Description

Hyaluronic acid, an ubiquitous and inert carbohydrate polymer, is a naturally occurring substance in our skin. Hyaluronic Acid (HA) used in dermal fillers is therefore quite well tolerated and helps correct loss of substance.

When is Hyaluronic Acid used?

First and foremost, HA is used to fill age-induced lines and deep wrinkles (nasolabial fold, marionnette and bitterness lines), restore facial contour (raise cheekbones, fill hollow cheeks) and improve the area around the eyes (bridging the “valley of tears”, restore volume to the eyebrows).HA can also improve lips size and shape (plumper lips, asymmetry correction, bring up the corners of the lips for a smilier face). If HA is injected superficially, you obtain long-term removal of superficial wrinkles (cheeks, above lips, forehead)Last but not least, HA filler injections rehydrate the entire face. This is called a "medical facelift" due to added firmness and increased deep hydration of tissues.

What results can I expect from HA fillers?

With an adequate amount of hyaluronic acid, it is possible to fill any wrinkle and correct any asymmetry, improve volume and appearance of areas of your choice (eg. lips, cheeckbones) whilst of course avoiding any ungracefulness (e.g. duck mouth). The goal must always be to maintain perfect harmony of the face.

Use of a product that is 100% degraded is particularly interesting, as it enables to adapt the injections to each face and to each age. It is undeniable that skin treatments are not the same when one is 40 as at 55 for instance. Having non permanent fillers enable complete flexibility and allows very natural results, evolving gracefully over the years.

Indeed, regular repeat sessions grant subtility and fine adaptation to the patient's personal evolution. At 40 you would naturally want to eliminate all lines, but at 60 may decide to leave a few stategically placed fine smile lines for instance. As an other example, very full, sexy lips may be a prerequisite at 30, and a less fleshy, more subtle smile be preferred at 70. 

For all these reasons, we never use permanent fillers or implants which have been unfortunately known not to age well (silicone, collagen, for instance). 

By regularly re-hydrating and filling wrinkles, HA is also a very good prevention of skin aging.

immediate results

Wrinkles and hollows disappear immediately, the oval of the face and beauty of the lips are restored. Results can be very spectacular, all the whilst respecting the natural harmony of the face. Involuntarily expressions such as « disappointment » induced by the bitterness folds, « anger » due to forehead wrinkles and thin lips can be removed. Various hollows giving a sickly or tired impression can be restored. The face resumes its pleasant, juvenile, rested and generally positive aspect.

long term results

By restoring the subcutaneous volume, premature aging is prevented (fewer new wrinkles appear, the oval of the face is maintained). Moreover skin renewal without its hollows and wrinkles ensures better overall skin quality and elasticity.

When combined with other treatments such as Botox (contraction of facial muscles) as well as other treatments for improved skin quality, (Intense Pulsed Light, Laser, Mesotherapy), the results are excellent.

How long does it last?

Deep injections (wrinkles, nasolabial folds, cheekbones, lips, oval, etc) with or without canula last between 6 and 10 months, even up to 18 months with denser hyaluronic acid.

Superficial wrinkles require a different process : the goal is to relax the wrinkles rather than filling them, allowing the skin to renew without its fine lines. 1 to 3 sessions will be required depending on the condition of the face, with an interval of 3-4 months to sufficiently alleviate these wrinkles. Then, if face volume injections are properly maintained (every 6-10 months) as well as botox (every 4-6 months), these superficial wrinkles do not reappear.

Which HA is best?

There is a wide variety of HA fillers available (monophasic, biphasic (microbeads), with varying degrees of reticulation, etc.). The best-known FDA-approved brands/names are: Anthéis, Voluma, Surgiderm, Teosyal, Esthélis, Restylane, Macrolane, Juvederm, Belotero, Perlane.

We systematically give preference to monophasic hyaluronic acid fillers, as they are turned over (degraded and synthesized) completely at 100% with no residues. We do not use permanent fillers such as Aquamid, Artecoll, Durolane.

Dr. Roux's choice of fillers is exclusively based on well-known, reliable brands, perfectly traceable and with virtually non-existent side-effects. His preference goes to hyaluronic acid containing lidocaine, an effective anesthetic of short duration, making it perfect for this type of intervention.

Contraindications

Pregnant or nursing mothers, patients under 18 years of age.
Previous nodules, granulomas or a history of inflammatory or other reaction with other fillers.
Autoimmune diseases (polyarthritis, lupus, Crohn), diabetes.

Procedure

HA injections are a very a safe technique, extremely well tolerated and do not require any downtime.

A session of hyaluronic acid lasts circa 30-40 minutes. You can go back to work immediately after the session.

The results are visible at once and you can see the progress of the treatment during the session itself.

Dr Roux only uses top quality fillers with maximum safety and traceability. Density of fillers depends on the area treated. Generally there are 3 types of hyaluronic acid treatments:

Volumizing injections

in order to restore facial volumes (typically cheekbones, naso-genic wrinkles, lips, oval of the face)

Superficial injections

to repair and fill superficial wrinkles (typically around the lips, on the cheeks, chin or forehead, crow's feet)

Injections for improvement of skin tissue

to rehydrate and strengthen and tighten skin tissue. These injections consist in depositing a thin layer of filler in a relatively large area (typically cheeks, temples)

All fillers, syringes and needles are sterile, disposable, and only the highest-standard hygienic measures are followed in our Clinic.

Injections are sometimes a little disagreeable. To improve your comfort, our hyaluronic acid contains lidocaine (short-term anesthetic) which makes the session much more pleasant, without numbing the injection site longer than needed.

Depending on the area, Dr. Roux will either use cannulas, which are less traumatic than needles, (for cheekbones, cheeks, for instance), or an injector that provides gentle and regular injections (ideal for nasogenial folds, lips), thus significantly reducing pain and hematomas.

In case of very fragile skin, temporary redness (24-48 h) and rarely, small bruising may appear at the site of injection. These do not last and are are easily hidden by a little makeup. As for the lips, a small inflammation often occurs, disappearing naturally after a few days.

Makeup is authorised after the session and one can return to their normal activities right away.

Recommendations



Facial movement is fine after treatment, but you should avoid strong manipulation or massage of the injected areas for the following 4 hours.
Application of a cold-pack or an arnica-based gel will reduce any discomfort or hematoma.
Make-up is allowed at the end of the procedure.
Anti-inflammatories (Aspirin) are banned 24 hours before the session.
No problem with sunbathing or practising sport after the session.

Repetition

Standard HA protocols indicate circa 6 months longevity. Accordingly, for most people, only two sessions a year are necessary to maintain optimal results.

Particularly dense HA used for increased volume last 12 to 18 months.

Side effects



With current fillers of top quality, side effects (granulomas, poor resorbsion, etc.) are rare and better controlled.

Injection techniques



Before the session, the injection strategy is agreed between the patient and Dr. Roux.

Cannulas are especially useful for fanning and layering. They can also be used for naso-genial folds and lips. However Dr. Roux usually prefers to fill the naso-genial folds and the lips with a needle injector, the results being more precise, injecting just the right spot with a minimum of punctures.

The automated injector used by Dr. Roux is extremely precise, both in terms of the amount of product deposited and where it is injected. The pain that one would normally expect from any injection is actually quite limited by the gentleness of this injector.

Moreover, the hyaluronic acid used by Dr. Roux contains lidocaine, so the site of injection receives immediate local anesthesia, thus rendering the session nearly totally painless.

In case the patient requires it, it is also possible to apply an anesthetic spray or to perform a dentist’s anesthesia of the mouth, numbing the whole area if so desired.

Before / After