Cosmetic Surgery


Fillers before and after

The fillers that I use in my practice are manufactured by the Swedish company Qmed. These products are known as Non Animal Stabilised Hyaluronic Acid (NASHA); this means that they are entirely synthetic (not derived from animal source as some other fillers are). Filler is a clear gel that is injected into the lower layers of the skin to plump out deep, ingrained lines and folds.

Hyaluronic acid, a chemical that is found in healthy normal skin. The function of hyaluronic acid in normal skin is to keep it well hydrated. Young skin has more hyaluronic acid in it than older skin, and this is part of the reason why the appearance of skin changes with age. Because it is made of this naturally found chemical, it is less likely to cause the problems seen with some other fillers.

Fillers are good for softening the 'nose to mouth' lines / folds that become deeper with age, and folds and deep ingrained lines in other parts of the face may also be improved by this type of filler. Touch is the product used for finer lines, including 'lipstick' lines around the upper lip. It is also used to make lips fuller or improve their shape.

Some lines, particularly expression lines, are more suitable for Botulinum Toxin treatment. Botulinum Toxin works in a completely different way to fillers, by weakening the muscles in the face that cause the lines, for example frown lines.

Filler treatment takes about 20 minutes. It involves multiple tiny injections with a very small needle and the treatment is somewhat uncomfortable or sore. Anaesthetic cream will be applied to the area being treated 20 minutes or so before the treatment; this will make it less sore. During and at the end of the treatment it is necessary for me to firmly massage the areas that have been treated. If you are having lip enhancement, I recommend local anaesthetic injections are used to numb the lips, as this is a very sensitive area (these are similar to the injections you might have at the dentist). The treated areas will be a red and puffy for a while afterwards – usually this has settled by the next day. After lip enhancement the lips swell quite a lot, and this sometimes alarms patients; again this usually mostly settles within 12 hours or so.

Treatment with this type of filler is not permanent; it lasts 3 - 4 months, and can of course be repeated.

I have had very few problems with these treatments, and almost no long term adverse effects have been reported. As with any medical treatment there are occasional problems, these include: lumpiness, allergic reaction, prolonged redness or puffiness and tissue necrosis (very rare). Bruising is not uncommon but is usually minor and can be easily covered with make up. If you take aspirin, ibuprofen or other anti-inflamatory painkiller, stopping this 7 days before the treatment will help minimise bruising.

If you wish I will apply special post-surgical make up after the treatment. You should not use your own make up or lipstick until the following day. Ice packs applied to the area will help reduce swelling and ease any discomfort after the treatment.

The result achieved (and the cost of the treatment) will depend on the volume of filler used. The amount used should not be over-done, or an unattractive, unnatural look will result; I advise using a relatively small amount of filler and having a 'top-up' if it is not quite enough (you will have to pay for any additional filler used). Fillers come in pre-filled syringes, the full volume may not be used for a treatment and is discarded if this is the case.