Background
Hyaluronic Acid (HA) is a long unbranched chain of repeating sugar units. They are highly polar and attract water. They are therefore useful to the body as a lubricant or shock absorber. HA is distributed widely throughout connective tissue, epithelial, and neural tissues. HA is also a major component of skin, where it is involved in tissue repair. Because of these properties, HA is a clear choice of product for use as a dermal filler. When HA gel is injected, it acts to support facial structures and tissue that may have lost volume or elasticity due to normal aging. It also draws water to the skin surface to keep it looking soft, hydrated, and youthful.
Hyaluronic Acid Fillers are manufactured to have varying properties. Some are created more firm. Some integrate into the tissue better. Some absorb more water. Some are more resistant to change and integration. Knowledge of the product and the correct choice for various areas of the face are crucial to a successful aesthetic outcome. For example, a firm product is desired to augment bony structures like the cheek and jawline. A soft product would be inappropriate for these areas but more ideal for the lips and under eye which have thinner skin.
What areas can be treated?
Common low risk treatment areas include the cheek bones, jawline, chin, and lips. Moderate risk areas include the nasolabial folds (laugh lines) and under eyes. Higher risk areas include the forehead, temples, and nose. Dr. Leonardo is well-versed and trained to perform Pan facial treatment safely. This means Dr. Leonardo can inject any areas of the face safely due to his medical knowledge and training. Please note, this does not mean these treatments are absent of risk but rather the knowledge of anatomy and technique lend to a safer outcome.
What can I expect during my appointment?
Although aesthetic in nature, injectable filler treatment is still a medical procedure. Consultation is always required prior to treatment to obtain pertinent medical history, to conduct a thorough physical examination, and to understand your aesthetic goals. Treatment options, limitations, risks, and benefits will be discussed based on your diagnosis.
The treatment area is cleansed with an antiseptic solution. Topical anaesthetic cream may be applied to the treatment area, although some areas do not require topical numbing. The product is then injected using very fine needles or a blunt tip cannula (BTC) which is basically a long thin metal tube with a blunt end. The BTC allows for less bruising since it generally glides past blood vessels without puncturing them. The bigger the cannula, the less chance for vascular injury and bruising, but it too is not foolproof. The BTC typically only requires one entry site per side to be able to administer the product to a wide area. You should be free of makeup when you return on a subsequent office visit. However, you will be able to wash and clean your face.
Follow Up appointments are scheduled 2 weeks after treatment. Photographs will be taken with the same facial expressions as during consultation for comparison sake. Adjustments are made if necessary.
What is the ideal age to start filler treatment?
Patients in their mid to late 20s can begin as a preventative measure. This is known as "prejuvenation". Often patients in their late 30s to late 40s initiate treatment to appear more refreshed. Those who begin later in life may require more volume restoration in conjunction with skin treatment. Depending on severity, advanced-age patients may have a satisfactory result. If not, there are other treatment options available but they may be more complicated and require more sessions to achieve their end result.
Will I Look Natural?
Dr. Leonardo's approach leads to natural looking results. He prefers to restore age-rated volume loss by augmenting bony structures for support of the soft tissue. He prefers not to inject superficially as this may result in heaviness of the dermal tissues which may make lines appear worse as the tissue is weighed down. His approach follows the rules of facial optimization to create a more youthful balanced appearance. Bleeding, bruising, and swelling are fair game after injectable treatment. Volume may appear exaggerated during the time immediately after procedure. Allow 2 weeks for the full result to mature as swelling subsides and the product is integrated into the proper tissue planes. Plan accordingly if you have a major event to look your best.
