Hyaluronic acid (HA) fillers have changed the non-surgical approach to facial rejuvenation as well as now being used for facial sculpting. They are still most commonly known for plumping up lips and filling nose-to-mouth lines (nasolabial folds) but these days dermal fillers have a broad range of other uses. These include highlighting cheek bones, targeting eye bags, concealing early jowls and even nose-reshaping.
Hyaluronic acid is a naturally-occurring compound found all throughout the body as well as in other residing organisms. It's natural functionalities include giving skin it is elasticity and lubricating joints. Commercially-available HA fillers include the JuvedermTM & VycrossTM ranges by Allergan.
Mary completed her nurse training at the Royal free Hospital in London and has over 20 years experience in Plastic and Reconstructive Surgery. She was the head nurse for Plastic Surgery at Charing Cross Hospital for a number of years before moving to work overseas. Her aid work in Cambodia involved her developing a national curriculum for surgical nursing and she returns to Cambodia every couple of years to train their nurse teachers. She is committed to ensuring that you receive a high standard of individualised care, especially in the pre- and post-operative period and has specialist knowledge in wound care. Mary is also a fully trained and accredited nurse injector for Botulinum toxin (Botox), and trained in Thermavein and customised facial peels. Her most recent other post has been working alongside Mr Pacifico and Ms Nugent in the NHS at Queen Victoria Hospital, East Grinstead.
Janis is an experienced specialist nurse with an extensive background using injectables for muscle relaxation as well as fillers. In addition, Janis sees pre- and post-operative plastic surgery patients and can provide insightful guidance and recommendation for a wide range of aesthetic treatments. Janis has a reassuring and calming bedside manner, and is sure to put even the most nervous patient at ease.
Mr Marc Pacifico MD FRCS(Plast) has been described as one of his generation’s rising stars in plastic surgery. His academic, surgical and practice achievements include, amongst others, coming top in the UK’s consultant level plastic surgery examinations (being awarded the Gold Medal), the publication of over 50 international peer-reviewed papers, being a regular invited speaker at conferences and the opening of his own private clinic, Purity Bridge, alongside his busy private surgical practice. He has built his reputation on a combination of a high level of surgical skill, his artistic eye and his holistic, friendly approach to patient care. His particular areas of interest include plastic surgery to the face and breast, as well as body contouring surgery. The look Marc aims to achieve is a natural, fresh look, in all areas of aesthetic surgery. Marc particularly focuses on the care his patients receive pre- and post-operatively, in order to optimize the outcome of surgery and provide all under his care with a smooth recovery after their procedure. Marc recognizes the continuum between non-surgical and surgical techniques, using all available options to formulate a bespoke treatment plan for every individual. This process has been further enabled by the opening of his private clinic Purity Bridge in Tunbridge Wells, that provides the best level of care possible to his patients. The art of rejuvenation is not a “one stop shop” but rather a process, with the right procedure required at the right time for the right outcome. That means maintaining surgical results with specifically timed non-surgical interventions, as well as a global approach to the individual that is outcome driven. Marc Pacifico is a fully accredited specialist in plastic surgery, and is on the Specialist Register in Plastic Surgery with the General Medical Council (number 4412407) and a member of BAAPS,BAPRAS and ISAPS. See a short video introduction to Marc here ›
Ms Nora Nugent FRCS(Plast) has joined Purity Bridge where she offers an individually tailored modern plastic surgery practice. The cornerstones of her practice are good communication with you and meticulous attention to detail as she feels this is vital to your decision to undergo any treatment under her care. This ethos is continued from your first consultation through to the end of your treatment to ensure that you get the highest possible care and are fully supported during this time. Nora aims to provide you with a clear and honest opinion on your condition and will ensure that you have the opportunity to ask any questions you may have before proceeding with treatment. Nora graduated from medical school at University College Dublin and completed her specialist training in plastic surgery with the Royal College of Surgeons in Ireland. To further develop her clinical expertise and skills, she then undertook specialist fellowships in North America and Australia. Training in advanced burn critical care and burn surgery (acute and reconstructive) was undertaken during her fellowship at Shriners Hospitals for Children – Galveston, Texas. Prior to taking up her consultant post in the Queen Victoria Hospital, East Grinstead, Nora obtained additional subspecialty training in Australia completing a plastic surgery fellowship at St. Vincent’s Hospital, Sydney which encompassed both aesthetic (cosmetic) surgery and reconstructive surgery (including microsurgery) and also a hand surgery fellowship with Victorian Hand Surgery Associates, Melbourne. This allows her to offer you a wide range of procedures across the spectrum of plastic surgery. She has experience in all areas of aesthetic surgery including breast, facial and abdominal surgery and strives to achieve a natural rejuvenated appearance for her patients. For some this may be a skin rejuvenation technique while for others surgery can be a better option. Nora Nugent is a fully qualified plastic surgeon with the FRCS (Plast) qualification and has specialist registration in plastic surgery with the General Medical Council. She is a member of BAPRAS and IAPS. Nora maintains a broad range of clinical interests within plastic surgery and regularly attends conferences within the specialty to keep up to date with evolving techniques and new developments in plastic surgery. She is also a member of multidisciplinary clinical groups overseeing the management of burns, skin cancer and lower limb injuries in the South East of England. While always looking for ways to improve the care she can provide, Nora will only offer new procedures once she is satisfied that they have been evaluated fully and offer a clear benefit to her patients.
