Dermal Fillers

Dermal Fillers – Post Treatment Advice

(NB: see separate page for specific advice regarding Radiesse)

If you experience extreme swelling or itching at the site of injection following treatment, or if you have any concerns at all, please call Clare McLoughlin RGN INP  on 0800 8766322

  • It is important that you follow the post treatment advice carefully after dermal filler treatment. This will help you to gain maximum effect from the procedure and reduce the risk of complications
  • Immediately after treatment, there may be slight redness, swelling, tenderness and an itching sensation in the treated area. This is a normal result of the injection. The inconvenience is temporary and generally disappears in a few days. If it continues, or if other reactions occur, please call me.
  • If you are having lip treatment the initial swelling may last longer. Some patients experience swelling for about a week and the lips can look somewhat uneven during this time. This means that the results directly after the treatment should not be seen as the final result.
  • Following treatment you may use a pain-killer such as paracetamol, if required and for a few days after treatment.
  • Bruising can be avoided or minimised by avoiding substances that thin the blood for 24 hours pre & post treatment these include: Alcohol, Aspirin, Non-Steroidal Anti-Inflammatory drugs such as Nurofen/Ibuprofen, Vitamin E, Gingko Biloba, Ginger and the prescription drug Warfarin.
  • However prescription medications must not be stopped without discussing the risks with your GP.
  • Avoid drinking Alcohol following your treatment as this may increase the bruising and bleeding at the injection site.
  • Arnica (a homeopathic remedy) cream or tablets are sometimes recommended a few days before and a few days after treatment as there is some evidence that this can reduce bruising;
  • Avoid touching the treatment area 6 hours after the treatment. After that the area can be gently washed with soap and water and light make-up can be applied.Avoid prodding or playing with the filler treated area following treatment unless specifically directed by your practitioner. Product has been carefully placed and there is a risk of shifting the product.
  • Until the initial swelling and redness have resolved, do not expose the treated area to intense heat (e.g. solarium and sunbathing) or extreme cold.
  • If you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another eruption of cold sores.
  • A touch-up treatment within 2 – 4 weeks after the initial treatment may be necessary to achieve an optimal correction.
  • Dermal fillers are long lasting but not permanent. You always have a choice to continue or change the combination of treatments – and the procedure can be repeated as often as you like.
  • Most patients choose to have a follow-up treatment 6 – 12 months after an initial treatment of wrinkles. When the lips have been treated a follow-up is normally needed after about 6 months.
  • Your practitioner will have offered you a review appointment 1-2 weeks following treatment, please attend this appointment.

If you experience extreme swelling or itching at the site of injection following treatment, or if you have any concerns, at all please either call Clare McLoughlin RGN  INP  on 0800 8766322

Dermal Fillers – Any side effects from filler treatments?

If you experience extreme swelling or itching at the site of injection following treatment, or if you have any concerns at all, please call Clare McLoughlin RGN  INP  on 0800 8766322

Side Effects

Dermal filler risks are usually minor, but they can seem serious. Injectable skin plumping is considered a minimally invasive cosmetic procedure. Side effects are quite common while serious complications are fairly rare. The problem with both normal post-procedure symptoms and true complications is that they are highly visible and uncomfortable (since fillers are used on delicate facial skin).

Depending on the area injected and the type of filler or pain control used, patients may find the procedure relatively painless to mildly uncomfortable. Treatments around the nose or lip areas are usually more painful.  Anaesthetic cream or a local anaesthetic injection is offered prior to the treatment to make it more comfortable.

The obvious immediate side effect is of slight bleeding after the needle has been inserted into the skin.  Temporary swelling, bruising, redness and soreness are all normal dermal filler risks. These symptoms are usually not serious and should resolve on their own over time. If these side effects persist for more than two weeks (or if they are severe), this may indicate a complication.

