Dermal Fillers are implants that are used for the treatment of deep skin folds and creases. There are a number of dermal fillers on the market with various properties.  They can be used to smooth out wrinkles and folds, even out scars, volumize area that have sunken, contour unevenness and basically can re-contour the skin.  In fact, fillers can be used to accomplish a complete, non-surgical face lift. Dr. Stewart frequently uses fillers to contour the jaw and cheek areas, fill nasolabial and marionette lines and smooth out the perioral area and redefine lips.

Hyaluronic Acid is a naturally occurring substance in the body and is an important structural element in the skin. It creates volume and serves various functions such as plumping the skin of the face, providing elasticity to the joints, and it gives the eye its round structure. HA fillers are gels that are transparent in colour but differ in the size of the gel particle of which they are composed. They therefore each have a different consistency. Each gel is designed to achieve the best cosmetic result for wrinkles and folds of various depths.  A detailed consultation and physical examination aids in the determination of the appropriate HA filler.

How do dermal fillers work?
Skin is composed of 2 layers. In between the layers is a jelly-like substance called Hyaluronic Acid. As we age, the once abundant Hyaluronic Acid decreases and the skin deflates or caves in to a certain extent. When this occurs a wrinkle or a skin fold develops. Fillers can replace the Hyaluronic Acid that our skin has lost over time. In effect, filling and plumping the wrinkles and deep skin folds. They restore the skin to its natural volume, thus lifting and smoothing wrinkles.

Dermal fillers may be classified in a number of ways but for purposes of simplification Dr. Stewart classifies by the longevity of correction.  The categories include temporary, permanent and semi-permanent.  Dr. Stewart preferentially uses hyaluronic acid (HA) fillers.  HA fillers are considered to be temporary and last 6-9 months.  HA fillers tend to be the first line for physicians performing soft tissue augmentation as their effect and therefore potential side effects are self – limiting.

Dr. Stewart prefers to use the temporary hyaluronic acid fillers, although semi-permanent and permanent fillers do exist. Juvederm Ultra, Juvederm Ultra Plus, Restylane, Restylane Fine Lines and Perlane are her fillers of choice. The choice of product used for a client is dependant on the procedure to be done.


Procedure
The first step is to consult with the client. Treatment will be personalized to the client’s needs and specifications. Before pictures are taken and the skin is cleansed. Treatment of the lips requires a local anesthetic dental block such as that used by a dentist to do a filling. The fillers are injected into the skin with a very thin needle. The gel particles disseminate and attract more water to the tissue thus restoring the natural volumes underneath the wrinkles. The result is the lifting and smoothing of the wrinkles or skin fold or plumping of the lips. This is all accomplished in approximately 30 minutes. As Hyaluronic Acid gradually degrades, each molecule binds to more water, and over time less filler is usually required to maintain the same beneficial cosmetic result. Results are seen immediately.

Side Effects
The most common side effects are:

• Bruising
• Swelling
• Infection (bacterial/viral)
• Nodules
• Temporary Tenderness

Safety
Because hyaluronic acid fillers are completely biocompatible with human Hyaluronic Acid, it has a highly favorable safety profile. Unlike older rooster-derived hyaluronic acids and bovine collagen products, these dermal fillers are free from animal proteins. This limits any risk of animal-based disease transmissions or development of allergic reactions to animal proteins.

HA dermal fillers can be reversed with hyaluronidase should that be necessary.

Please refer to the contact page to book an appointment with Dr. Stewart.