What is dermal filler therapy?
Dermal filler therapy has been widely accepted by patients in North America, much more so than cosmetic dentistry. You don’t need to believe me — just ask the women in your life and your female patients if they have heard of dermal fillers injections. Ask patients if they have ever had Botox or dermal fillers and you will quickly find that these are immensely popular aesthetic therapies.
What does a dermal filler do?
Simply put, a dermal filler injection is a material injected underneath the skin in the nasolabial fold, marionette lines, and oral commissures, which plump up these areas and smooth out the wrinkles. Lip augmentation is also done with dermal fillers. Traditionally, plastic surgeon and dermatologist offices provide these services. Notice that I said their “offices” provide these services. Most dermal fillers are placed by nurses and medical aestheticians who work in the office of a plastic surgeon or cosmetic dermatologist.
Generally, when you look at the world of aesthetic injectable treatment, botulinism toxin (Botox Cosmetic) is generally for the top half of the face, and dermal fillers are for the bottom half. The main areas where dermal fillers are used are in the nasolabial folds, the oral commissures, and the marionette lines. These are the areas that frame the teeth and mouth, and are certainly within the realm of dentistry and dental treatment. Dermal fillers are gently placed in these areas through an extra oral injection right under these folds and creases to plump them up. By the way, these are exactly the same areas that you routinely inject. The only difference is that you typically inject these areas intraorally when you deliver local anaesthesia.
What was really interesting to me during my dermal filler training courses is that the nurses, dermatologists, and plastic surgeons that I trained with had absolutely no problem giving the extra oral injections for dermal fillers, but were a bit squeamish about delivering local dental anaesthesia and giving intraoral injections. The dentists that I trained with were exactly opposite and were very comfortable with the intraoral injections, but were initially a little unsure of themselves on the extra oral injections.
How long do dermal fillers last?
Depending on the dermal filler used, the effects can last anywhere from six months until forever. There are temporary dermal fillers and permanent dermal fillers. Typically, most health-care professionals shy away from permanent dermal fillers because if the filler is placed in an improper position, its permanence becomes a huge issue and liability. Most dermal fillers placed are temporary and dissolve in six to 18 months.
There are a few types of dermal fillers on the market. Bovine and human collagen have been used in the past but require pre-testing by the patient and are not very popular anymore. Hyaluronic acid like Juvederm and Restylane dermal fillers are today’s most popular and widely considered best dermal fillers. Hyaluronic acid is a naturally occurring substance in the body that is lost with aging. Hyaluronic acid dermal fillers add volume to the facial structures, are very hydrophilic, and look very natural. Hyaluronic acid fillers typically last six to 12 months and can also be used for lip augmentation, which is a big advantage. Restylane and Juvederm Ultra are very recognizable names and very popular dermal fillers.
Calcium hydroxyapatite is a naturally occurring substance in the body that is used in a popular dermal filler called Radiesse. Radiesse is a thick, viscous material that typically lasts longer than hyaluronic acid fillers because it takes longer for the calcium hydroxyapatite material to break down. In addition, as the calcium hydroxyapatite breaks down, the body naturally replaces it with collagen, which keeps the area free of wrinkles longer.
The choice of dermal filler material is very important depending on the areas that are being injected and corrected. It’s essential to know which material is being used, and as with everything else, the right material should be used with the right application. This obviously comes with proper dermal filler training.
What patients Want
Lets talk about patients and what they want. You’d be amazed at the number of people in your practice who use dermal filler therapy and Botox therapy. These are immensely popular products and treatments. Any patient that has had this kind of therapy doesn’t need any education. They basically walk in and say, “Let’s get started.” They know what to expect and are extremely pleased that you can attain a profound level of anaesthesia to make this a completely comfortable experience, something they probably haven’t had while undergoing dermal fillers.
Interestingly, because of the temporary nature of dermal filler materials, liability issues and wrong treatment are very limited. The reason for this is that the areas where dermal fillers are used will completely return to normal within six to 12 months, so there’s no long-lasting result that can occur. Like anything else, you have to take into account the anatomy of the patient, what you are trying to accomplish, and which dermal filler materials will work best in each circumstance.
Training is Important
Dermal Fillers training is the key to performing this exciting treatment. I have trained many dentists and medical professionals in facial injectable therapies such as dermal filler and botulinism toxin therapies. You need to become competent in the mechanisms of these materials, reviewing the facial expression muscles, indications, risks and benefits of these treatments, hands-on training in placing these materials, and preventing and managing complications. With some practice, you’ll be well on your way to performing these procedures. Many state dental boards allow dentists to deliver these aesthetic facial injectable therapies, so check with your own state board.
Results of Dermal Filler Injections
In general, the results from most injectables are temporary; commonly lasting from a few months to about a year. This depends on the type of facial filler or injectable used. For optimal results, additional treatment sessions are encouraged. A dermal filler or injectable treatment entails a series of tiny injections under the skin’s surface – at the subdermal-dermal levels. The amount administered depends on the depth and size of the skin defect or wrinkle. With the evolution of dermal fillers and injectable filler it would be great resource to add to your dental or medical practice.
The American Academy of Facial Esthetics (AAFE) is the industry leader in providing the most updated and comprehensive training in all facial aesthetic fields. Are Courses are authorized Allergan training courses. We offer two full days of live hand on patient training to teach proper procedures and technique with regards to Botox and dermal fillers. For more information about our courses check out our Botox and Dermal Fillers Training page.
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