Practicing Safe Aesthetic Medicine
Dermal Fillers – Volume Loss | Facial Contouring
It is not just lines that become a problem with age. Skin gradually thins, elasticity is lost and there is a decline in collagen, hyaluronic acid and elastin. There is noticeable loss of volume with changes in facial bone and soft tissues. The attractive youthful triangle comprising of high cheeks and a small chin reverts to a bottom-heavy appearance as cheeks flatten and jowls appear. This is what we can try to tackle with the aid of dermal fillers.
Available Dermal Fillers – Teosyal | Restylane | Juvederm | Radiesse
The basis of most dermal fillers, such as Restylane®, Juvederm® and Teosyal® is hyaluronic acid. Hyaluronic acid improves skin hydration, promotes collagen synthesis and normal skin function. It is crucial in the structural integrity of the collagen matrix, providing structural support and nutrients.
Our approach to facial rejuvenation is to examine the face according to Leonardo da Vinci’s 3 facial zones (Upper Third, Middle Third & Lower Third). Creative & artistic abilities have a great role here and clinicians tend to have a ‘double vision’ in which at first they clearly recognize the areas of volume loss and demonstrate this to their clients (many of whom are unaware of the gradual volume loss that has been occurring over years), and second, able to visualise the cosmetic result prior to dermal fillers treatment
Despite being the second most commonly performed aesthetic treatment, dermal fillers treatment still raise uncertainty and scepticism in many individuals. Much of this is due to unfavourable reports of ‘pillow faces’ and ‘trout pouts’. Additionally, the role of fillers is often misunderstood. On a basic level, it can be said that fillers do as they should; they fill. However, they have advanced much beyond their initial indication for ‘filling’ wrinkles. Sophisticated facial sculpting and contouring is possible with experienced hands.
In order for improved and natural results our cosmetic doctors may recommend a combination of treatments including dermal fillers, botox, skin treatments and/or cosmeceuticals just as artists uses more than one colour the best cosmetic doctors use the power of synergistic effect of more than one treatment modality.
Treatment Lines and Wrinkles
Sleep lines around the forehead are common and may be due to multiple factors such as position of sleep and type of pillow used. These lines present great difficulty in treating as continuing the sleeping style will effect the results. However, with some minor adjustments to your sleeping position and a combination of skin collagen building treatments which include dermal fillers in the various layers of weakened skin and cosmeceuticals that promote strong collagen synthesis we can treat these lines to appear softer.
The familiar, wearisome frown lines are an everyday complaint at our London clinic. For most, botox is the treatment of choice relaxing the muscles responsible for these ‘dynamic’ lines. However, ‘static’ frown creases that are visible at rest respond well to a combination treatment with dermal fillers.
As frown lines are such a common concern it would naturally be understandable to assume that dermal fillers in this region are an easy procedure. It is, however, a treatment that requires advanced, skilled practitioners who can apply appropriate experience and caution.
These frown lines were previously treated by botox to relax the muscles. Further treated successfully by dermal filler injections.
Signs of ageing are most prominent in the under-eye area and can give the impression of tiredness and fatigue. The puffiness under the eye does not necessarily have to be due to ageing, it could be hereditary or even a result of an unhealthy lifestyle. Tear trough treatment performed using the dermal fillers works optimally for the under-eye area if carried out by an expert. At CosmeDocs clinic we have the best doctors from around the world having hands-on experience with tear trough and other popular cosmetic treatments. Discover more about the cosmetic treatments we offer and the state-of-the-art techniques that we implement during the procedure. MORE DETAIL
Nose being the centre of the face plays a significant role in defining one’s overall facial appearance. Hence it is not surprising how people are so conscious and particular about the shape and size of their nose. Non-surgical nose job is ideal for those who wish to have a nearly perfect nose without any humps or bumps. The procedure is minimally invasive and has the shortest recovery period. However, it must be acknowledged that it should be performed under the supervision of an expert under the clinical environment to achieve best results. At CosmeDocs clinic you can confidently opt for a non-surgical nose job knowing that our team of experts is well trained and well equipped.
The ‘triangle of beauty’ on our face ideally comprises of a well-defined cheekbone, a fine jawline and a nicely pointed chin. Unfortunately, as time takes us towards our late 20’s we tend to lose the natural volume of our facial features. The external factors such as exposure to sun and one’s lifestyle play a secondary role while the ageing factor retains the primary position. This loss of natural fillers from our skin steals the radiance and distorts the facial structure and harmony. Undergoing cheek, chin and jawline dermal fillers treatment at CosmeDocs clinic will help you restore your facial harmony. Our professionals ensure the use of high-quality and right amount of dermal fillers in combination with the latest techniques to provide satisfactory results.MORE DETAIL
The deep, diagonal folds that appear at the sides of the nose and extend to the corners of the mouth, or further, are also known as the ‘nasolabial folds’. These deep furrows are characteristic of the ageing face and project a fatigued, harrowed appearance. There are a multitude of causes for these grooves including loss of soft tissue volume, reduced elasticity and gravitating fat pads from the cheek region. Expressions over time also play a part. The procedure takes approximately 10-20 minutes and most individuals leave with mild redness and minimal swelling.
