Dermal fillers are composed of a clear gel, known as hyaluronic acid (HA). HA is naturally occurring and abundantly present within our bodies. It is a very hydrophilic, or water-loving molecule, which accounts for its ability to give plumping and hydration to tissues. The molecules of HA are stuck to each other during the manufacturing process, and the number and type of bonds between the molecules determines how stiff, thick, or pliable a particular filler is. Stiffer fillers are best used deep in the tissues, for volumising, while softer and more pliable formulations may be used in more mobile areas such as the lips. The softest formulations do not create any volume, but are used to deeply hydrate the skin from within. Selection of the correct filler is paramount to achieving the desired result. At Fitzgerald plastic surgery, only FDA-approved fillers are used: these are the highest quality products on the market, and the ones which have been tested most rigorously for safety.
At Fitzgerald Plastic Surgery, all dermal and lip filler treatments are performed by consultant plastic surgeon, Ms Éilís Fitzgerald.
Why does it matter who does the treatment?
Dermal fillers are classified as a medical device, which unfortunately means that they are not subject to the same controls as prescription medications. As hard as it is to believe, the current situation in Ireland it that it is entirely legal for individuals with no medical training whatsoever, to purchase and inject these products. This is a potentially very dangerous situation, as the injecting individual has no medical knowledge or expertise to recognise or to treat complications from the treatment. In addition, they have no recognised training in anatomy or facial aesthetics, that would permit them to perform these treatments correctly. Such individuals cannot legally inject the substance which is used to dissolve fillers, as it is a prescription medication, which can only be administered by doctors. The ability to dissolve filler immediately should a problem arise is an essential part of being able to safely perform these procedures for people.
While these products and treatments are very safe, there are certain risks associated with treatment. They also need to be placed in such a manner that respects natural anatomy, and facial aesthetic principles. Plastic surgery and dermatology are the only recognised specialities in which doctors are taught these principles over the course of many years. This level of training simply cannot be matched by doctors from other specialities (and none), who complete as little as a one day training course before terming themselves "cosmetic doctors" or similar. Please beware and be aware of who is doing your treatment. Ensure your doctor is on the Irish Medical Council's Specialist Register in either Plastic, Reconstructive & Aesthetic Surgery (as Ms Fitzgerald is), or in Dermatology.
Only a fully qualified plastic surgery consultant such as Ms Fitzgerald, or a consultant dermatologist, has undergone the years of training in respect of the anatomy and aesthetics of the face, to permit these treatments to be performed with maximum efficacy and safety.
Certain medications make you more prone to bleeding and bruising; these include aspirin, ibuprofen, Difene, and other NSAIDs (non-steroidal anti-inflammatories). Please do not take them for a week before treatment.
If you are on any prescription blood-thinners, including aspirin, warfarin, plavix, Eliquis, Pradaxa, etc., you must check with the prescribing doctor if it is safe for you to stop these medications for treatment. If you are advised against stopping your medication, please do not do so. This may mean you are unsuitable for filler treatment. Please contact the office if you are unsure.
If you take fish oils, evening primrose oil, high doses of vitamin C or E, St. John's Wort, ginko, or ginseng, you should stop taking these a week before treatment, to reduce the risk of bruising.
It you wish, you can take arnica by mouth for the week before and following your treatment, to reduce the chance of bruising. Unfortunately, we cannot absolutely guarantee that bruising will not occur. Please bear this in mind when planning the date of your appointment in relation to social events, etc.
If you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another eruption of cold sores. Please let the office know at the time of booking your appointment if you are prone to cold sores: you may require medication taken before your filler treatment, to reduce the risk of an outbreak.
Dermal fillers are not suitable if you are pregnant, allergic to any of the ingredients, or have a diagnosis of certain neurological disorders. You will be asked to complete a screening health questionnaire in advance of your treatment. Should you have any questions, please just ask in advance of treatment.
While many people choose to attend without any make-up on their face, your skin will be thoroughly cleansed before the procedure, so there is no need to come bare-faced if you do not wish to do so. You will be advised against applying foundation, etc., for several hours after the procedure. Eye make-up does not need to be removed.
Should you wish to have numbing cream applied prior to your treatment, please be aware that you will need to attend up to an hour in advance of your scheduled appointment time with Ms Fitzgerald to have this applied. This is because it takes some time to be fully effective. Please ensure that you inform us of your requirements in this regard, as we cannot otherwise guarantee that adequate time will be available for application and efficacy of the cream.
Immediately after the treatment, there may be redness, bruising, swelling, tenderness, and/or itching near the injection site.
Please avoid itching , massaging, or picking around the injection site, unless you have been specifically instructed to massage the area.
Swelling, redness, bruising, etc. is generally considered to be normal, and should subside rapidly within a few hours to a few days after treatment. This is normal and generally disappears within a few hours to a few days. If these symptoms last more than 3 days, please contact the office.
We will provide you with an ice pack at the time of treatment. Many people find it useful to continue applying cool compresses at home afterwards (a bag of frozen peas works well). Arnica cream (available for purchase at the office), and/ or arnica tablets can help with bruising. Some people find the herbal supplement bromelain useful to help bruising resolve.
Avoid any activity that makes you become red in the face – be that strenuous exercise, a sauna, or a warm environment. Yoga-lovers should avoid inverted poses. This is to prevent additional bruising. Wait until all swelling and redness have resolved before going back to these sorts of activities.
Avoid pressure to the treated area(s), other than massage as directed during your consultation.
If there is a visible bump, you can massage the area.
If you are concerned, please do not email, but contact us by telephone on 015553777. Office hours are Tuesday to Friday, 9am to 5pm. If you have concerns outside of those hours, you may contact the Beacon Hospital on 012937535.
Depending on the area injected, the product used, and previous or concurrent treatments, results can be expected to last from about six months (for lips and skin retexturing treatments) to 12-18 months for volume restoration.
Glowing healthy skin is, without question, the number one thing to enhance the result of any treatment. As part of our holistic approach to facial rejuvenation. We encourage all patients who undergo an injectable treatment with Ms Fitzgerald a complimentary skin health consultation with our expert aesthetic nurse Ger Kelly. This consultation can take place at any time in the four weeks following your injectable treatment and many people find it works well to schedule it in conjunction with their review appointment with Ms Fitzgerald. We would be delighted to provide you with further information on request.