Archive for 'juvéderm'

Annoying and unsightly bumps after receiving dermal fillers

Dermal fillers are on the rise, but with increasing popularity and people opting for cheaper and often ill-experienced administrators, comes an increase of risks and side-effects.
Here at Castleknock Cosmetic Clinic, we are seeing more and more unfortunate individuals presenting to us with lumpy and irregular lips following a bad lip augmentation elsewhere. It’s not unusual for patients to have contour irregularities of the facial skin in the immediate period following dermal filler injections. In the vast majority of patients this is usually related to either bruising or swelling and may take a week or so to resolve. With good injection technique, long term bumps should be rare. Lumps and bumps only occur in less than 5% of treatments and should be very small and hardly noticeable when they do occur.

Unfortunately, in unskilled hands these lumps, bumps and areas of hardness may be related to uneven injection of the dermal filler or superficial injection of a filler intended for deeper application. Although hardness can happen with any filler, more commonly they are caused by too much of the filler being injected at one point in the skin. Hyaluronic acid dermal fillers tend to absorb water which can accentuate the problem, specially in the lips where they’re noticed as lentil sized beads.

If the bumps persist, they can be treated. In some cases gentle massage will address the problem. In other cases removal of the offending dermal filler will be requires and thats when I see patients presenting to me for correction. Removal of dermal fillers irregularities can be accomplished by either manual extraction using a specialised instrument or by using the enzyme hyaluronidase to dissolve the material.

In Summary:

Once the treatment settles lumpiness should not be felt. Persistent irregularities can be treated successfully

What to do if you notice lumps after my dermal filler injections?

Infection needs to be ruled out. Contact your treating doctor to assess if antibiotics and other treatments may be required.

If you can only feel the lumps and not see them, then don’t panic, because simple massage should take care of the irregularities.

If you can see the lumps, keep an eye on them and if they don’t disappear in 2 weeks then see our help at Castleknock Cosmetic Clinic.

Removal of lumpy dermal filler:

It could be possible to manually remove the offending dermal filler:

• Physical removal by a specialist extraction needle
• Injection of a dermal filler dissolving medication called Hyaluronidase / Hylase

What do you think? Did you find this article blog helpful? I’d love to hear your comments comments@castleknockcosmetics.ie or tweet me @dr_h_kahlout. If you found this blog article helpful I’d appreciate a positive review on our Facebook page.

Dermal fillers and neurotoxin wrinkle injections are the top two most popular minimally invasive cosmetic procedures in Ireland and worldwide. Thinking about getting some work done? Before you make an appointment, read these six important factors to keep in mind before calling that number.

1. Who’s injecting me

Ninety percent of the success of these kinds of cosmetic treatments depends on who is doing them, the remaining 10 percent is dependent on the product. Think of it this way: If you got a bad hairdo, would you blame the scissors or your hairdresser? Word of mouth is the best way to find an injector. If you know someone who looks amazing (and you know they’ve gone under the needle), ask who they go to. But with so many people offering fillers and other injections these days (beauticians, nurses, dentists, your neighbour and her biannual Botox party), it’s extremely important to inquire about credentials. He or she mightn’t necessarily be a full-fledged doctor. But be sure to ask how long they’ve been doing aesthetic injections and how they were trained. Ask to see before-and-after pictures of patients they’ve done, not just those from a brochure for the product. Book an appointment for a consultation first. A no obligation consultation gives you the opportunity to discuss your desires and expectations, and to take some time to think about it before you return for the actual procedure.

2. Cheap for a reason

You get what you pay for when it comes to cosmetic injections. While prices vary depending on the exact product used and where you live, fillers typically range from €250 to €900 per syringe. In other words, a quick deal for €100 dermal filler is a red flag; you might end up on an episode of Botched. At your consultation, discuss your budget and see if it’s in line with what your injector recommends. Patients come in having saved enough money for one injection, but often they need more than that. You’ll get the best results if you wait until you can afford to pay for a complete treatment.

