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These products contain stabilised hyaluronic acid which is present in all living organisms, and is identical in all species and tissue types. In the form of clear gel, it is used to smooth wrinkles and folds or to add contour. There are three choices of gels which are stable and bio-degradable, and are derived by bacterial synthesis. Accordingly, no skin tests are required, as these products have no immunologic properties.

How do these products work?

In the skin, hyaluronic acid binds water and creates volume. These products are long-lasting

because the initial volume is maintained through the degradation process by replacement with water, the less concentrated the product becomes, the more water it is able to bind, so the volume is maintained, until the product is completely degraded. All have the same concentration of hyaluronic acid, but the three products differ in gel particle size.

How is the treatment administered?

Depending on the region to be treated, a number of injections will be required. The lips are an

especially sensitive area, and will almost certainly require an injected anaesthetic, similar to a

dental block, although it is occasionally possible to use a topically applied anaesthetic cream.

Are there any special precautions?

You should not consider treatment if you are pregnant or breast feeding, have auto-immune

disease, or have extremely sensitive skin.

These products should not be used near areas of skin affected by dermatitis or infection, and

treatment should not be used in conjunction with laser or chemical peel treatments.

Are there any risks?

There will usually be some swelling and redness, and occasionally bruising especially when

anaesthetic has been injected. Occasionally there may be itching, pain, discoloration, or

tenderness at the injection site. Resolution is typically spontaneous in one to two days. As with all injected treatments, there is a risk of infection, but this is unusual. An infected bruise is a rare occurrence and would necessitate medical advice and antibiotic treatment, as the consequence of an untreated infection could be serious. The risk of bruising will be increased by treatment with Aspirin or Warfarin. If you are prone to cold sores, treatment may precipitate an eruption. Hypersensitivity reactions have been reported in one in two thousand treatments and consist of swelling and in duration at the injection site. Rarely, acne form papules may develop. These problems are usually self limiting and settle within two weeks.

There is a potential risk that the product can be injected into s blood vessel, causing a blockage and subsequent tissue damage, or damage to the facial nerves. These are theoretical risks which have not as yet been reported with these products.

Occasionally a temporary palpable lumpiness may be noted in some patients

Alternative treatments.

There are alternative treatments to hyaluronic acid fillers, and these include botulinum toxin.,

collagen, chemical peels, laser treatments, surgical treatments, or indeed no treatment at all.

Are there any risks with anaesthetic treatment?

Local anaesthetic treatment is very safe, and any side effects are generally mild and self limiting, such as bruising or slight swelling and inflammation. However, as with many treatments, usually associated with large doses, side effects may rarely be serious and can include low blood pressure, a very slow pulse nervousness and agitation, drowsiness, confusion and fits

Further information on Hyaluronic acid fillers

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