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The word Fillers can conjure up all sorts of preconceived ideas of faces looking not quite right or overdone..so the purpose of this short blog is to help lessen the fear of filler treatment.

Volume loss is a fundamental component of facial ageing and this happens due a variety of reasons including fat redistribution, skin laxity and skeletal changes in our faces.


As we age, the natural collagen and elastin in the skin diminishes , as cells lose their ability to produce more of their youthful component. The skin becomes dryer, thinner and less able to fix itself. When we’re born, we have plentiful amounts of hyaluronic acid (HA) in our body, but as we get older this store of HA diminishes, leaving the skin less well supported, and so lines and wrinkles develop.


The MD codes were developed and pioneered by the world famous plastic surgeon Dr Mauricio De Maio using the Vycross collection of Juvederm Dermal fillers. The Juvéderm range of fillers contains a variety of products, which can be used to treat different areas, from fine lines on more delicate parts of the face to deep skin depressions.

By lifting and smoothing targeted folds and wrinkles, dermal fillers can make a difference to a person’s appearance, giving them a fresher look.


The treatment of volume loss with dermal fillers will usually involve injecting this naturally occurring product (HA) through a tiny needle. The discomfort is minimal as the treatment does not take long to perform. The aesthetic outcomes of treatments with dermal filler are seen immediately after the treatment but are at their best at 2-4 weeks.


I always say to my patients that facial enhancement is a journey and treatment plans can always evolve according to needs and budget. In my opinion if your considering dermal filler treatment , most patients will benefit from replacing lost cheek volume.

This not only enhances the mid face, but it also improves the appearances of the “nose to mouth lines” and ” sad lines” and around our eyes...This statement is obviously subject to individual facial assessment and consultation.


Using small volumes of dermal fillers strategic sites eg CK1/CK2/CK4 (CK= cheek) we can build the foundation needed for rejuvenation. The use of MD Codes identifies precise sites in the face where the use of dermal fillers will create natural looking lift and rejuvenation and allows for bespoke, tailor made treatments, which take into account facial proportions and anatomy.

Negatives vectors in the face can be lifted so to change the emotional attributes on a patients face... so we can make the patient look happier, more rested, more youthful and less saggy.


So to conclude dermal fillers are not to be feared..they are a great way to enhance your beauty by replacing volume in a subtle and natural looking way... however choose your injector wisely as good anatomical knowledge is essential.

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Updated: Jan 18, 2020




My philosophy at The Medished is to create & maintain healthy skin for life – for all patients. We should all be able to look good for our age, and healthy skin is what we all want. The good news is that we can address the appearance of ageing skin with keys ingredients..


Understanding The Skin Basics

There are 2 layers of the skin, the e​pidermis​ and the ​dermis. Medical grade skin care is licensed to get to the dermis of skin so to increase production of collagen and elastin.


The epidermis consists of cells called the keratinocytes and melanocytes. The dermis contains cells called the fibroblasts. A healthy skin cell cycle is 6 weeks..as we age the cycle increases in length so causing uneven texture making fine lines and wrinkles more noticeable.


So How does skin age?


Human skin is constantly exposed to environmental stressors and UV radiation contributes to 80% of oxidative stress and free radical damage leads to older looking skin. Other factors include the natural ageing process, trauma and hormonal changes.


What can we do ... Adopt a good skincare regime!


●  Cleanse​ to remove irritants and surface debris for a clear complexion


●  Exfoliate regularly to instantly polish the skin to restore a smoother texture for a healthy glow, and to remove dead skin cells so that the active products can penetrate deeper into the skin


●  Tone​ to balance skins natural PH levels


●  Treatment​ to maximise skin barrier function to achieve dramatic results


●  Hydration​ to provide hydration and anti-inflammatory benefits


●  Sun-protection​ combined ingredients to protect the skin against harmful UVA/UVB rays and HEV light


Key ingredients to promote healthy skin


●  Retinol​ - reduces and prevents the appearance of fine lines. Helps clear break outs

Improves skin tone and texture


●  Vitamin C​ – builds collagen, lightens and brightens the skin, reduces inflammation, neutralises free radicals and helps maintain normal cell turnover


●  Hydroquinone​ – regulates melanin production ie reducing brown spots/age spots.


●  Glycolic acid​ – restores smoother skin by increasing cell turnover


●  Lactic acid​ – increases epidermis hydration. Softens keratinocytes and increases cell turnover


●  Salicylic acid​ – Smooths the stratum corneum. Unclog pores. Regulates oil production.


I believe the key to confidence is looking your best. The right skincare regime can make a huge difference to reduce the effects of ageing and sun damage. I am very passionate about skincare as I feel that this is something we can maintain for life .


The reason I love using Obagi and ZO products is because conventional off the counter skincare can only offer limited results. They are not licensed to penetrate through the epidermis to the deeper dermal layers.


Medical grade products, can targets the epidermis and transforming your skin’s health to look brighter, clearer, softer, smoother, firmer and naturally younger!


The Obagi and ZO skin health ranges are well-known throughout the world as leaders in skin health. Obagi is based on the belief that every person can enhance, rejuvenate and sustain beautiful skin for life and that there is truly an Obagi system for everybody to achieve this.


