31.7.2022 | Treatments
10.5.2022 | Treatments
Treatment with dermal fillers in Swansea is now commonplace, since the substances (and treatments) have revolutionised aesthetic medicine over the last 20 years since the introduction of Restylane with FDA approval in 2003, the first modern dermal filler. Before this, practitioners had to use bovine collagen or fat transfer which had many drawbacks. Modern hyaluronic acid dermal fillers replace lost volume and can rejuvenate and beautify. It also helps the overlying soft tissues, lifting the face and reducing ageing facial shadows.
Hyaluronic acid is a naturally occurring substance within the skin. Naturally, it only lasts around two or three days before being recycled, so dermal fillers have linked molecules, leading to long-lasting results. Other fillers such as Sculptra and Radiesse work differently and are particularly good for specific indications such as in the hands.
The concentration of hyaluronic acid and the degree of cross-linking will determine the properties. In our Swansea clinic, softer dermal fillers are often used in areas such as the teartrough or lips where more natural movement are needed, where thicker, more robust gels placed onto the underlying bone tend to be used in the cheeks, chin and forehead for example.
We have come to appreciate that aesthetic treatment should focus on the underlying causes such as structural changes in the skeleton and soft tissues. As we age, there is a loss of volume, most pronounced in some regions of the face, accompanied by soft tissue laxity and sagging.
At Infinity Aesthetics Swansea, Owen has level-7 training, having the knowledge to inject dermal fillers around the face to create a harmonious, rejuvenated appearance. He can inject with needle or cannula depending on the area within the face, adjusting the technique and depth of injection to remain as safe as possible and obtain the best result. Typically, he starts in the midface around the cheeks or temple to provide a lift which can be seen in the tissues of the lower face before targeting these directly.
It is imperative, however not to overfill a face as this can lead to an abnormal appearance, such as excessive lip size or massive cheeks. When using dermal fillers in our Swansea aesthetic clinic, we always aim for a natural appearance, considering timeless beauty proportions.
None or topical local anaesthetic
Some of the specific areas that Owen targets include:
Cheek dermal filler; a crucial part of midface rejuvenation and often the first place to target. Injections are mainly deep underneath the muscle layer to restore volume lost from the bony skeleton, also lifting the muscle layer which can provide a subtle nonsurgical facelift to the lower face and restore the triangular shape of youth.
Dermal filler for temples; this is an underappreciated area to restore temple hollowing, providing a subtle lift to the mid-and lower face and a brow lift due to myomodulation (allowing muscles to change activity due to underlying dermal filler).
Dermal filler for the forehead; this replaces volume in the frontal part of the skull and is placed underneath the muscle layer to smooth wrinkles and provide a smooth convex surface which is youthful and desirable.
Teartrough dermal filler; Owen performed a precise evaluation to accurately place dermal fillers in the teartrough to fill the teartrough groove. This must be done carefully and subtly so as not to overfill, which can cause persistent oedema.
Chin dermal filler; as we age the mandible recedes so the chin shrinks back. This affects the profile, making the nose look longer. Restoring a feminine or masculine chin, depending on the desired look can make a person appear much more dynamic and youthful, balancing facial proportions.
Nonsurgical rhinoplasty; this is one of Owen’s signature treatments, with a safe, precise and effective technique learned from the top specialist in the UK (Dr Ayad Harb). He uses tiny needles to place small boluses of filler onto the nasal skeleton, correcting a nasal hump, deviation of the nose, a broad nasal tip and drooping of the nose.
Dermal filler for jawline; this can produce a sharper and defined jawline, again making a person look younger and much more facially dominant. This is mainly done with a cannula disguising jowling and producing a masculine or feminine appearance (depending on exactly where the filler is placed). This is great in combination with Morpheus8 treatment.
Dermal filler for marionette lines; Owen uses a needle and cannula to strengthen the tissues around the marionette zone which can lead to downwards drooping of the corners of the mouth. This is great in combination with midface treatment to provide a lift due to stretching of the muscle layer.
None or topical local anaesthetic
Around 95% of the dermal fillers that Owen uses are made of hyaluronic acid which is discussed in the article above. This is a natural substance although the molecules are held together by laboratory processes. It is a very safe substance and is totally biodegradable and can be reduced or quickly with a reversing enzyme.
Dermal fillers will typically last between 6-24 months, depending on the type of filler, the area injected, the volume and other factors such as individual metabolism.
