DERMAL FILLERS

You must not use any NSAIDs or blood thinning supplements for at least one week after the treatment and discontinue the consumption of alcohol and caffeine for at least 72 hours after the treatment - the chemicals in these products have a blood thinning effect on the body, reducing its ability to clot and exacerbating bruising and swelling.

You must sleep on your back, face up, with the head slightly elevated to help reduce swelling (if the treatment was carried out on, or above the neck line), until the swelling has completely subsided - elevating a swollen area above the level of the heart helps the extra fluid to move back towards the heart for circulation to other parts of the body, thus reducing swelling faster and more efficiently.
It is also possible to squash or flatten dermal filler whilst it is settling if excessive force is applied to the treated area - such as when sleeping sideways, leading to asymmetry.

You must avoid activities that involve the radiation of heat or an increase to core body temperature such as sun bathing, saunas, and hot tubs, for at least one week after the treatment, as this will exacerbate swelling - swelling is caused by bleeding in the tissue, and heat draws more blood to the area, exacerbating swelling.
Sun exposure also breaks down both collagen and hyaluronic acid, damaging the dermis, where collagen and hyaluronic acid are produced.

You must avoid strenuous exercise for at least one week after the treatment for multiple reasons - exercise leads to sweating, and sweat can mix with the bacteria on the skin, contaminating the treated area and leading to infection. In addition to this, exercise also increases core body temperature and blood flow, which can exacerbate bruising and swelling as more blood is drawn to the treated area. An increase in blood flow will also accelerate the metabolism of the administered product before its diffusion and tissue integration are complete, which will lead to substandard results.
An average of one litre of fluid is also lost per hour of strenuous exercise - this can have a dehydrating effect on the body, decreasing the available fluid for the administered product to absorb from the surrounding tissues, which will lead to substandard results.

You must not use topical hair or skin care products and must avoid any hair removal or hair dying treatments for at least 48 hours after the treatment - this can lead to skin irritation.
If a subsequent treatment is due to be applied in close proximity to the treated area, this may only be done once it has fully healed.

You must drink plenty of water (4-5 litres, daily) for at least two weeks after the treatment and must not consume alcohol, caffeine or foods with diuretic or dehydrating effects on the body for at least 72 hours after the treatment - water is a major component of the blood and dehydration reduces the bodies blood volume, which reduces oxygen and nutrient delivery to the wound bed, impairing wound healing and therefore recovery.
Hyaluronic acid - the main component of dermal filler, is also hydrophilic in nature, absorbing up to ten times its volume with water from the surrounding tissues, making adequate hydration essential for optimal results.

You must avoid touching the treated area or applying make up for at least six hours after the treatment to avoid exposing the treated area to any bacteria - leading to infection.

You must not fly for at least two weeks after the treatment - the changes in cabin pressure can cause blood vessels to leak into the treated areas, which will dramatically increase swelling and bruising.

You must avoid the application of pressure against the treated area or the surrounding areas for at least one week after the treatment, this means avoiding tight fitting clothing or accessories and treatments that involve firm pressure or massages - this can cause irritation to the treated area and displace the administered product.
Sunglasses for example, can squash dermal filler whilst it is settling.

You should avoid or limit cigarettes and vapes where possible for as long as possible after the treatment - smoking reduces the amount of oxygen in the blood and narrows the blood vessels, impairing wound healing and therefore recovery.
Smoking also involves the contraction of the lip muscles whilst heat can lead to the product becoming more mailable, therefore if the lip area has been treated - this can displace the administered product whilst it is settling. Other actions that involve the contraction of the lip muscles such as sucking and kissing should also be avoided or limited whilst the administered product is settling.

You may apply a sterile, cold compress to the treated area, to help reduce swelling, until the swelling has completely subsided - cold temperatures will help to constrict the blood vessels, decreasing circulation and reducing swelling.

You may take anti-histamines, as directed by the manufacturer, to help reduce swelling, until the swelling has completely subsided - histamine is a chemical that causes blood vessels to expand and the skin to swell. Anti-histamines work by blocking the effects of histamine, which reduces swelling.

You may take acetaminophen or paracetamol to help manage any discomfort after the treatment.

