What you should know about fillers......

It has been a while since I wrote anything about fillers. However, recently during one of my socializing events I was faced with a lot of questions regarding fillers and botox. There was a great confusion between the two, still, despite both being very separate and totally different entities in terms of chemical compound and function.

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1. So what Are Fillers?

Fillers are substances you use to fill up areas of your face or body which has underwent volume depletion and is also used to reduce static lines. It can be from any substance like silicone gel, collagen, hyaluronic acid, calcium hydroxypatite, PLLA, PMMA or even biological fillers like heated PRP or fats. The most commonly used in a medical aesthetic practice are the hyaluronic acid fillers which are non-permanent and lasts between 6 months all the way to 24 months depending on how the cross-linking and molecular weight of the filler.

2. Are All Fillers the Same?

Definitely not. Different chemicals form different fillers. Therefore it is really important to know what type of fillers were used on your face. Some may not be reversible. Always ask your doctor what he or she is using. Not only it is good for you to know, but it also helps the subsequent treatments if you require any.

3. If I do not like the filler effect can I remove or change it?

Only Hyaluronic acid fillers can be diluted with hyaluronidase. The other fillers are almost impossible to remove without any surgical intervention. So make sure you know what you are putting under your skin.

4. How much does fillers usually cost?

Fillers are usually quoted by per syringe of usage. An original high-end filler product can cost anywhere from RM 1600-RM 3600 per syringe. Some other lesser brands cost between RM 800- RM 1500 per syringe depending on where it was made and specifications. Anything sold cheaper than that would either be non-original products or maybe expired fillers? Or sometimes the doctor is not so experienced that they give cheaper pricing to practice. Honestly, who would charge super cheap for well trained hands? The training itself requires a lot of money.

5. Does it hurt?

Honestly, any procedure involving needles would hurt to some extent, but depending on the type of filler, some fillers hurt more than the rest. It also depends on whether there is any lidocaine inside the filler that will reduce pain tremendously. Local numbing like creams can be used although it doesn't really make much difference physically (maybe psychologically) and local infusion of lidocaine does help to reduce pain effectively although very specific filler work would be impaired as there is already tissue distortion. You can discuss with your doctor pain management techniques that can make your experience much tolerable. So apparently, you do not need to suffer too much pain for beauty. If, in event the doctor injects and suddenly there is severe pain, please speak up and tell him or her. Severe pain might mean that an artery is being hit, or other crucial vessels, or even allergy to the filler.

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6. What can fillers do for me?

I always tell my patients, imagine fillers are like cement or plasticine. You can create volume which is not there like nose, cheeks or chin. You can redefine areas of your face and make contours, you can even smoothen deep lines. You can redefine your lips to make it more prominent or replenish the younger look. You can put it at your tear trough areas and reduce the sagged eye look and make you look fresher. You can reduce appearance of scars and improve photo angles (if your doctor is really really good). 

7. If I use a good filler, will it guarantee a good effect on me?

A good filler is always recommended to get the best effect. However, the other more important component is the doctor. How good is he/she at creating the effect you want? A lot of people think that filler injecting is just about injecting, but actually it is not. The best filler injectors in the world can put fillers on to a persons face and make him or her look more attractive but at the same time make it look as natural as possible that to most people, it doesn't look like any fillers were done. (Until you compare the before picture).

