Choice of filler product is equally important as injection technique

NEW YORK — Knowledge of available filler product profiles is as vital to aesthetic success as the injection technique used, according to an educational program presented at Facial Aesthetics New York.

Many of the fillers available outside of the U.S. that have not been approved by the FDA can have higher rates of complications due to contaminants, according to Joely Kaufman, MD, FAAD, of SKIN Associates, Coral Gables, Florida. FDA approved fillers, however, have a reliable safety profile.

Kaufman recommends hyaluronic acids because of their versatility and excellent safety profiles. As hyaluronic acid is chemically identical across species, there is less chance of antigenicity. Kaufman has also found, in her practice, that because hyaluronic acid’s makeup is similar to what is found in human anatomy and used for other treatments such as injecting into joints for arthritis patients, her patients seeking cosmetic treatments feel more comfortable with the product. It is also easy to dissolve in the case of complications.

Whatever product is chosen, Kaufman advises that its entire profile should be considered, including the amount of crosslinking and length of chains within the product, as this can affect inflammation and longevity of results.

Regarding injection technique, the depth of injection depends on the area being augmented. The optimal technique is also dependent on the type of augmentation, but retrograde linear threading, fanning, and bolus injections are useful, non-aggressive options for most cases.

If the patient needs work to restructure the face, Kaufman explained, the injections should be deep. However, if the work being done is superficial, such as augmenting small creases or minor work around the nasolabial fold, be sure to only inject into the superficial layers. – by Talitha Bennett

Disclosure: Kaufman reports she receives consulting fees from Alcaris, Allergan, Cutera, Galderma, Lutronic, Merz, Teoxane; is on the speakers bureau for Allergan, Cutera, Galderma and Lutronic; and has performed contracted research for Allergan, Galderma, Merz, Neothetics and Revance.

Reference:

Kaufman J. Dermal Fillers: Basic and Advanced Techniques. Presented at: Facial Aesthetics New York; Nov. 3, 2016; New York.