Bruising can be avoided or minimised by avoiding substances that thin the blood for 24 hours pre & post treatment these include: Alcohol, Aspirin, Non-Steroidal Anti-Inflammatory drugs such as Nurofen/Ibuprofen, Vitamin E, Gingko Biloba, Ginger and the prescription drug Warfarin.  However prescription medications must not be stopped without discussing the risks with your GP.

Systemic Dermal Filler Risks

Since bovine collagen dermal fillers have been discontinued, the chances of having an allergic reaction are very small. Even hyaluronic acid fillers, which are usually non-reactive, can cause a reaction in sensitive patients. These include prolonged redness, swelling, itching and or hardness and bumps in the skin. Such signs may appear at some or all of the points of injection, they can last for several months or longer, but this is extremely unusual. Allergic reactions can usually be treated successfully with steroid injections in the affected area.

Patients who are prone to getting cold sores may experience an outbreak after being treated with dermal filler (the same thing often happens with a chemical peel). This problem can be addressed with a course of antivirals. If you have HSV-1, you may need to begin antiviral treatment prior to receiving dermal filler injections.

Anaphylaxis is an extremely rare, life threatening allergic response to an allergen, such as bee stings, or local anaesthetics. Your practitioner will take a medical history, and will ask you about any allergies or sensitivities you may have, it is important you provide detailed accurate information and include all potential sensitivities you have; even if these seem irrelevant to you. Your Nurse practitioner should be up-to-date with basic life support skills and have adrenaline available to manage this emergency situation.

Rare Side Effects/Complications

Cysts, bumps, irregularities, nodules and granulomas and biofilms are all potential injection site dermal filler complications. If the filler is injected too close to the surface of the skin, it may be visible as a bluish lump. In this case, the lump may be removed by making a small cut in the skin and squeezing the filler out. Or, it may be dissolved using hyaluronidase (an enzyme that breaks down HA fillers).

More long lasting, uncomfortable and disfiguring lumps in the deeper dermal layers may develop due to an inflammatory response to the dermal filler itself. If these lumps do not resolve or respond to less invasive therapies like steroids, they may have to be surgically removed.

Very occasionally, delayed side effects can occur many months after the first treatment. These side-effects usually appear as red lumps showing up underneath the skin. Sometimes, these may be permanent. There is some evidence that these may be more common and more difficult to treat with some of the permanent fillers.

Serious Dermal Filler Complications

Infection is one of the most potentially serious dermal filler risks. However, it is also extremely rare. Infection can usually be treated with antibiotics if it does occur. A slightly more common and very serious complication is tissue necrosis caused by intraarterial embolization. This occurs when a bolus of HA filler is accidentally injected into a blood vessel. Once the blood vessel is blocked, the tissue it supports dies off from lack of oxygen. This can lead to the development of a red or black lesion on the facial skin and underlying tissue. The tissue may erode away, leading to disfigurement. If the injected material blocks an artery leading to the eye, this can result in blindness (a very rare complication). Choosing a practitioner with a high level of experience in injecting dermal fillers is the best way to avoid these complications. The practitioner should also know the signs of intraarterial embolization (sudden pain and redness) and have hyaluronidase on hand to dissolve the hyaluronic acid immediately.

Aesthetic Dermal Filler Risks

Some of the most common complaints about dermal fillers involve cosmetic issues like incorrect placement, asymmetry and overfilling. An experienced practitioner is most likely to avoid these problems and offer the kind of subtle correction that’s not overdone. It’s important to go slow at first and not ask for too dramatic a change. You can always add more later; but taking out what’s already injected is trickier. Hyaluronic acid is the only readily reversible dermal filler. If the placement or volume is wrong, the filler can be dissolved with hyaluronidase. With other products, you may just have to wait until the filler is absorbed into your body.

There is also some risk of the injected dermal filler material shifting once it has been placed under the skin. This may cause lumps under the skin in undesired places. The risk of shifting increases if you touch, prod or play with the injection site once the procedure is finished

If you experience extreme swelling or itching at the site of injection following treatment, or if you have any concerns, at all please call Clare McLoughlin RGN  INP  on 0800 8766322

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