If you have been supplementing with Arnica tablets prior to the treatment, continue supplementation with Arnica tablets for one week after the treatment, as directed by the manufacturer. You may also use topical Arnica, as directed by the manufacturer, until swelling and bruising has subsided. Arnica is believed to lead to vasodilation, the opening of blood vessels - this inhibits blood and other fluids from accumulating in the treated area, which helps to reduce swelling and enables the body to re-absorb any bruising.

If you have previously suffered from cold sores and are having dermal fillers administered in close proximity to the mouth area, there is a risk that the needle punctures from the treatment could contribute to another eruption of cold sores - if cold sore medication (such as Acyclovir) was started two days prior to the treatment, continue to take the medication after the treatment until the area has fully healed to help mitigate this risk.

After the treatment, there may be mild bleeding, scabbing, slight redness, bruising, swelling, tenderness and an itching sensation in the treated area - this is a normal side effect of the treatment and generally disappears after a few days - if any of these symptoms continue after a week, or if any other reactions occur, please contact the clinic.

If the needle makes contact with a blood vessel - the blood vessel can leak and cause an internal bruise, this is known as a hematoma which is essentially a word used to describe a bad bruise. A hematoma occurs when blood leaks outside of a blood vessel, it can look dark in colour and feel lumpy but the blood will be re-absorbed by the body and the colour and texture will soon return to normal. It can take up to two weeks for a hematoma to resolve and they often appear worse before improving.

If a lump appears please do not massage it, as it is likely swelling. If a lump that has been caused by swelling and trauma is massaged, it will become aggravated and cause further inflammation. It is best to leave the lump alone and let it heal. If a lump has not resolved on its own within two weeks, contact the clinic for further advise.
I will massage any lumps out during the appointment if necessary.

One of the main dangers of dermal fillers are the risks of vascular occlusion and vascular compromise.

Symptoms of these conditions include:
- Changes in the skin colour such as blanching - or white spots, blotches or mottling
- Immediate, severe, and disproportionate pain
- A fever and/or chills

Other secondary and later-stage diagnostic symptoms include blisters, pustules, and tissue necrosis - which typically develop a few days after the initial complication. Scarring may occur as the end stage of the necrosis and healing process, particularly if intervention has not been undertaken.

CONTACT THE CLINIC IMMEDIATELY IF YOU HAVE ANY OF THE ABOVE SYMPTOMS!

A vascular occlusion occurs when blood is no longer able to pass through a blood vessel. It may be a complete occlusion or a partial occlusion, resulting in a diminished blood supply. If a vascular occlusion is not treated it will develop into necrosis or tissue death.

Vascular compression is slightly different and occurs when a blood vessel is compromised due to the external force surrounding the vessel causing a compression blockage.

A vascular compression can sometimes be resolved through heat and massage however, a vascular occlusion will need to be resolved through the administration of hyaluronidase, an enzyme used to dissolve hyaluronic acid.

Arterial episodes typically have an acute onset and occur as the product is injected, venous episodes on the other hand tend to have a delayed onset and can occur once the client has left the clinic - although the two are not mutually exclusive.

If there is evidence of a vascular occlusion or a vascular compromise that cannot be resolved through heat and massage - the dermal filler will need to be dissolved immediately using an enzyme called hyaluronidase, which breaks down hyaluronic acid into monosaccharides by cleaving its glycosidic bonds.

Occasionally, clients may be allergic to hyaluronidase which could lead to anaphylaxis. Anaphylaxis is an extremely serious medical condition - to safeguard against this, a patch test using a small quantity of hyaluronidase is administered into the forearm. If the patch test indicates that you may be allergic to hyaluronidase, the treatment will need to be carried out under hospital observation.

Although the results of dermal filler appear to be instant, the swelling following treatment can last for up to two weeks - the treated area can look somewhat un-even during this time. In addition to this, hyaluronic acid-based fillers are water-binding and can take up to four weeks to fully integrate into the body’s tissues. It is for this reason that the full results of the treatment are not visible until four weeks after the treatment.

It may take multiple treatments to achieve the desired result. Once the desired result has been achieved, a subsequent appointment will only be required if more dermal filler is desired.

IF YOU HAVE ANY QUESTIONS OR CONERNS FOLLOWING THE TREATMENT, PLEASE DO NOT HESITATE TO CONTACT US!