DR G DE AGUIAR

PLASTIC, RECONSTRUCTIVE & COSMETIC SURGEON

Procedures - Injectable Fillers


Introduction:
As we age, our ability to maintain youthful smoothness and elasticity in our skin diminishes, causing our skin to become drier, thinner and less able to replenish itself. Our body’s natural matrix of supportive structures, mainly collagen and hyaluronic acid, decreases and our skin becomes more lax, causing wrinkles and creases which can make us appear older than we are. Also, as we age, our faces naturally lose subcutaneous fat. Dermal fillers can help restore volume and fullness in the face giving the skin a plumper, smoother and more youthful appearance.

Planning for Treatment
Facial rejuvenation is very individualized. That's why it's important to discuss your desires and expectations with a suitably qualified plastic surgeon who has experience with many different types of surgical and non-surgical facial procedures. In your initial consultation, your plastic surgeon will evaluate your face - the skin, the muscles and the underlying bone - and discuss your options and goals for the procedure. Your doctor will help you select a treatment option based on your goals and concerns, your anatomy and your lifestyle. Your surgeon will ask you about your medical history, drug allergies, and check for conditions that could cause problems of interactions with injectable materials. During the consultation, various options will be discussed including the myriad of non-surgical rejuvenation methods, including injectable dermal fillers, fat grafting, Botox injections, laser resurfacing, chemical peels, thread lifts, dermal needling and skin care products.

What are the different types of fillers?
The search for a perfect filler remains elusive. Over the years, a variety of fillers have being used, including collagen, PMMA(polymethylmethacrylate) fillers (contain 20% tiny PMMA microspheres suspended in 80% purified collagen gel) and hydroxyl-apatite (a mineral-like compound found naturally in human bones, suspended in a gel-like formulation). They have all had unwanted side-effects and have largely replaced by hyaluronic acid (HA) or fat.

Hyaluronic Acid is a natural substance found in our bodies. It is well suited to plump thin lips and fill facial creases such as nasolabial folds. When injected, hyaluronic acid acts like an inflated cushion to support facial structures and tissues that may have lost volume or elasticity due to normal aging. It also brings water to the surface of skin to keep it looking fresh and supple.It may also be appropriate for some surface wrinkles and concave scars. The results may last 6 months or longer. Typical products include Restylane, Perlane, Juvederm, Voluma etc.

Human fat (see fat injection link), harvested from your own body, can be reinjected to enhance facial fullness, fill deep creases and to build up shallow contours. Fat injection requires a more extensive procedure than other injectable fillers because it uses liposuction techniques to extract the fat prior to injection.

What to Expect from Treatment
The most important fact to remember about injectable fillers is that the results are not permanent. Injected material is eventually metabolized by the body. You should not expect the same long-lasting results that may be gained from cosmetic surgery. In some individuals, the results may last only a few weeks; in others, the results may be maintained for many months. Researchers believe that age, genetic background, skin quality and lifestyle as well as the injected body site may all play a role in the injected material's "staying power." However, the precise reason for the variation of results among patients has yet to be identified.

Where Your Treatment Will Be Performed
Injectables are usually administered in a surgeon's office-based facility. The procedure takes about 15 to 20 minutes. Most injectable products contain local anaesthetic agents so the pain of the injection is usually minimal. If more extensive injections are to be performed, topical anaesthetic or nerve block procedures can be offered. If, however, you are being hospitalized for a facelift, neck lift, brow lift, or any other procedure, your injections may be administered at the same time.

Benefits of commercially available soft tissue fillers:

  • Dermal fillers are among the most popular aesthetic procedures because they carry immediate results, very few risks and little recovery time.
  • Safe, time-tested, effective treatment that provides immediate results.
  • No downtime for injectables—patients can immediately resume work and all normal activities.


Risks Related to Injectables
  • When injectables are administered by a qualified plastic surgeon, complications are infrequent and usually minor in nature. Still, individuals vary greatly in their anatomy, their physical reactions and their healing abilities. The outcome of treatment with injectables is never completely predictable.
  • Hyaluronic Acid: side effects are typically mild or moderate in nature and last for less than 7 days. Adverse events include redness, pain, firmness, swelling, lumps/bumps, bruising, itching, infection and discoloration.
  • Fat: Allergic reaction is not a factor for fat because it's harvested from a patient's own body. However, there is still a small risk of infection and other infrequent complications.
  • No need to obtain tissue from another part of the body.


Fat Injection
Fat-injection procedure is also known as autologous fat transplantation or micro-lipoinjection. Fat cells are extracted from the patient's abdomen, thighs, buttocks or elsewhere and reinjected beneath the facial skin. Fat can fill in sunken cheeks or lines between the nose and mouth, correct skin depressions, minimize forehead wrinkles or enhance the lips. After cleansing and treatment with local anesthesia, fat is withdrawn using a syringe with a large-bore needle or a liposuction cannula. The fat is then prepared and injected into the recipient site with a needle. Sometimes an adhesive bandage is applied over the injection site. Slight overfilling may be necessary to allow for fat absorption that occurs. When fat is used to augment the cheeks, this overcorrection may cause the face to appear abnormally full. While some treatments require a brief recovery period, many patients resume normal activity right away. Expect some swelling, bruising or redness in both the donor and recipient sites. The severity of these symptoms depends upon the size and location of the treated area. Stay out of the sun until redness and bruising subsides - usually about 48 hours. In the meantime, you may use makeup with sunblock protection to help conceal your condition. In some cases, swelling and puffiness in the recipient site lasts several weeks, especially if a large area was filled. While some patients report results lasting 1 year or more, the majority of patients find that at least half of the injected fullness disappears within 3-6 months. Therefore, repeated injections may be necessary. Your doctor will advise you on how to maintain your results with repeat treatments.

Procedures by Dr De Aguiar

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Body

Just as the facial muscles may sag or wrinkle with age, so can the skin on the torso, breasts, thighs and upper arms.

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Breast

Loss of skin elasticity, the force of gravity and other factors such as weight loss, pregnancy and breast-feeding ultimately affect the shape and firmness of a woman’s breasts.

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Face

As part of the natural aging process, our skin progressively loses its elasticity and our muscles tend to slacken.

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Reconstructive

From the top of the head to the tip of the toe, and from newborn babies to the very elderly, reconstructive surgery is used to treat a wide range of conditions.

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Non Surgical

Apart from the cosmetic uses of Botox, the drug has been used to treat more than 70 medical conditions.

Commitment

Choosing to have plastic surgery requires thorough research and educated decision-making. This website is designed to help guide you get to know a little bit more about my practice and understanding of the procedures and treatments available to you. I look forward to meeting you which will allow you to make a better informed decision around treatments or surgery best suited to you.

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FAX: 011 304 6800
CELL: 072 144 9901

ADDRESS: Room GF07, Netcare Waterfall City Hospital