What are Dermal Fillers?
Dermal fillers are injectable treatments that reduce the appearance of wrinkles, lines and deeper folds, rejuvenating the skin to give a more youthful appearance.
Dermal fillers are made of various natural and man-made (synthetic) materials that have been developed over many years for injection into the skin.
Are Dermal fillers permanent or Temporary ?
Dermal fillers tend to be broadly classified into two types of dermal fillers, either non-permanent (resorbable) or permanent (non-resorbable).
Non-permanent fillers last 6-18 months depending on the product used.
Dr Teri Johnson only uses resorbable fillers because permanent fillers have a higher risk of permanent side effects.
What are Dermal Fillers made from?
In the 1980s collagen was the first dermal filler approved in the USA.
However, the leading dermal fillers used by most UK practitioners nowadays are hyaluronic acid based products. Hyaluronic acid is a natural component of our own skin which can be synthesised. Hyaluronic acid based fillers have the advantage that they can last 4 to 18 months depending on the product and they can be broken down by the enzyme hyaluronidase if needed so the filler can be removed more rapidly if necessary.
Other non-permanent fillers to be developed include ones using Poly-L-lactic acid and calcium hydroxylapatite.
Which Dermal Filler should I have?
Dr Teri Johnson has had many years experience performing thousands of treatments with a wide variety of dermal filler brands. This experience has helped her work out which fillers work the best in different areas for different skin types and indications, to give the effect you want to achieve. Some dermal fillers suit some skin types more than others, so if the right filler is not used you will not get the result you want.
At your consultation Dr Teri will assess your skin type, texture and the problems you hope to address. She can then recommend the most appropriate treatment for you and will show you some before and after images of her previous treatments that she has performed with that product to enable you to decide if the treatment is for you.
Dr Teri uses only quality assured premium dermal fillers such as Restylane, Juvederm ultra, Juvederm Vycross, Radiesse, Emervel, Teosyal, Belotero.
If you have had dermal fillers in the past it is helpful to give Dr Teri as much information as possible about the treatment. It will benefit you and her if she knows which products where used, where they were injected, if they achieved the results you expected and if you had any unwanted effects from the treatment.
Dermal fillers come in different thicknesses, and in general, the thicker the product, the deeper it is injected into the skin to help contour the face and plump out lines and wrinkles. Thinner products are less prone to lumpiness and are great for hydrating the tissues but are only affective in treating finer superficial lines.
Which areas can be treated with a Dermal Filler?
Popular Dermal Filler treatment areas include:
Lip Rejuvenations for ageing shrunken lips
Lip Enhancement to volumise lips
Marionette Line reduction
Naso-labial folds (nose to mouth lines)
General Volume Enhancement ( 8 point lift)
Advance Technique Treatments are also available:
Which Dermal Filler Treatment does Dr Johnson specialise in ?
Dr Teri Johnson has years of experience in all the above treatments. However there are few treatments she excels in due to her continued passion for learning and development. One of the treatments she loves performing are lip treatments, she has spent many years perfecting her treatments to deliver a bespoke result using various different fillers to suit the individual. The results are natural, so you can see the improvements but no one else would suspect you have had a treatment, unless of course you want them too!
Dr Teri has performed a large number of Lip Rejuvenation treatments on ladies in their 50s, 60s and 70s with wrinkling around the mouth and lips or have lost lip volume and want a very natural softening rejuvenating effect. Her Lip Enhancement treatment is popular with the younger clients who want a more obvious Lip plumping effect.
Dr Johnson is one of the few Sculptra specialists in Cheshire, she performs hundreds of Sculptra treatments a year and it is her treatment of choice for clients looking for a natural volumising rejuvenation treatment, the great thing is it can last 2 years.
What does a Dermal filler Treatment involve?
Dr Teri Johnson will apply some effective prescription topical anaesthetic cream to the area to be treated to reduce the pain caused by the injections before the procedure.
Dr Teri will then take photos of the area to be treated and go over the treatment with you again to make sure the procedure is definitely what you want.
You will then be asked to read and sign a consent form detailing the treatment and the possible side effects.
If you are happy to proceed Dr Teri will cleanse the area to be treated once you are comfortable on the treatment couch.
Small amounts of dermal filler are injected directly into the skin using an ultrafine needle. The treatment should be relatively painless or mildly uncomfortable. Most of the fillers contain lidocaine so the area treated will become more numb as the treatment progresses. This numbness can last up to an hour after the treatment.
Duration and recovery
Afterwards, there might be a small amount of swelling which will quickly subside. The actual treatment takes between 10 and 60 minutes, however an extra 30 minutes is required to allow the numbing cream to take affect and for your photos to be taken.
