Before and after liquid facelift for volume
Liquid facelifts including dermal filler are the treatment for volume loss and ageing. As we age, we lose volume in our faces, from forehead, temples, eye area, cheeks and jawline and chin. This is one of the most popular treatments at our Sydney clinic.
As we age, our faces lose volume, the bone and soft tissue dissolves, leaving us with reduced structural support , creating loss of volume, folds and wrinkles. It is easy to replace the volume loss with dermal filler. Volume loss causes that thinning of the face, the loss of roundness that typically starts in the mid 20s and becomes really obvious in the 40s. Some patients (often those with very round faces) love when this loss of volume occurs, even though they can see that they look older. The more narrow the face is to start with, the more obvious and aging this facial volume loss is. Those patients who keep themselves very lean are also the hardest hit. Runners and other heavy exercisers in particular can look much more gaunt in as they age.
Lipoatrophy, which can be associate with HIV is an extreme form of volume loss making the patient appear very gaunt..
Dermal filler can improve:
volume loss in the cheeks: This is easy to treat
The shape of the face: Some patients need more volume in the front of their lower cheeks and some patients need more volume at the side of their cheeks, and some just need the lower cheek “holes”from fat loss filled, some need their temples treated, and others need their deep nasolabial folds filled: The patient will be assessed and the doctor will have a discussion with the patient about their anatomy, and how it can be improved.
Cheek volume is crucial: as we age, we lose volume in the cheeks and hence structural support of the overlying tissue. This can be replaced.
TREATMENT WITH DERMAL FILLERS
Protocol for volumising treatment:
There is not just one protocol, becaus aging is so individual, so the patient needs to be assessed
Choosing the dose of dermal fillers for volumising
Typically the dose to start with for volumsing is 4mls
Patients with lipoatrophy will need much bigger doses.
The doctor will assess the face and decide on the best dose after taking a history and examining the patient. If a patient has a history of complications with dermal fillers, or if their budget is small or if they want a more subtle result, then a smaller dose might be chosen to start with.
Pain relief during treatment
A numbing cream (eg EMLA or LMX ) may be applied to the area prior to the treatment (45 minutes prior is ideal) Glad wrap may be used over the numbing cream to increase its effect.
If a cannula is used, local anaesthetic is used prior to the cannula being introduced into the skin. With volumising treatment, cannula is usually used
There is local anaesthetic in the dermal filler
Ice is always used to decrease pain and to reduce the risk of bruising.
Very rarely patients will use Penthrox for dermal filler in volumising treatment
Nitrous oxide (happy gas) is available for patients to use
Occasionally patient will take some muscle relaxants 30 minutes before treatment. With this option, the patient will need someone to drive them home
What happens during the injectables treatment itself?
The face will be cleaned with alcohol.
Ice will be applied to the area briefly before treatment The doctor will inject using a very fine needle. Then pressure with gauze will be applied.
If a cannula is used, a small injection of local anaesthetic is injected into the skin and then a fine needle makes a small hole in the skin where the cannula is inserted. With a volumising treatment, often there are 4 injection sites only, so bruising is minimal. The injection sites are: 2 at the hairline and 2 at the jawline.
How will I look after dermal filler for volumsing?
There may be redness and swelling.
The sites around the cannula entry points may be white from the local anaesthetic
Side effects risks with dermal filler for volumisation?
Bruising occurs in a significant number of cases.
Swelling in the injection area will occur. This will laser for 48 hours
Asymmetry: Sometimes one side is better treated than the other, this is usually because the patient is asymmetrical to start with.
Infection is a very rare complication, but always a possibility when the needle goes into the skin.
Necrosis (blood vessel being blocked, interfering with blood supply to the skin) is very rare. This could lead to scarring
Need for further treatment: Often with lips, it will take several syringes of product to get to where the patient wants to be.
Instructions for care afterward
No makeup for 4 hours
No heavy exercise that day
No acid face products for 24 hours
No spas no saunas, no hot yoga for 1 week post treatment
What to expect after a dermal filler treatment?
The effect of the dermal filler will be obvious immediately
Most of the swelling from the dermal filler will have resolved by 2-3 days after the procedure. There may be a small amount of swelling for even 2-4 weeks after the procedure.
What if I get asymmetry at some time before the 2 week point? Do I call the doctor?
No. No need to call the doctor. Sometimes asymmetry will occur because one side is more swollen or bruised. Usually it will right itself by the time of the review appointment. If it doesn’t, then it can be examined at the review appointment. There is no point in coming in early for treatment of asymmetry as there is often swelling associated and so the final result cannot be seen until at least 2 weeks. Treating asymmetry too early could lead to further asymmetry
How long will the treatment last?
The answer to this is very individual and depends on the patient’s anatomy, metabolism, the dose, the placement, the product etc. Typically with our most commonly used dermal filler, the protocol is: If the patient is happy with the results at 1 month (ie there has been adequate fill) they should be treated at 6 months, then at 6 months and then once yearly. If the patient is not satisfied with the results at 1 month (ie more dermal filler is required to obtain the results that they desire), then further dermal filler should be injected every 1-3 months until the desired appearance has been reached, and then the patient should have treatment at 6 months, then 6 months, then once yearly
Cost of dermal filler in lower cheeks:
Cost is per syringe. $600-$700 per ml
Sometimes packages of dermal filler for volumising are available (4mls for $1800)