FAQs Fillers

Pre-Treatment Instructions

1. To minimize risk of infection it is important to avoid dental work, including cleanings, for the 2 weeks before and after your filler procedure. We also ask you do not have filler within 2 weeks of a vaccination, particularly for Covid-19 to avoid risk of swelling or nodular reaction.
2. Discontinue aspirin for 10 days if possible, and ibuprofen (Motrin, Advil) and Vitamin E for 5 days prior to the procedure, as these medications will make you more likely to bruise. If you have been prescribed one of these medications, ask your doctor before you stop taking it. Tylenol will not cause bruising and is preferred for the week prior to treatment.
3. If you are prone to bruising, you may use oral or topical Arnica preparations as per package instructions. Eating pineapple which contains bromelain can also help for a few days prior to the procedure. Vitamin K containing foods such as green leafy vegetables can also be helpful.
4. Machine wash any fabric facemasks you will be wearing to avoid wearing soiled masks after the procedure. Make sure your facemasks don’t press into the area you wish to have treated. Blue surgical style disposable masks are generally effective without pressing into the facial areas treated.
5. Given facemask wearing during the pandemic we recommend trying to decrease oral bacteria and its effects on the treated area. You may accomplish this by using mouthwash to swish and spit 2x per day after brushing starting a day or two prior to the procedure and continuing for at least a week post procedure. Try Crest Pro-Health, Listerine Cool Mint or CloSYS Antibacterial mouthwash to decrease oral bacteria.
6. If you wish to use numbing cream, you must apply this before coming into the office. We cannot allow patients to sit with numbing cream in our office for safety reasons during the pandemic. Numbing cream (such as Topicaine) is particularly useful for injections around the mouth/lip area and for fine lines on the cheeks. Apply a thin area 30-45 minutes before your appointment and reapply in your car just before you enter the office. You may pick up a tube in our office a few days before your procedure or order in advance from Amazon. https://www.amazon.com/TOPICAINE-Lidocaine-grams-Anesthetic-
   Numbing/dp/B0028M5E5E/ref=sr_1_8?dchild=1&keywords=topicaine&qid=15945 69250&sr=8-8

What are Dermal Fillers?

Juvederm Ultra/Ultra Plus, Juvederm Voluma/Volbella/Vollure and Restylane L/Lyft/Silk, and RestylaneRefyne/Defyne, are injectable products made of hyaluronic acid chains by different manufacturers. Hyaluronic acid is a molecule that binds water and is normally found in the deeper layers of the skin. These fillers do not contain any animal products. Hyaluronic acids have been used in this country for medical treatments in the eye and joints for many years and have been used for cosmetic purposes in the U.S., Europe and Canada for over a decade with an excellent safety profile. The thicker variants of these products, Juvederm Voluma/Juvederm Ultra Plus, and Restylane Lyft are generally used for deeper folds and cheek volume and is injected more deeply. The newer fillers Juvederm Volbella and Restylane Refyne are used for finer lines and is injected higher up in the skin.

When will I see results?*

Results are generally noted immediately, although mild swelling, bruising and redness generally can take at least 48 hours to resolve. Maximum results may take 1-2 weeks to fully appreciate. Makeup may be applied the day after treatment. If more correction is desired, additional treatments can be performed at least 1 week after an earlier visit leading to further improvement.

How long will the results last?*

Benefits initially last about 6 to 12 months for most hyaluronic acid fillers, though Voluma studies demonstrated most patients maintained results at 2 years. Voluma is commonly used for cheek and mid face volume (and is slightly more expensive than the other fillers). Longevity will vary depending on the area treated and the individual patient. Lip enhancement may resolve more quickly because of the mobility of the area.

Do the injections hurt?

Most fillers now contain lidocaine anesthetic which has made the procedure more comfortable. Numbing cream may be applied before the appointment at home prior to the appointment to improve the experience. We use ice packs in the office which helps with discomfort as well as swelling. We may also use the cannula technique when indicated to minimize discomfort in the cheek area primarily.

Are there risks to the procedure?

Transient bruising at injection sites can occur, particularly if you have had recent aspirin or ibuprofen(Advil). Puffiness, tenderness and/or redness may result for 1-4 days, and rarely longer. Small areas of firmness may be palpable, and rarely visible, but blend in with time. If necessary, any visible bumps from the filler can be removed using a tiny injection of a medication that dissolves the filler(hyaluronidase). Very rarely, prolonged swelling, redness, itching, firmness or bluish bumps may last weeks or longer. It is unknown if this is increased by wearing masks or other changes during the Covid era. Other rare side effects include dizziness, headache, rash, visual disturbances, infection, or reactivation of cold sores. Extremely rare side effects include compression/occlusion of blood vessels leading to formation of a scab which can result in a scar. Exceedingly rarely this can lead to blindness or stroke.

Who should not be treated with Hyaluronic Acid Fillers?

You should not be treated if: You are pregnant or nursing, you have multiple severe allergies or history of anaphylaxis, you are taking a blood thinner such as Coumadin (Warfarin) or high dose aspirin, you have a bleeding disorder or if you have had a previous allergic or severe swelling reaction with hyaluronic acid fillers.

Patient Instructions for Fillers

Pre-Treatment Instructions

1. To minimize risk of infection it is important to avoid dental work, including cleanings, for the 2 weeks before and after your filler procedure. We also ask you do not have filler within 2 weeks of a vaccination, particularly for Covid-19 to avoid risk of swelling or nodular reaction.
2. Discontinue aspirin for 10 days if possible, and ibuprofen (Motrin, Advil) and Vitamin E for 5 days prior to the procedure, as these medications will make you more likely to bruise. If you have been prescribed one of these medications, ask your doctor before you stop taking it. Tylenol will not cause bruising and is preferred for the week prior to treatment.
3. If you are prone to bruising, you may use oral or topical Arnica preparations as per package instructions. Eating pineapple which contains bromelain can also help for a few days prior to the procedure. Vitamin K containing foods such as green leafy vegetables can also be helpful.
4. Machine wash any fabric facemasks you will be wearing to avoid wearing soiled masks after the procedure. Make sure your facemasks don’t press into the area you wish to have treated. Blue surgical style disposable masks are generally effective without pressing into the facial areas treated.
5. Given facemask wearing during the pandemic we recommend trying to decrease oral bacteria and its effects on the treated area. You may accomplish this by using mouthwash to swish and spit 2x per day after brushing starting a day or two prior to the procedure and continuing for at least a week post procedure. Try Crest Pro-Health, Listerine Cool Mint or CloSYS Antibacterial mouthwash to decrease oral bacteria.
6. If you wish to use numbing cream, you must apply this before coming into the office. We cannot allow patients to sit with numbing cream in our office for safety reasons during the pandemic. Numbing cream (such as Topicaine) is particularly useful for injections around the mouth/lip area and for fine lines on the cheeks. Apply a thin area 30-45 minutes before your appointment and reapply in your car just before you enter the office. You may pick up a tube in our office a few days before your procedure or order in advance from Amazon.
   

https://www.amazon.com/TOPICAINE–Lidocaine–grams–Anesthetic–
Numbing/dp/B0028M5E5E/ref=sr_1_8?dchild=1&keywords=topicaine&qid=15945 69250&sr=8–8

*Individual Results May Vary*