No recovery time is required after a dermal filler treatment and you can return to day to day activities straight away. You may experience some slight swelling or bruising to the area being injected which typically doesn’t last longer than 48 hours.
You must not wear make up for 24hours after treatment to avoid the risk of infection.
Dermal Filler Side Effects
Common side effects from dermal filler treatments include:
Bruising, swelling, redness, tenderness and slight bleeding at the injection sites, which will disappear either almost immediately or over a 24 – 48 hour.
Bruises can last a week or slightly longer if you are unlucky.
Very Rare side effects from dermal filler treatments include:
The filler can move away from the intended treatment area over time
You may have an immediate allergic reaction to the filler, which can lead to anaphylaxis
The filler may form lumps under the skin
In extremely rare cases, the filler could block a blood vessel, which can lead to tissue death (necrosis), permanent blindness .
Why should I see a medical practitioner for a dermal filler treatment:
Premium dermal fillers are classed as medical devices and the manufacturers recommend that treatments should only be carried out by medical professionals, although this isn’t currently a legal requirement.
If a rare side effect were to occur after a dermal filler treatment only a medical practitioner is able to manage the complications as prescription only treatments such as antibiotics, hyaluronidase ( to dissolve the filler), adrenaline ( in case of a rare anaphylactic reaction) etc are needed. Dr Teri Johnson has the training, protocols and important equipment to deal with these rare but potential side effects and emergencies so she can manage them appropriately.
Summary of Fillers:
One of the most popular dermal fillers used in the UK launched in 1996.
A clear non-animal biodegradable gel based on hyaluronic acid that now contains lidocaine to reduce the discomfort during treatment .
Dr Johnson uses:
Restylane Moderate sized particles make it ideal for moderate wrinkles and lip enhancement.
Perlane The particle size of the gel is larger, making it ideal for deep lines, folds and facial contouring such as check, brow and chin enhancement.
Restylane Lipp This product has been designed for injecting into the lips and is structured to withstand the large amount of movements that occur in the lips from day to day.
For more information click here: Restylane
Juvederm is a hyaluronic acid gel injected into the skin with a fine needle, that plumps out the skin filling lines, and deeper folds.
Made from a cross linked hyaluronic acid similar to the body’s own natural collagen.
It is a safe treatment available in different formulations. It was improved in 2008 to make it last longer and it now contains lidocaine to reduce the discomfort during treatment.
Dr Johnson uses:
Juvederm Ultra II for filling fine lines and fine wrinkles e.g. smokers lines.
Juvederm Ultra III for wrinkles and moderate furrows e.g. mild to moderate nasal furrows
Juvederm Ultra smile for lips.
Juvederm Ultra IV for deep folds and lips. e.g. Naso labial folds, marionette folds, and adds volume to lips.
Juvederm Volbella for lip rejuvenation and tear trough rejuvenation
Juvederm Voluma for volume restoration
Dr Johnson uses the Juvederm range for a lot of her lip treatments, for the 8 point lift and cheek enhancements.
Radiesse is made up of calcium hydroxylapitate microspheres in a gel. Once injected it stimulates your skin to produce new collagen.
Radiesse has FDA approval and does not contain any animal or human derived components and does not require an allergy test. Designed for the correction of large and small soft tissue creases but can also be used for facial contouring/shaping. Launched in 2000 and becoming increasingly more popular as it tends to last longer than the above products.
Dr Johnson uses Radiesse for Hand Rejuvenation, Marionette lines, naso labial folds and volumisation
For more info click here: Radiesse
A mono phasic cross linked Hyaluronic acid filler which is good for finer lines and wrinkles where little volume is needed.
For more info click here: Belotero
Another monophasic hyaluronic acid filler with a full product range. For fine lines, lip augmentation, smokers lines, and facial contouring (adding volume to cheeks, chins and other facial features).
For more info click here: Teosyal
Emervel® is an exciting and sophisticated range of soft dermal fillers designed to help you look and feel your best. Smooth away facial lines, restore volume or enhance your smile with a lip treatment. The Emervel range is designed to complement the varying stages of facial ageing to provide natural looking results.
All Emervel® products are based on hyaluronic acid (HA), a natural substance found in your own skin. Optimal Balance Technology™, the unique technology behind Emervel, ensure its fixed HA concentration is the most suited to our own body’s concentration for enhanced safety and longevity.
After treatment with 1 syringe of Restylane to right naso-labial fold.
Before treatment you can opt for local anaesthetic cream, or a local anaesthetic block.
All our treatments are performed by Dr Teri Johnson.
After treatment with 2 syringes of Restylane. The left side has now been treated also.