Dermal filler treatments with products such as Juvederm, , Belotero, Restylane and others are among the most popular non-surgical facial treatments available today. Dermal fillers are used not only to fill lines and folds but also to volumize the cheeks, lips and temples and accentuate other areas of the face such as the jawline. The realization that much of the aging process results from volume loss and deflation of the face has further boosted the popularity of these volumizing treatments. You can view a sampling of our before and after dermal filler photos to see what is possible with these products.
What can be done to fix “botched” hyaluronic acid filler treatments?
Unfortunately, the popularity of dermal fillers has spurred anyone with a needle to get into the business of injecting fillers. Often, there are poorly trained or insufficiently experienced injectors performing medical treatments on unsuspecting patients. The tragic end result is that many of these treatments are “botched.” Fortunately, there are a handful of options to fix bad filler treatments. In some cases, a bad result is simply due to the filler being poorly placed. It is possible to add small amounts of strategically placed filler to reshape and contour the injected area and salvage a beautiful result. This takes advantage of the previously placed volume of filler and does not require starting over or completely replacing all of the product.
In other cases where hyaluronic acid filler has been improperly injected in the incorrect tissue layer or when the area has been overfilled, the filler must be removed or reduced. Thankfully, we have a product called Hylenex (hyaluronidase) that can dissolve hyaluronic acid based fillers within hours. This injection is placed directly into objectionable collections of filler to remove some or all of the filler. It takes experience to know how much Hylenex to place in a given area but the dose can be adjusted so that anywhere from a small amount of filler to the entire syringe can be removed in one treatment session. The right approach requires an in depth discussion between the two of us to know exactly how much Hylenex to place in which area of the face.
What about Radiesse or Sculptra? Can these products be dissolved?
Radiesse and Sculptra, so called bio-stimulatory fillers, create more difficulty in terms of filler revision because we do not have an easy way to dissolve or remove the filler. Make no mistake, these products are both safe and highly effective when used properly. However, when injected improperly significant deformities and contour issues can result that are not easily remedied. Typically, injection treatments ranging from saline (sterile “salt water”) to steroids are used to try to break up and soften the filler and hasten your body’s removal of the product. These injections do not work immediately and often require multiple treatments.
In cases where injection treatments are ineffective, the product is either allowed to wither away on its own (this can require years) or the offending nodule is removed surgically. Surgical removal is highly effective but given the need for incisions and subsequent possible scarring this is usually the approach of last resort.
How do I assurance a good filler result?
The first step to a great filler result is finding an experienced physician injector. In most cases, this will be either a Plastic Surgeon or Dermatologist.
- Ensure that their office performs ALOT of filler treatments and that the doctor performs the injections. You deserve the best!
- Review before and after photos in office or on the doctor’s website and make sure that you like the aesthetic. Eliminate injectors that create over-done or over-filled results. Pass on “duck lips” and pillowy cheeks. If the office puts those photos on public display, that is likely the goal result that they consider to be beautiful.
- Meet with the doctor and make sure that you trust them and appreciate their aesthetic eye.
- Listen to their advice and ensure that it is consistent with your concerns and goals.
- Lastly, ask about their experience level. Have they been injecting filler for many years? Have they injected thousands of patients with concerns similar to yours? Do they train other injectors on safe injection techniques and proper use of these products.
In my practice, the answer to all of these questions is yes. I’ve trained dozens of injectors in the Denver area and have revised or repaired bad filler results for hundreds of Denver, Colorado area patients.
What if I’m unhappy with my results and need second opinion?
Give us a call or email photos. We can evaluate your photos and give you some basic advice. Let us know what product was used and how many syringes were injected. If you’re unsure, your injector’s office should be able to tell you. We will give you a plan for how to improve upon your result and let you know what results are realistic. The bright side is that there is no injectable treatment result that cannot be refined, revised or remedied. There are always options. After meeting you, I can give you very specific advice about the type and degree of improvement that you can expect. We can also get you back on the right track to ensure that you’re happy with your future results.
It would be my pleasure to discuss with you either filler treatments or refinement of the filler treatments you’ve already had performed.