DERMAL FILLERS: WHICH FILLERS ARE RIGHT FOR ME?
Fillers in Dubai | 1 April 2019
Which filler is the best for you, and which filler should you choose for a specific treatment: nasolabial wrinkles, lips, nose, cheeks, quality of skin tone, or undereye bags? The internet and media are full of contradictory information. Although there are dermal fillers such as Radiesse (calcium hydroxylapatite crystals), Sculptra (poly L-lactic acid), and permanent fillers like Aquamid, in this guide, I cover dermal fillers based on hyaluronic acid – as these are the only dermal fillers I personally recommend. The reason for this is that hyaluronic fillers are not permanent, they have no lasting effects, they yield the most natural results, and if necessary, can be removed and dissolved using a special enzyme.
If a doctor prefers the use of renowned brands such as Restylane, Juvéderm, or some other (i.e. Teosyal and Belotero hyaluronic fillers), then the patient is definitely in very good hands, because these brands offer a whole range of different fillers, with various densities, hyaluronic concentration, and molecule size, let alone years of medical testing and research. My medical experience in aesthetic medicine has shown me that no specific brand is ideal, which is why it is in every patient’s interest that their doctor has a selection of at least 2 of these brands of fillers. Hyaluronic dermal fillers, along with Botox are the main tool of modern aesthetic medicine. Hyaluronic acid is a natural component of our skin, and its main task is skin hydration, as well as collagen reinforcement, and the restoration of elasticity. Our skin thus acquires a glow, stays firm, we have a healthier skin tone, and lost volume is restored in the face.
The history of hyaluronic dermal fillers is a relatively brief one. Bengt Agerup, a Swedish scientist and genius, was the first to stabilise hyaluronic acid in 1996. Up to then we only had inferior collagen and dangerous silicone fillers, but when the first dermal filler, Restylane, was produced in Uppsala, the world of aesthetic medicine changed forever. Over 25 million treatments using Restylane fillers have been performed all over the world to date. Most hyaluronic fillers are produced by fermenting bacteria in a laboratory, meaning they are produced in a natural and organic way (rare brands of hyaluronic fillers such as Dermavisca stem from animal sources – the fleshy comb of a rooster). This hyaluronic acid (the largest production plants of natural hyaluronic acid are in France and China) is used not only in dermal fillers, but in cosmetics and many creams, as well as in mesotherapy. Each brand of filler uses a different method and technology to stabilise and bind the hyaluronic acid, so that it can last in the skin for an average of 6-36 months. There can be a great difference between various dermal fillers. The stabilisation process and binding of hyaluronic acid varies with each brand, and the consistency of each filler is also different, as well as the concentration of hyaluronic acid, size of the molecules, and density. Furthermore, only some dermal fillers such as Restylane, Juvéderm and Teosyal contain lidocaine, a local anaesthetic. This, for me, is essential, because the treatments are less painful, and are a mark of a serious dermal filler brand.
WHICH FILLER IS THE BEST FOR WHICH TREATMENT?
I will begin with the lips because in my many years of experience i have come across the greatest controversies especially when it comes to this treatment. Although it appears to be simple, it is one of the most difficult procedures in aesthetic medicine, and one which requires years of experience.
Today I am proud to say that I perform countless lip augmentations and contouring on a monthly basis. Restylane is a dermal filler i have used for years for lip augmentation. The results are excellent and yield very natural and soft lips. It is still one of my favourite lip fillers because it contains the optimum concentration of hyaluronic acid. Drawbacks? The results only last 6 months, and the lips are very swollen right after the procedure; however, the swelling dies off in just 24 hours.
Restylane Kisse is the latest version of Restylane classic filler, with everything the same, except that results last over 9 months, because of the larger molecules and higher concentration of hyaluronic acid, due to the use of Emervel technology. There is no significant swelling following the procedure, the lips look exceptionally natural and very sensual.
Juvéderm Ultra 3 is a very good lip filler from the house of Allergan, but offers subtle results that last for only 6 months. Allergan has recently launched its new Vycross technology, under which is its selected lip filler, Juvéderm Volift, although Juvéderm Volbella can also be used.
Juvéderm Volift lasts for 9-12 months, there is no significant swelling following the procedure, but I have noticed minor swelling in some patients, which can be manifest as small balls and thickening of the upper lip after a couple of weeks. However, this problem quickly dissipates on its own, or after a massage.
Teosyal kiss and Neauvia Lips are also a very good dermal lip fillers. As the names suggest, they are specially formulated for lip treatment. They yield great results, with minimal side effects. Although it is difficult for me to determine the best filler for this treatment, I would give the title to a specially designed lip filler – Restylane Kysse. Right behind are definitely Juvéderm Volift and Restylane Lyps. In most cases, only 1ml of filler is enough per treatment, and it is not recommended to do more than that. It is wiser to come back after a month’s time and add another 1ml if your doctor finds it appropriate. What is most important is that the results are natural, and the face proportional.