3. Your expectations

Even if you really want Kris’s cheekbones or Kylie’s lips, bringing snaps of your favourite celeb’s isn’t for the most part helpful. Find a picture of yourself when you loved the way you looked, and bring that to your appointment. A photo of yourself in your prime might be especially helpful, as your face was at its fullest then. This gives you a more realistic point of reference and will also help me better understand how to enhance your natural features. Even if you’re going in because there’s just one nasty wrinkle bothering you, be open to suggestions. As a cosmetic doctor I see your face in a three-dimensional way that’s entirely different from how you see it. As long as you’re seeing someone who is properly trained, be willing to take on board their recommendations, even if they’re not something you initially thought of.

4. The actual product

There are many more dermal injectables available than you realise, and it’s important to educate yourself on the various options out there. Take neurotoxins for instance, despite the fact that Botox is a household name; it is not the only botulinum toxin out there. It’s like calling any vacuum cleaner a Hoover, even if it’s a completely different brand. Dysport, Azzalure, Bocouture, Mybloc and Xeomin are all botulinum toxin brands; while it’s essentially the same type of toxin, there are subtle differences between them. Some work faster some spread further and others hold stronger! A good doctor will stock all types for different patient needs.

There’s even more variety when it comes to fillers. The largest category is those that are made of hyaluronic acid, a substance that’s naturally occurring in the body and can hold multiple times its weight in water. Dermal fillers include Restylane, Juvéderm, Teosyal, Perfectha and Belotero. Despite the fact that they’re all made of the same thing, there are differences in the size and how the hyaluronic acid particles are linked together, ultimately resulting in different correction properties. Even within each of these brands there are variations. For example, along with Juvéderm there’s Juvéderm Volbella and Juvéderm Voluma, both of which have slightly different-size particles and are better for filling different areas of the face. Restylane has various fillers as well, Silk and Lyft. Ask your doctor exactly what is inside the syringe and why it was chosen over another option.

5. What to do before and after the injection

While injectables are minimally invasive and can be done in minutes, there are a few important things to keep in mind pre- and post-appointment. For toxin injections there’s nothing you need to do beforehand, and the only restrictions afterward are not exercising or stoop your head down for about four hours.
Fillers are a different story with after treatment swelling being prominent. After filler injections bruising and swelling are the most common injection site side effects, especially in sensitive areas like the lips. Schedule your filler appointments at least a week before a major event. I also suggest that you stop taking aspirin, green tea and fish-oil supplements two weeks prior to getting dermal filler injection, since all are blood thinners that can increase the likelihood of bruising and swelling.

6. How long the results will last

Multiple factors affect the durability of the results: the product used, how much was injected, where it was put in the face. As a general guideline, botulinum toxin lasts around four months, while hyaluronic acid fillers last anywhere from six to 18 months. So if you like the new looks, be prepared to make this another part of your beauty routine that will require some upkeep. And if you don’t like the results, keep in mind that hyaluronic acid fillers are reversible. A special enzyme can be injected that will dissolve the HA filler within a week. All good cosmetic doctors should be able to provide the enzyme. Toxins on the other hand are not. However, so it’s always better to ask for less and add more later. It’s common practice at Castleknock Cosmetic Clinic Dublin to have my first time patients to come back two weeks after their injection to reassess the results and touch up with more if needed (at no extra cost).

What do you think? Did you find this article blog helpful? I’d love to hear your comments comments@castleknockcosmetics.ie or tweet me @dr_h_kahlout. If you found this article helpful I’d appreciate a positive review on our Facebook page.

One option for facial volume restoration is readily available dermal filler materials like hyaluronic acid. HA is manufactured by many companies. In Ireland the most popular are Restylane, Juvéderm and Perfectha. Another option for facial volumisation is injecting a collagen enhancing polymer filler like Radiesse, Ellanse or Sculptra. A process known as neocollagenesis starts as a result of the controlled inflammatory material injected. The filler induce reactive collagen synthesis which helps us to create a gradual tissue volume addition over time. Either type of fillers, HA and neocollagenesis simulators could be used in the process of Softlift available at Castleknock Cosmetic Clinic and injected without any pain and minimal bruising. While these procedures are safe, it takes experienced hands, eyes and aesthetic judgement to achieve the best outcomes. Results can be expected to last up to a year with HA’s and up to two years with the latter neocollagenesis promoting fillers.

What do you think? Did you find this short blog helpful? I’d love to hear your comments comments@castleknockcosmetics.ie or tweet me @dr_h_kahlout. If you found this article helpful I’d appreciate a positive review on our Facebook page