Flaccid, wrinkled lips lacking contour trouble many individuals. The vertical lines that appear around the mouth, also known as smoker’s lines, can terribly age an individual and detract from the sensuality and vitality that lips can be associated with. Women can find it infuriating when lipstick bleeds into these lines, blurring any lip definition.
There are a variety of treatments available which can be discussed with a personal approach by our accomplished cosmetic doctors. Botox may be advisable to relax some of the lip muscles, reducing the effects of habitual puckering. Dermal fillers can be injected into the lines themselves or into the vermilion border to strengthen the supporting edge of the lip. Resurfacing treatments such as peels and lasers can also greatly smooth the lines.
Ever noticed those creases/wrinkles appearing near the mouth and reaching out towards the jaw? These lines are aptly named as marionette lines. Not only do they make you look sad permanently but also degrade your facial proportion. While in some cases these lines are hereditary they can also be developed due to otherfactors such as loss of skin elasticity,excessive lower jaw usage, damaged soft tissues etc.
Injectable treatments such as dermal fillers are a viable option for restoring these marionette lines effectively. Dermal fillers workby restoring the downturned mouth corners and filling out the creases/wrinkles. A combination of Botox and dermal fillers treatment might be used in severe cases where Botox would be useful in uplifting the sad smile while dermal fillers would reduce the furrows. Repeated use of dermal fillers is encouraged by our team of expert doctors to treat intense furrows. This repeated session of dermal fillers over time enables the fillers to penetrate the tissues and absorb within.
Ever wondered how pouting to take a selfie can degrade the volume of your lips over time? Excessive use of lips can contribute to the loss of volume and stimulate the signs of ageing. The use of lip balms, chap sticks and other similar products temporarily hydrate the lip surface. To achieve plumper lips for a long-lasting period hyaluronic fillers are encouraged by cosmetic experts. Getting non surgical lip enhancement treatment from a well-reputed clinic like CosmeDocs is considered an effective anti-ageing solution. Hyaluronic fillers when injected in the right amount ensure plumper, soft, naturally hydrated lips for a sound period of time.MORE DETAIL
The most popular fillers in the UK are Hyaluronic Acid (HA) based due to their safety, versatility and ease of administration. The various HA fillers differ in concentration, formulation and degree of cross-linkage. This affects their duration of action and the amount of swelling following the procedure. Most HA fillers now contain lidocaine to improve patient comfort and reduce the need for additional anaesthetic.
Radiesse®, a longer acting filler, is also popular for particular concerns and gives great structural support. It helps to stimulate fibroblasts which in turn help to synthesize new collagen.
The filling effect is apparent after the procedure and the treated area may be red and tender with some swelling. As there is a risk of bruising this may start to appear following the procedure. However, bruises will be more obvious in the subsequent days.
Certain medications and supplements thin the blood making bruising more likely. When possible, it is advised to stop taking aspirin, vitamin E, St John’s wort, gingkgo, evening primrose oil, garlic, feverfew and ginseng 2 weeks before treatment. It is best to avoid alcohol and nonsteroidal anti-inflammatory medication, such as ibuprofen and diclofenac, 2 days before.
Arnica tablets or gel may be used 2 days prior to treatment and continued afterwards for 2-3 days.
Cold compression just after the procedure will reduce swelling and constrict blood vessels, reducing any further bruising.
Warm compression may be used a couple of days after if bruising has developed. This will help speed up the healing process.
Pineapple and papaya both contain bromelain which helps to break down proteins releasing trapped blood from the tissues. Topical and dietary vitamin C will also aid the healing process as it helps to build collagen around vessels.
Camouflage make-up may be worn, although it is best to avoid application on the day of treatment if possible. Advice can be given on recommended make-up coverage.
The vast majority of dermal filler treatments have no complications. Initial swelling, redness and tenderness usually settles within a couple of days. If bruising does occur it can take up to 14 days to heal so procedures should be planned well in advance of important events.
Any asymmetry that may occur can usually be managed by correction with additional filler. Bumps or lumpiness can be improved with massage during and after the treatment. If they persist, HA fillers may be broken down using the enzyme hyaluronidase.
