Hyaluronic acid is a naturally occurring substance within the body which is found in the deep layers of the skin known as the dermis, and one of its functions is to keep skin smooth and healthy by helping it retain water. As we age our body's production of hyaluronic acid gradually declines, resulting in visible signs of ageing. Natural lines and wrinkles deepen; lips lose their fullness; lines appearing around the mouth and nose area, and cheeks lose volume giving them a sunken and hollow appearance.

Dermal fillers are a man made, non-animal, substance that mimics the body's natural depleted store of hyaluronic acid.

Once injected the fillers provide support and structure to the skin, giving a plumped and youthful appearance. The semi-permanent fillers provide safe, long-lasting and natural looking results.

​Using a needle or cannula, small quantities of the filler are injected into the dermal layer of the skin. The product temporarily fills wrinkles, restores volume loss and enhances features by lifting and supporting the skin in the area being treated. The treatment time can vary between client (no longer than 45- 60 minutes).

​You may be offered an anaesthetic cream prior to injection taking place, however all product used contains anaesthetic properties to further reduce discomfort.

The initial effects of the treatment are seen straight away but it can take up to 14 days to see the full effect. The effects of the treatment usually last between 6 and 8 months, this will vary from person to person and be depending of what product used and what area is treated. The average effect of treatment to the lips is less than in other areas dues to the high vascularisation and action of the lip area. Deep lines will be softened and may take a couple of treatments until the optimum result is seen. Should you choose not to continue with dermal fillers the gel will biodegrade in the skin and simply disappear.

Millions of people worldwide have had these injections and the safety of the product is well established in the well trained hands. The facial vasculature structures are complex and an Indepth anatomy knowledge is vital to be able to minimise any potential risks as well as having the ability to respond rapidly to any complications in order to keep you safe.

People taking certain medications which reduce or inhibit metabolism (cimetidine, beta-blockers etc) are advised not have dermal fillers treatments. Treatment is also not recommended in pregnant or breast feeding women.

Potential side effects with hyaluronic acid (HA) based dermal fillers are normally very minor and short-lived and often relate to the injection procedure rather than the filler. Complications are rare when the procedure is carried out correctly and by a professionally trained aesthetic practitioner and every safety measure will be taken to minimise these.

The most commonly reported side effects are:

• Bruising, swelling, redness, indurations (hardening of the skin) or nodules may develop at, or near the injection site. These usually resolve within 1 – 2 weeks.

• The injection of dermal fillers in patients who are prone to herpes simplex (cold sores) may trigger an outbreak, particularly when injecting into the lip area. Prophylactic antiviral treatments may be appropriate and will be discussed with these individuals during the initial consultation.

Less common side effects:

• Infection is possible at the injection site although rare and can be treated with antibiotics.

• Dissatisfaction with the procedure is always a possibility, your lips may not be as big as you imagined they would be/ they may feel bigger than you wanted. Asymmetries may be accentuated or noted more, or you may not like how they feel. Expectation management is a crucial part of the initial consultation.

• In rare cases discoloration of the injection site, abscess formation, granulomas, hypersensitivity and haematomas have been reported.

Extremely rarely reported:

• occlusion and compression of blood vessels in the area which can lead to skin necrosis (skin death) and permanent scarring.

• Delayed allergic reactions (hypersensitivity) may occur which can result in swelling and redness after several weeks which may need prolonged treatment.

• There have been a few reported cases of blindness across the world which may have been attributed to the treatment with dermal fillers in the temple area, tear trough and nose re shaping.

• Severe allergic reactions including anaphylaxis are a very rare possibility.

Although these will no doubt sound scary, your practitioner is well trained to minimize these risks by using appropriate fillers and volumes and respect the anatomy. All equipment and medications required to manage any of the above reactions are at hand should they occur.

The initial effects of the treatment are often seen straight away but it can take up to 14 days to see the full effect. When Ellanse fillers have been used the result will continue to improve over the first 3-4 months.

The effects of the treatment usually last between 6 and 18 months, this will vary from person to person and be depending of what product used. The average effect of treatment to the lips is less than in other areas dues to the high vascularisation and action of the lip area. Deep lines will be softened and may take a couple of treatments until the optimum result is seen. Fine lines can almost disappear. When you start to notice the effects of your fillers wearing off you can come back for a top-up treatment. Should you choose not to continue with dermal fillers the gel will biodegrade in the skin and simply disappear.

Most people find the treatment very tolerable but some areas can be more tender than others. Topical aesthetic creams will be applied before your treatment (you can also purchase Emla cream from your local pharmacy and apply 45 minutes before your appointment for your maximum comfort).

Most fillers also include a local anaesthetic – lidocaine, which helps to make the procedure less painful and all treatment will be done using either a micro cannula or small needle for your comfort.

Some factors may make it feel more painful such as stress or hormonal fluctuations.

As with any injectable treatment you may experience some redness, bruising, swelling or tenderness after the treatment. Although most people can resume their daily activities straight after the treatment, it can take up to 2 weeks to fully settle.

The procedure is best performed at least 2 weeks before a special occasion.

Yes. In order to minimise the risk of infection, side effects and complications you should follow some pre-treatment advice:

• Do not consume alcohol for at least 24 hours before treatment as it can thin the blood and increase the possibility of bruising.

• Avoid hair removal – shaving, waxing, laser treatment or creams in the area receiving the treatment to minimise irritation and reduce the risk of infection.

• Avoid anti-ageing creams containing substances like retinol. glycolic acid and alpha hydroxy acid to minimise irritation and reduce the risk of infection

• Do not wear makeup on the day of the procedure to reduce the risk of infection.

• Make sure you eat before the procedure to stop you feeling faint.

Certain medicines, vitamins and supplements may need to be stopped seven days before treatment to minimise the risk of bruising. However always discuss this with your practitioner before stopping ANY medication.

Blood thinners like aspirin (never stop these if been prescribed by your GP without seeking their advise)

Anti-inflammatories eg ibuprofen

High dose vitamin E

Omega 3 fish oils

Gingko biloba

St Johns Wort

Redness, swelling, bruising and some tenderness is common after the treatment and may continue to develop over 3-5 days but after this should gradually settle.

If experiencing bruising apply arnica cream can sometimes be helpful.

Cool compresses for two days following treatment can also help. After two days, warm

compression will encourage blood supply to remove traces of the bruise.

For swelling antihistamine tablets may also help.

Avoid to touch, rub or press the area or the use of makeup for the rest of the day to prevent the introduction of infection to the injection sites.

You may feel or see where the product has been placed for about two weeks following treatment but as the filler gradually incorporates into the matrix of your skin it will soften.

Lip treatment generally takes a little longer to settle and may feel tender, lumpy and appear

uneven - Massage any lumps firmly and this will gradually resolve itself within the first two

weeks.

Do not have facial beauty treatments or massage for two weeks following treatment and

avoid exposure to strong sunlight and extremes of temperature for the same length of time.

If there is discomfort following treatment you may take Paracetamol. Avoid the use of Aspirin,Ibuprofen or other anti inflammatory drugs as these may increase the risk of bruising.

Things to look out for:

• Any redness, tenderness or swelling that are worsening after 3 days rather than starting to settle.

• If developing pain as opposed to tenderness, skin appears mottled, dusky, skin getting red or hot to touch or if you are developing a fever.

Contact your practitioner straight away for advise if you are experiencing any of the above and an urgent review will be arranged.