Mr Brent Tanner is a highly experienced and renowned Consultant Plastic Surgeon. He has a special interest in non-surgical rejuvenation techniques to the face, with a particular interest in the Pearl LASER as well as injectable techniques to produce harmonious, natural and fresh results.
Dr Roxy (MBBS BSc DRCOG MRCGP) has been practising medicine for 11 years since gaining her primary medical qualifications from Guy’s, King’s and St. Thomas’ School of Medicine in London in 2006. Due to her interest in the holistic care of patients, she undertook a further degree in psychology from King’s College London in the middle of her medical training. Dr Roxy’s past medical experience covers a broad range of medical specialties, including Accident and Emergency, Vascular Surgery, Colorectal Surgery, Care of the Elderly, Stoke Medicine, Gastroenterology, Palliative Care, Obstetrics and Gynaecology and Paediatrics before she completed her post-graduate training to become a GP.
Dr Roxy has a special interest in aesthetic dermatology, and completed her aesthetic training at the Harley Academy in London. She has worked closely alongside and been mentored by aesthetic surgeons (including Purity Bridge’s Marc Pacifico) and practitioners who are well known internationally and top players in the aesthetics world. Dr Roxy regularly attends conferences both nationally and internationally to keep up to date with the latest techniques in aesthetics and products available.
She holds full registration with the General Medical Council, and is a member of the Royal College of General Practitioners and British Medical Association.
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 consist of local anaesthetic to ease the distress of the injections and also to reduce any post-injection pain
The result of HA treatment are long-lasting but not lifelong. Commonly results will last 6-12 months prior to further top-ups are signified. For the lips, 6-monthly treatments may be needed.
The procedure is done on an outpatient basis and takes about 10-15 minutes, depending upon the number of injections needed.
The effects will take 4-10 days to show, and we invite all patients back for a review appointment at 14-days post-treatment
The injections feel a bit like a small mosquito bite and are not particularly painful. Afterwards, some small red marks are usually present for a short time, before they resolve.
Treatments usually take 15-30 mins. A fine needle or cannula (blunt-tipped needle) is applied to inject HA into the skin to soften lines and wrinkles, sculpt the face or enhance the lips.
It is normal to experience some discomfort after the injections. Redness, swelling, pain, itching, bruising or inflammation at the injections sites may also happen. These typically go away after a number of days .
You may be recommended to massage the treated area to help spread the HA and reduce any lumps developing in certain situations.
Cool gentle compresses might assist to minimise any swelling and bruising
Paracetamol can be used for any discomfort after treatment
Ideally you should avoid make-up and direct sunlight on the treated areas until the following day
It is also a good idea to avoid aspirin, or non-steroidal pain-killers (ibuprofen, Nurofen), St Johns Wort or high doses of vitamin E supplements for a week right after treatment. These may enhance bleeding and bruising at the injection site.
Refrain from exercise and alcohol for at minimum 6-hours right after treatment.
It is ok to wash your face as normal the evening of the injections.
As HA is biodegraded, future treatments will be required to maintain the results. Return visits are usually at 6-12 months post-treatment.
People who take medicine to thin their blood (such as aspirin and warfarin) will be at higher risk of bruising so need to be cautious with HA fillers. Likewise, people who take long-term steroids typically have thin skin and can beat higher risk of some complications from the injections - this will be discussed with you in person during your consultation. HA fillers should not be used if you are pregnant or breastfeeding. Furthermore, we would not treat anyone under 18-years old, apart from very exceptional circumstances (such as facial asymmetry issues or underlying bony anomalies. If you suffer from cold sores, please speak to the team regarding this as you may require treatment with an anti-viral medication to decrease the risk of cold sores being stimulated by HA treatment.
Complications with HA fillers are uncommon. As described above, redness, swelling tenderness and bruising can occur at the site of injection.
Allergic reactions are uncommon with HA, as this is a naturally-occurring compound.
Under- or over-treatment is a possibility with HA filler treatment. If the area is deemed to be under-treated, further HA might be given (at cost). If over-treatment has occurred, the best way to approach this in your individual situation will be discussed with you. Occasionally the HA can be massaged to distribute it before the body naturally reabsorbs it; otherwise, injections of hyalase (an enzyme that can dissolve HA) might be indicated.
There have been rare case reports of serious problems associated with HA fillers, including blindness, when the HA filler has been accidentally injected directly into a blood vessel. Fortunately this is very rare and every precaution is taken to reduce this risk.
Prices starts from £295