3. Dermal Fillers (HA based fillers) & Anti-wrinkle Injections
Non-permanent fillers (HA) have been used for skin rejuvenation for over 15 years with good effect. This treatment involves a fine needle or cannula (blunt needle) to place a specific amount of gel composed of a sugar into different depths of the skin to achieve a specific outcome, either volumize the area (e.g. under eye hollowness) or soften or reduce static wrinkles or lines (e.g. “smokers lines” of the upper lip). The outcome is immediate, and the treatment is well tolerated with mild to minimal pain. The filler also contains a local anaesthetic (“numbing ingredient”) to facilitate the treatment, which lasts usually less than 20 minutes. Dr Omarjee will sometimes also place a medical grade topical anaesthetic gel to the upper lip area skin prior to dermal filler to further make his patients a ease during the injecting process.
Dermal fillers (HA) can be a good option for some patients with static wrinkles in the upper lip area or for volumizing hollowness in the under-eye area, or also known as the tear trough area. The results can last for months to up to 2 years in some people after one treatment. There is usually no downtime, except the possibility of some bruising (mild to moderate on average), and temporary swelling for a 1-2 days in most patients.
For upper lip lines, there are static and dynamic lines to address. Dermal fillers work in 2 main ways to improve these lines; volumizing the upper lip area between the skin and the deeper muscle (orbicularis oris), like inflating a balloon, creating a more convex smoother and less lined appearance. And secondly injecting into the vertical orientated lip lines to make them shallower and blend more with surrounding skin.
Dr Omarjee usually likes to add anti-wrinkle injections into the upper lip area also to reduce the activity of the orbicularis muscle, which reduces some of the dynamic lip lines. This quick and beneficial effect usually takes 1-2 weeks to reach its optimal result and complements the dermal filler volumizing. Hence the combination of dermal filler and anti-wrinkle injection is a good treatment, with minimal to no downtime, and can improve the upper lip area (as well as lower lip area lines) to a nice extent. It is important to balance the amount of dermal filler and anti-wrinkle injection to reduce any side effects, which if occur are usually short lived (a few weeks) These can include prolonged swelling in area of dermal filler, difficulty whistling, a mild numb feel to the upper lip area and mild dribbling when drinking from a cup. The anti-wrinkle injection treatment needs to be repeated every 3 months on average and the upper lip filler every 5-6 months.
For the undereye area (tear trough area), if deemed suitable a dermal filler can be placed to increase the volume in this area and reduce the shadowing that occurs as a result of volume loss. This volume loss can actually start from an early age as of genetic factors and will usually steadily worsens over time, giving the individual a hollow or tired appearance. The actual placement technique and choice of a very specific type of filler in this complex area is critical to the success of treatment of tear trough rejuvenation. Dr Omarjee prefers to use a cannulae (blunt needle) approach to volumizing tear troughs to minimize risks with treating this area. Some of the rare complications associated with dermal fillers anywhere on the face are related to vascular occlusion, which can lead to skin loss (necrosis) and associated scarring and worse still, irreversible blindness. Blindness is a rare complication of dermal filler and is more associated with midline injections of dermal filler (e.g. nose, forehead/frown area, temples). Like with all medical treatments, it’s imperative to know the risks, potential benefits of the proposed treatment, as well as the qualifications and experience of your injector.
Antiwrinkle injections can also be utilized in some people for under-eye area wrinkles. Each patient is assessed to see if their skin is suitable for this treatment. The orbicularis oculi muscle in the under-eye area can be partially relaxed to reduce under-eye wrinkling, but this benefit needs to be balanced with maintaining lower eyelid function and lymphatic drainage of this area. Also, the skin on the lateral part of your eyes can reflect your age (known as the “crow’s feet” area), a little Dr Ed magic with anti-wrinkle injections in this area is usually very rejuvenating to the whole ocular area.