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Update on dermal fillers: Inject to reflect patient’s ideals of beauty

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WAIKOLOA, Hawaii — When contemplating the use of dermal fillers, consider the patient’s expectations and ideals of beauty, because what the patient sees and what the clinician sees may not be the same, according to a speaker here.

In the Oculoplastics Symposium: Principles of Aesthetic Oculoplastics at Hawaiian Eye, Femida Kherani, MD, shared with colleagues clinical tips on the use of dermal fillers.

Femida Kherani

“It’s important to have clear communication,” she said. “Ask [patients] what bothers them and be clear about what they want. Tell them what you see and discuss the limitations of fillers.”

If the patient’s expectations are unrealistic and cannot be achieved, Kherani said that she will turn down the patient’s request.

Hyaluronic acid injectables , the mainstay of fillers, is the ideal biofiller because its simple chemical structure is identical in all species and tissues; it is highly hydrophilic, rapidly metabolizes in vivo and may stimulate collagen synthesis, she said.

In Kherani’s filler procedure, she obtains the patient’s informed consent and standardized photos, then performs a facial cleanse and prep, and applies topical 30% lidocaine in a lipothene base as a nesthesia. These steps are followed by the injections by needle or cannula depending on where the injection is to be given, application of ice and then the patient receives postoperative instructions. She prescribes Valtrex (valacyclovir hydrochloride, GlaxoSmithKline) if the patient has active herpes simplex virus. Follow-up is in 7 to 14 days.

“Pre-procedure assessment is critical,” Kherani said. “Don’t inject if you are uncomfortable. Communicate clearly about the limitations of fillers to help manage expectations, and inject to reflect the patient’s ideals of beauty.” – by Patricia Nale, ELS

Reference:

Kherani F RA. Update on dermal fillers. Presented at: Hawaiian Eye; Jan. 16-23, 2016; Waikoloa, Hawaii.

Disclosure: Kherani reports she is a speaker for Allergan, Alcon and Merz.