I use non-permanent gel fillers like Restylane®, Perlane, Juvederm and Laresse. They are Hyaluronic acid (HA) fillers. HA is a natural polysaccharide that exists in all living organisms. The HA in dermal fillers is produced biosynthetically through bacterial fermentation, so it is biocompatible and there is no risk of transmitting disease. The gel is able to integrate with the adjacent tissues, allowing passage of oxygen and nutrients. Restylane® is characterised by the fact that its HA molecules are cross linked, which makes it long lasting - but not permanent. Exactly how long a treatment lasts is quite individual: it depends on your age, skin type and muscle activity as well as the injection technique. The HA gel particles are absorbed slowly and water takes its place. When totally absorbed, the gel disappears unnoticed from the body.

How long does it last ?

Clinical trials indicate that Restylane® is effective for 9 months to a year for the treatment of wrinkles and for around six months for lip augmentation. It lasts less time in areas subject to muscle movement.

Which areas does it treat best ?

This substance is a cosmetic polyfilla and has a range of uses, including lip sculpture, filling lines and folds. It is used to particularly good effect in the nasiolabial lines. These run from nose to corners of the mouth and are often the first sign of ageing. It is also good in smile lines, frown lines and crows-feet, although it is often advisable to combine dermal filler with the use of Botox in these areas of very active expression. Dermal fillers also have a role to play in the treatment of under eye hollowing or dark circles. Restylane® can be used to augment lips or cheek bones and fill out some scars. Some catwalk models choose to use it as a cushioning pad in the ball of the foot.

Treatment times average 45 minutes and the results are instantaneous. I use a combination of numbing cream and local anaesthetic injections to make the procedure as comfortable as possible. The product is injected in small amounts to give natural volume and smooth wrinkles.

The down side?

• Some mild bruising may occur. These signs may take 2-3 days to vanish. The corners of the mouth tend to bruise a little more.
• Transient redness, swelling, itching or discomfort. In the case of a lip augmentation, the swelling can be considerable for a few days.
• Discolouration at the implant site. Typically, resolution is spontaneous, within one or two days of injection into the skin, and within a week after lip augmentation.
• Temporary palpable lumpiness at the implant site.
• Joint pain or muscle pain or headache have been reported, but are unlikely.

What can go wrong ?

• Blistering
• Infection
• Cold sores. If you have a history of cold sores in the treated area, filler injections may cause them to break out again. I will give you a prescription for antiviral tablets that must be taken before and after the treatment.
• Allergic reaction;
  
  Immediate allergic type reactions:
  Prolonged redness, swelling, itching or hard lumps at the points of injection. Sometimes they can last for several months or longer, but this is extremely unusual.
  
  Delayed allergic type reactions happen with a reported incidence of 1 in every 8,000 patients. Red lumps may appear underneath the skin many months later and are permanent in a small number of cases.

In very rare cases (less than 1 in 15,000 treatments) granuloma (lumpy tissue), superficial necrosis (skin death) and urticaria (red wheals) have been reported. These reactions generally start a few days after treatment, but can appear after 2 to 4 weeks. They are generally reported as mild to moderate and self limiting, with an average duration of two weeks.

Conditions that will mean you can not have this treatment:

• Active infection e.g. acne.
• Known allergy to Hyaluronic acid.
• Pregnancy and breastfeeding (as there is no research data)

Costs:

Cost will depend on the number of syringes needed to create the desired result. A quote will always be given at your initial consultation.

For example: one syringe of Restylane® will give a subtle lip enhancement or be sufficient for mild nose - mouth lines and will cost £270 - £300.

A syringe of heavier density Perlane and one syringe of Restylane®, may be required for more pronounced nose - mouth lines will cost £570 - £600.