For this purpose, several clinically proven products and skin care systems have been developed, which can be prescribed to you after a thorough consultation and analysis of your skin which is made at the first meeting at the Medished. This consists of anti-ageing therapy which has been specially formulated to penetrate the surface of the skin, which in turn transforms the functions of skin cells at the cellular level to repair the damage inside, leaving younger, healthier looking skin.






Obagi and ZO have developed a range of products and skin care systems which I could prescribe to you after a thorough consultation and analysis of your skin..these Medical grade products are available here at the Medished subject to consultation, so why not pop in for chat!

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Let’s talk about lip fillers....Done well … lip fillers can really enhance someone’s face. Lip fillers are a clinical procedure however they definitely require an artistic eye. It’s all too easy to spot badly done lips.. I see so many badly done lips which definitely don't do that. I pride myself in being able to create bespoke lips that will look fabulous on your face.


It’s important that Lips should fit your face nicely and have good balance, proportions and not be too overpowering. If a Patient has big eyes if may be easier for them to look good with bigger lips .. smaller eyes need smaller lips.


I always look at my patients profile and see if they have any asymmetries which I can improve.There are many issues that can be addressed for example....… volume can be enhanced, the cupid’s bow redefined, smokers lines reduced, the vermillion border strengthened and hydration increased.


I only use Hyaluronic Acid Fillers and I stock the reversal drug on site(hyalase) if for any reason the filler needs to be dissolved. I think the key to producing beautiful lips is that I have a good anatomical knowledge so I understand the areas of the lip that can be injected safely.


THE MEDISHED PROCESS


All of my patients at The Medished will need to have a full consultation prior to any filler treatment and a cooling off period. I will take a full medical history and advise you of the risks and benefits of the procedure before making a recommendation of the most appropriate lip

Filler product for you. 


All appointments are a minimum of an hour to allow time for the topical anaesthesia to work for the first 15 minutes. During the lip filler procedure I will be regularly consulting you so that you are happy with the outcome.


It is however impossible to know how your body will react to the product and the procedure.  I always inform my patients of all possible outcomes so that they are empowered with the knowledge so that if there is a complication we would be able to act on it.


You will have a safer, more informed and stress-free recovery if you are aware of the commonly occurring and rare complications.


Aesthetic treatments such as lip fillers are medical procedures that take some time to settle but each person is different and so for the most optimum effect, you may need to return within a fortnight for a follow up appointment.


TOP TIPS PRIOR TO TREATMENT

  • Do not exercise beforehand

  • Do not take aspirin/ibuprofen the week before a treatment

  • Consider using arnica in the week before your treatment

  • Have the lip area clean and make up free

  • Avoid using make up for at least 4 hours after your treatment

  • No Alcohol 24 hours before and after treatment


POSSIBLE COMMON COMPLICATIONS

  • As I am using needles in the majority of patients, bruising can be very common

  • Bleeding and swelling which can be asymmetrical.

  • Hyaluronic acid fillers attract water to the area is is placed hence can add to swelling

  • A haematoma can occur 1/10 patients which is a blood filled bruise. Over the next 1-2 weeks, the body will reabsorb the blood cells and fluid from the region.

  • Filler does not settle evenly with the formation of a lump.  They can be evened by massage but if that is not effective then you need to come back to the MediShed for me to smooth them.


Post treatment advice


In the first two days after your lip filler treatment:

  • Do not rub or massage your lips

  • Do not take aspirin/ibuprofen and avoid alcohol

  • Use a cold compress on your lips for 15 minutes in every hour

  • Sleep with your head slightly raised

  • Swelling is most noticeable in the first two days after your treatment but if there is some swelling after 48 hours, an over the counter anti-histamine might help. 

  • Bruising might take longer to improve, depending on its severity. 

Rare complications


Delayed Onset Nodules:


This is when a lump presents weeks or months after treatment and can be inflammatory or non inflammatory. It may need possible removal and antibiotics.


Very Rare Complications


VASCULAR OCCLUSION :


This is when the blood flow is interrupted due to some filler blocking or putting pressure on an artery.The risk of this occurring is estimated to be 1 in 30,000. The area of skin or other tissues that are supplied by the affected vessel will start to die without the necessary blood supply.  


SIGNS OF VASCULAR OCCLUSION

  • There will be an immediate blanching, paleness and the tissue turns white when the blood flow is interrupted...generally in areas far away from the actual injection .

  • There is usually immediate pain but it can be 24 hours after being injected.

  • If no treatment is initiated to improve the vascular flow, the skin will start to appear dusky, a bluish tint, with fine reticulations (lace like) to areas beyond the site of injection. This occurs within 24 hours.  

  • If still no reversal drug is used(hyalase), the skin will start to die, turning black, and possibly leading to an associated infection. 


All of my patients at the Medished will also be taught how to check for capillary refill.

This is to check the blood flow is not compromised post lip filler injection.


If a vascular occlusion does occur .…I will keep you in clinic and perform a hyalase pulse protocol until good blood flow is restored.



Finally! Don't worry your in safe hands…


The majority of the time all is well and my patients enjoy the effects of their lip enhancement..its good however to understand the procedure so that you are fully informed.


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