8. So say that I am interested, how sure can I be safe to do the procedure?

For newbies and virgins, I usually tell them to stick to hyaluronic acid fillers for any work because at least if you do not like it, we can dissolve it or wait for the effect to go off. The other most important thing is how well the doctor is trained because not all doctors are trained to do fillers. In my years of training other doctors practical filler techniques, I notice that even the way a doctor holds the syringe is enough to tell me how experienced they are. It is not the same as blood taking or other hospital procedures. Furthermore, to train the hand to be steady enough to evacuate the product from the syringe equally is quite a task if you are not use to it. To create beautiful natural looking work requires an additional artistic eye to detail which not all doctors have. Furthermore, if any problems from the procedure were to arise, a trained aesthetic physician would know what to do. Beautician filler injectors are the worst because for 1, you do not know what are they really using (they have no access to original medical grade products), 2. They are not trained to understand surgical anatomy or deal with complications, 3rd, if you allow a beautician to inject you, you cannot take any action on to them if the job is not done well, as they are not regulated by law, and you would have committed the first offence of going to a non-professional. Furthermore, there is a science and mathematical equation when we put fillers on to a person's face that is being taught in our training so that you remain looking like a human (and not some weird alien from star trek or some other sci-fi movie).

If you have any more questions on fillers, feel free to contact us at drmmclinic@gmail.com or 03-21106608.

Redensity II - Solution for tear trough

      Dark under eye rings can be such a nuisance to many of us. It makes you look tired, sick or just unhealthy. But some people are genetically prone to have rings under the eyes. Being Asian, we are predisposed to have a more prominent under eye problem due to the structure bone which is flatter than others. In Indians, we would see a hollower eye socket and thus appearance of the eye ring is more prominent especially with age and we start losing some of our malar fat. Look in the mirror and you will notice that the area next to your nose tend to appear flatter, and in some people there is a line. This is what you call a tear trough line.

Over the years, doctors have been using soft fillers to treat this problem. The light weight fillers give a satisfactory effect but only lasts approximately 3-6 months and the cost is high. Much sturdier fillers may cause lumps and bumps and not to mention the Tyndall Effect. 

What is Tyndall Effect?

The Tyndall effect, also known as Tyndall scattering, is light scattering by particles in a colloid or particles in a fine suspension. It is named after the 19th century physicist John Tyndall. It is similar to Rayleigh scattering, in that the intensity of the scattered light depends on the fourth power of the frequency, so blue light is scattered much more strongly than red light. An example in everyday life is the blue colour sometimes seen in the smoke emitted by motorcycles, particularly two stroke machines where the burnt engine oil provides the particles.

In relation to the tear trough, when fillers are placed beneath the thin skin, there is a chance of this effect occurring especially if the fillers are placed too superficially. The only way to remove it is by dissolving the filler with Hyaluronidase. However, even this does not guarantee 100% reduction of the Tyndall effect. Despite the fillers lasting less than a year, I have come across people with Tyndall effects lasting up to 2 years. Thus, in this case, cosmetic concealer would be prescribed. 

Hence my reservation in treating tear troughs in the past. I usually treat the malar area wmith fillers by replacing the lost of fat pads and volume. It gives satisfaction to most patients but there are those who require a little bit more. Thankfully since last year Teosyal came up with a filler designed especially just for tear trough - Redensity II.

Redensity II is a new age filler which allows thin area injection without causing Tyndall effect. It is a hyaluronic acid filler that is combined with a restructured complex of vitamins to tackle tear troughs, dark circles and fine lines around the eyes. It exerts minimal pressure on surrounding tissue giving the eye a homogenous, long-lasting and natural fill. A clinical study done on test subjects find that 100% of candidates would recommend this procedure to be done as it is quick, with minimal downtime (some none at all) lunch time procedure that gives satisfactory results.

But no matter how good the filler, the injector must be well-trained and have steady hands to give you the best result. It is a pretty forgiving filler which allows some room for error and will recorrect itself. Done by trained hands you will have minimal to no bruising. This service starts from RM 1500 / session and the effects lasts up to 12 months. I'm completely in love with this filler and now using blunt needles, this service is comfortable and gives wonderful results. The best look is after 2 weeks but immediately after you can see the difference.

For more information or appointments do contact us at 03-21440080 / 014-2233268 or email to faceworksclinic@gmail.com. You can also LIKE us on Facebook and send your enquiry through there.

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For more information call us at 03-21440080 or email to info@faceworksclinic.com