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Hyaluronic acid (HA) is a naturally-occurring substance found throughout the body as well as in other living organisms. It’s natural functions include giving skin its elasticity and lubricating joints. Commercially-available HA fillers include the JuvedermTM & VolbellaTM ranges, by Allergan, amongst others. It remains the most popular lip filler but can be used as a facial filler elsewhere too.
HA is a clear gel that is injected into or just under the skin in small amounts to restore volume and structure. The injections may be performed on an outpatient basis (i.e. in the clinic). Modern HA fillers contain local anaesthetic to relieve the discomfort of the injections and to minimise any post-injection pain
The result of HA treatment are long-lasting but not permanent. Typically results will last 6-12 months before further top-ups are indicated. For the lips, 6-monthly treatments may be necessary.
Treatments typically take 15-30 minutes. A fine needle or cannula (blunt-tipped needle) is used to inject HA into your skin to fill wrinkles, add volume or shape your face or lips.
It is normal to experience some discomfort after the injections. Redness, swelling, pain, itching, bruising or tenderness at the injections sites may also occur. These usually subside after a few days but can last up to two weeks.
You may be advised to massage the treated area to help distribute the HA and minimise any lumps developing.
Cool gentle compresses may help to reduce the swelling and bruising
Paracetamol may be taking for the discomfort after treatment
Until the initial redness and swelling have resolved, avoid exposure of the treated area to intense heat, such as strong sunlight
Avoid taking aspirins, or non-steroidal pain-killers (ibuprofen, Nurofen), St Johns Wort or high doses of vitamin E supplements for a week after treatment. These may increase bleeding and bruising at the injection site.
Avoid exercise and alcohol for at least 6-hours after treatment.
The treated areas may be washed with soap and water. If required, light make-up may be applied with clean fingers following treatment.
As HA is naturally biodegraded further treatments will be needed to maintain the results. Return visits are typically at 6-months post-treatment.
People who take medication to thin their blood (such as aspirin and warfarin) are at higher risk of bleeding and bruising so should avoid HA fillers. Similarly, people who take long-term steroids often have very thin skin and are at higher risk of complications from the injections. HA fillers should be avoided if you are pregnant, breastfeeding, prone to lumpy scar formation (keloid and hypertrophic scars) or under 18-years old. If you suffer from cold sores, please speak to the team about this as you may need treatment with an anti-viral medication to reduce the risk of these coming back following HA treatment.
Fortunately HA complications are unusual. As stated above, redness, swelling tenderness and bruising may occur at the site of injection.
Allergic reactions are very unusual with HA, as it is a naturally-occurring substance.
Under- or over-treatment may occasionally happen. If under-treatment occurs, further HA may be given. With over-treatment, the HA may be massaged firmly to distribute it more widely to lessen the effects, until the body naturally reabsorbs it.
There have been rare case reports of very serious complications associated with HA fillers, such as blindness, when the HA filler was inadvertently injected into a blood vessel. Fortunately this is extremely rare and every precaution is taken to minimise any risks.
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