Softer fillers such as in the lips and tear trough typically last around six months when first injected although with subsequent injections do seem to last longer with many people still seeing an improvement after one year following the second treatment. There is evidence on MRI scanning that dermal fillers can last considerably longer even if they are not palpable.
Firm fillers such as in the cheeks or chin can last 18-24 months and sometimes more.
Owen only uses FDA-approved fillers from the world’s top laboratories. He uses a combination of Restylane (USA), Teoxane (Switzerland), Belotero (Germany) and Juvederm (USA). As these are FDA-approved, there is data from studies in patients to demonstrate safety and efficacy. Many of the newer fillers originating from (for example) the Far East have very little safety or efficacy data but are considerably cheaper; Owen only uses dermal fillers with robust clinical data to ensure that the treatments are safe and effective.
Hyaluronic acid dermal fillers are reversible with an enzyme called hyaluronidase, breaking the bonds that bind the dermal filler gel together. This is done if there is overfilling or migration of dermal filler. Sometimes it is important to dissolve any filler before starting again as eventually placing too much filler in a certain structure can lead to a poor aesthetic result. Owen performs a skin prick test to reduce the likelihood of allergy for injecting the substance.
All injections entail some discomfort but for most people, this is much less than expected. In more sensitive areas such as the lips, Owen uses strong local anaesthetic and typically uses the smallest possible needles, alongside cooling and vibration to reduce the transmission of pain impulses through small pain fibres. Also, using a cannula in some areas means fewer needle entry points. Most people find that cannula treatment can be slightly odd but does not typically tend to be particularly painful.
Straight after the dermal filler procedure, there should be a noticeable improvement. It can take around two weeks or so for the dermal fillers to integrate fully into the surrounding tissue but straight away he will have a good idea as to how the result will look. In some areas such as the lips where there tends to be immediate swelling, it can be a little difficult to tell the final results straight away. For deep injections, you can see most of the effect immediately in most cases.
Yes, in general hyaluronic acid gels are incredibly safe. There is an exceptionally low risk of allergic reaction although they are mixed with local anaesthetic so there is a small risk of allergy from this. A tiny number of patients (around 0.05%) go on to experience lumps forming in the filler over many months or years and this can be treated with certain medical approaches such as saline steroid injection and ultimately filler dissolving with hyaluronidase. As mentioned above, Owen only uses fillers with FDA approval and a strong evidence base for safety.
Post-procedure care is essential and Owen makes himself personally available to deal with any side effects or complications, whenever these may occur. This includes out-of-hours emergency care in the unlikely event that this would be needed.
Dr Owen Thomas is a highly trained aesthetic physician with a level 7 qualification in injectable treatments.
He uses his passion and skill combined with a professional, ethical and safe approach, to enable his patients to feel rejuvenated, confident and ready for everything life has to offer.
As we age, we lose volume over our forehead, leading to a loss of the smooth convexity of youth and leading to a sunken appearance and illusion of a longer nose.
Hand rejuvenation is an increasingly commonly requested treatment, also known as the ‘Radiesse Hand Lift’ because of the special long-lasting dermal filler used.
The nonsurgical rhinoplasty (liquid nose job) uses dermal fillers to improve the profile and shape of the nose, and is a signature treatment for Dr Owen Thomas, who has trained with the top consultant in the country who pioneered the modern version of the technique.
It is a long-lasting alternative to surgery, with far less recovery time and can make a huge difference to the lives of our patients who have longed for a more aesthetically pleasing nose.
Over recent years, the chin and jawline area has become much more important, giving a strong, youthful look and giving balance to the overall facial appearance.
Assessment and treatment of the chin together with assessment of the nasal profile and lips is often called profile balancing. This looks to create a harmonious dependent on facial portions, typically using dermal fillers in the chin and lips and a nonsurgical rhinoplasty where indicated.
A full facial profile may also look at assessment of the forehead where frontal bossing can lead to a slightly hollowed appearance and may also benefit from soft fillers injected into the forehead. This is a potentially high risk area due to arteries that run within the forehead and a medical injector would be essential to reduce the incidence of complications. You can see more on forehead filler at the link here.
As we age, we lose volume in our temples, giving the face an appearance which is sunken and more skeletonised, but can be treated with dermal fillers.
Tear trough dermal fillers are injected in the area under the eye used to combat the sunken area under the eye (tear trough) dark circles or ageing signs.
Nasolabial folds run from the corner of the nose down towards the corner of the mouth often becoming more pronounced with ageing as laughing and smiling over a person’s lifetime causes these to become deeper often adding years to a person’s appearance. It is however a natural line, and care must be taken not to obliterate this (as it looks weird and not aesthetically-pleasing).