Many doctors believe that there is no dermal filler suitable for this procedure, but from my own personal experience and following many successful treatments, I can confirm that this is not true. With my experience of undereye treatments, this is a remarkable treatment that yields outstanding results, and the best fillers for it is Teosyal Redensity II. Here it is possible, with great expertise, to use both thinner and thicker dermal fillers. Knowledge is what counts most. Over the years, I have tried using other dermal fillers in this facial zone such as juvederm Volbella, belotero, restylane perlane and although they yielded adequate results, too much oedema was reported, and the effects were not as good as the above-mentioned fillers. Teosyal is the absolute king for undereye bags. In 80% of cases, 1ml of dermal filler is enough to erase bags under the eyes – even extra-large ones. 10% of patients require more than 1ml, while 10% need to come back for their third ml.
NON-SURGICAL FACE-LIFTING / CHEEK AUGMENTATION
This increasingly popular treatment offers a natural facelift for skin that has lost volume and appears relaxed. With the expert administration of hyaluronic dermal fillers, there is no more need for a scalpel and surgery, because this can yield very effective and natural results with non-surgical face-lifting, and requires the use of 2ml – 5ml of dermal filler. What’s more, the effects can last for even 18 – 36 months (because this treatment uses denser fillers with larger molecules). The first such filler on the market was Restylane Sub Q, but it has proven to be too hard a filler, and so over the last 5 years my favourite filler for lifting the face, cheeks and saggy skin around the chin is definitely Juvéderm Voluma. It is a wonderful filler with large molecules that provides an adequate lift, which can easily be injected.
For these procedures, I can also pay compliments to Restylane Lyft, which has recently emerged on the market. It is a new technology from Galderma which is now keeping stride with Juvéderm. These two brands are unique in that they come in 1ml doses and can be injected with a syringe. Other brands either do not have these fillers with larger molecules (vital for an adequate facelift), or only offer 2ml ampules that can solely be applied through a cannula, which may be unsuitable for many patients. It is my opinion that in the majority of cases, fillers must be administered with a syringe and not a cannula, as this yields better and more accurate results, which is logical. From patient to patient, if we take into account their age, skin type and condition, at least 2ml of filler is needed for a non-surgical facelift, but the dosage can rise up to 8 – 10ml of filler, which is obviously administered in 2 to 3 separate treatments.
When it comes to the nose, dermal fillers in Dubai should not be too dense due to the sensitive anatomy of the nose, yet must also have enough strength to lift and contour, fill in imperfections and align the nose. Restylane Lyft can achieve perfect results with no side effects but also Juvéderm, Teosyal, Neauvia and other fillers in Dubai, are also suitable for this treatment. As always, the most important factor is the expertise and experience of the doctor. If we select a proper brand of hyaluronic acid, along with a good quality doctor, in most cases 1ml is enough to yield results that last over 18 months.
The correction of nasolabial wrinkles is still the most sought-after dermal filler treatment. It is a procedure that is most easily performed with the longest lasting effects. But, just a word of warning – I must emphasise that extensive knowledge, skill and expertise is also required here, not only to achieve the best results, but also because this zone demands detailed cognisance of its anatomy, in order to avoid side-effects such as vascular compromise, which cannot occur when administered by an expert, but becomes highly probable when one is in “unprofessional” hands. Here, many dermal fillers are very suitable, and so one can choose from a wide pallet. The dermal filler in Dubai should be thinner, with less molecules, such as is the case with Juvéderm Volbella or Volift filler, Restylane Classic, Teosyal Global Action or Neauvia Intense Flux. When dealing with shallow wrinkles, 1ml is enough for both wrinkles, but in many cases 2ml are required.
REJUVENATING THE SKIN OF THE FACE, NECK, DÉCOLLETÉ AND HANDS WITH STABILISED HYALURONIC ACID (“SKINBOOSTERS”)
Modern aesthetic medicine is turning more and more to treatments of the skin itself and its rejuvenation. Laser treatments, plasma treatments, and dermal rollers are increasingly popular, but hyaluronic preparations achieve the best results. The skin of the face, neck, décolleté and hands gain a new glow, while wrinkles, pores and scars disappear. Elasticity is restored, and the skin is firmer. In a treatment which I call medical mesotherapy, the best product are Restylane Vital Skinbooster and Neauvia Hydrodeluxe. In Restylane Skinbooster the greatest advantage is the technology of the syringe itself that has a special “clicker” to provide a precise dose with each prick of the needle. Neauvia Hydrodeluxe offers a very competitive package with more product at the same cost of other Skinboosters. The latest product of this type on the market is Juvéderm Volite, which yields excellent results, but we must also mention Profhilo, a recent market launch by Ibsa. It is an innovative dermal filler that is something between a dermal filler and a skinbooster.
Fillers in Dubai