help you feel good overall, but fillers respond better to a hydrated body.

DO Make an Appointment at Blue Ridge Dermatology

At Blue Ridge Dermatology, our expert dermatologists are experienced in both medical and cosmetic dermatology. If you are looking for a qualified professional to perform a procedure like dermal filler injections, look no further. All of our injectable dermal fillers are administered by our advanced nurse injector. To make an appointment, call us at 919-781-1050.

Contact us to discuss your requirements of Cheek Contour Filler. Our experienced sales team can help you identify the options that best suit your needs.