Below is a list of rare but more serious complications:
Tissue Necrosis: Injected filler can obstruct blood supply to skin tissue causing ischaemia which can lead to necrosis. It may occur immediately after injection or hours later. All practitioners should be trained in managing these rare events should they ever occur.
Granulomas: These are nodules that may appear months or years after a treatment and they are more common with permanent fillers. They arise when the body reacts to the filler material by walling it off. They can be treated with corticosteroid injections or excision.
Infection: As the skin is breached, there is always a possibility of infection. To reduce this risk, the practitioner will ensure the area is adequately cleaned and that equipment and techniques utilised minimise any risk of contamination. Any persons with a history of cold sores in the area to be treated should be warned about the risk of reactivating infection. This may be prevented with prophylactic medication and treatment following the procedure.
Scarring: Although rare, it is possible for a scar to form if there has been any infection of if an individual has a history of hypertrophic or keloidal scarring. This information will be gathered whilst taking a medical history.
Dermal filler treatments are tolerated very well with mild discomfort. The fillers usually contain an anaesthetic which helps to minimise pain and a topical cream anaesthetic can also be applied if required. As the procedure uses different injection techniques and generally takes slightly longer than a botox treatment it may seem more uncomfortable.
Hyaluronic acid fillers normally come in 0.5 and 1ml syringes. The volume used will be decided on the area to be treated and the best possible filler for that indication.
Radiesse® or Calcium Hydroxylapatite is available in 0.3, 0.8 and 1.5ml and would be used for a semi-permanent result where more structural filling is required. Again, the volume used would be decided after examination of the particular area.
After the procedure the practitioner will massage the area to smooth any obvious lumps. At home a gentle massage may be used with the tips of fingers for the next 48 hours only if a lump can be felt. Usually the filler settles down within 2-3 weeks and feels ‘normal’. If a bump persists it is advised to see the practitioner who may be able to correct this with a firm massage or break the product down.
Although rare, it is possible to be allergic to filler material. This may be a mild allergy which could result in prolonged swelling or a severe hypersensitivity with swelling, redness, bumpiness and a rash. Treatment for these rare reactions usually requires antihistamines and steroids which would be arranged by the practitioner.
If the area is aggressively massaged after treatment, the product can move. Therefore it is best for individuals not to touch the area after treatment unless they feel any lumps or bumpiness whereby gentle pressure is recommended.
It is very rare to be able to ‘see’ the filler. HA fillers are colourless gel and not visible when injected correctly. If a filler is injected too superficially, the product may be seen as a bluish discolouration of the skin. This can be managed with compression and sometimes an injection to break some of the product down.
Once the swelling subsides, the filler takes 2-3 weeks to settle and feel more like the surrounding skin/lips.
Usually people ‘look better’ without obvious changes in their appearance. Good practitioners will be replacing volume that has been lost over the years and hence rejuvenating the overall features. As particular areas may swell more than others, such as the lips, a treatment may be obvious to family/friends.
This depends on each individual. Most fillers used last 6-12 months, however, as they also help to stimulate collagen and plump the skin it may not be necessary to have a repeat filler after this period of time. Unfortunately, some individuals may break the product down more rapidly than others. Advice is best sought at consultations or review appointments
Usually this is fine if there have been no complications. The Dermal Fillers London practitioner will want to know when the treatment was carried out, which product was previously used and the reasons behind wanting a different filler.
For Lines, Wrinkle Folds
- Teosyal (Swiss) 0.5ml From £225
- Teosyal (Swiss) 1.0ml From £325
- Teosyal (Swiss) 1.2ml From £375
- Teosyal (Swiss) 3.0ml (Face Volume/Mild Jowls) From £850
- Teosyal (Swiss) 6.0ml (Face Volume/Mild Jowls) From £1500
- Juvederm | Restylane | Perlane From £350
- For Frown Lines & Crows Feet Visible at Rest £250-£275
- Filler Dissolution From £250
More than one session may be required
I’ve done Botox with CosMedocs and was impressed with their service and professionalism. Not to mention affordable prices. I was Botox virgin and had my reservations at first, but doctor’s advice made them all go away. And I’m really happy with the results.” – NC
I had a botox treatment with cosmodocs. I found the price very reasonable. Even better the results were excellent. I will definitely use this service again.” – BH
I am a very satisfied customer of Cosmedocs – I’ve had three facial areas treated with Anti-Wrinkle Injection at CosmeDocs in recent years, and find the treatment swift, thorough and effective. Also, Dr Haq’s pleasant and friendly manner makes the treatment as painless as possible!” – CFSP
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