As we age, tissue is lost from the chin which recedes and with loss of tension in the supporting ligaments of the mid and lower face, lines form running from the corner of the mouth down towards the chin (Marionette lines).
Lips are a crucial part of facial beauty and attractiveness for both men and women and can be enhanced with lip filler in our Swansea aesthetic clinic with masterclass techniques for definition and natural volume, without producing an unnatural over-filled appearance.
The eye (peri-orbital) area is one of the first parts of the face to show the signs of ageing, due to a loss of volume and wrinkles caused by facial movements.
Aging causes many changes in the appearance of the face including loss of volume, horizontal and vertical descent of the tissues, brow ptosis, hollowed temples, hollow cheeks and a loss of muscle tone resulting in a more ‘aged’ look.
Typically this is associated with aging but it is important to note that brow ptosis can also occur as result of sun exposure (where dermal damage occurs), dermatoheliosis (premature aging of dermis), dermabrasion or brow trauma.
In some cases it can even be inherited, where the brows are inflexible and cannot achieve a lifted appearance.
Facial volume loss can cause a young, full face to become older and thin. Chubby cheeks seen in young people are not always due to weight gain, but rather represent a firm, smooth face that has not yet experienced any problems in soft-tissue health.
As the face loses fat, the skin can sag and lose elasticity. Wrinkles may appear as the soft tissue beneath the eyes shrinks. Facial volume loss may make individuals appear older, but there are many ways to combat the underlying causes of the condition – reduced collagen production, for example.
Over the last 10 years aesthetic medicine has changed focus from individual areas of the face to look at the reasons behind ageing, including significant facial volume loss.
A full and round face shape can begin to lose volume, appearing sunken and skeletal for a variety of reasons. Ageing naturally, weight loss, hormone shifts, UV exposure, smoking, injury, and certain medical conditions that require specific medicines that result in volume loss all contribute to a loss of fat in the facial region.
Facial volume loss occurs predictably in the bones of the face alongside weakening of the ligaments supporting the facial muscles and ligaments and loss of collagen and elastin in the skin.
This causes a sunken appearance in some areas, forming excessive folds such as in the nasolabial area, changing eye shape and leading to jowls and a weak chin due to bony recession.
A lack of collagen makes a face appear older. The role of collagen is to provide a supportive structure for the skin, resulting in plump, firm skin. As we age, the elasticity of facial skin also declines as collagen diminishes. When facial fat decreases and shifts as we age, the lack of collagen and fat may make a face look older.
Once evenly-distributed face fat around the eyes, cheeks, forehead, temples, and mouth shrinks, resulting in facial volume loss. Round cheeks sink downward, causing hollowness under the eyes. Lips lose their plumpness as they age and appear thinner.
As time passes, fat may accumulate in areas where the skin was previously taut, such as in the lower jaw. When facial fat is stored in the lower face, it may result in unsightly jowls of sagging skin hanging on each side of the jaw and the neck.
Wrinkles are a result of daily, repetitive facial muscle contractions. The loss of facial fat and the resultant decrease in facial muscle activity causes deep wrinkles and folds. This, coupled with a reduction in collagen that gives thick, supple skin, can result in an undesirable appearance.
The eyes are a crucial component of a youthful look. As we age, there is bony volume loss around the eye, making the eye look more sunken and hollowed (a skeletal appearance).
Forehead and frown lines are an early sign of ageing as over time the skin loses its ordinary connective tissue support with decreasing levels of collagen and elastin.
A misshapen nose can have a visible bump (called a dorsal hump) in one place, an indentation close to the tip or drooping of the nose.
The hands are a part of the body that can show a person’s age, often neglected compared to the face.
Formation of jowls around the lower face make us look much older than we feel.
Many people find that over time that can accumulate in the compartments under the chin giving rise to a loss of the normal chin-to-neck angle and the appearance of a double chin.
Deep nose to mouth lines (marionette lines) are due primarily to a loss of volume around the mouth in the bone and soft tissue, with ligament laxity.
Lipstick lines, otherwise known as smokers’ lines, appear as small vertical creases and wrinkles that run along the lips of older people, usually perpendicular to the border of the lip.
Some individuals can have a chin that recedes into the face with loss of protrusion. This can be genetic or due to trauma.
31.7.2022 | Treatments
10.5.2022 | Treatments
31.7.2022 | Treatments
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