CATEGORY AUSTRALASIAN DENTIST 51 CLINICAL Preventing filler migration and other complications While uncommon, undesirable results are disheartening. Take note of the following to minimize the risk: 1. Choose an Experienced Injector Opt for a qualified injector with deep knowledge of facial anatomy and injection techniques. If you are a practitioner, it is important that you inject with precision, and reduce the amount of filler you are using. In some cases, this will mean not injecting at all if your patient already has lips of good proportion. Knowing when to dissolve before enhancement is also key. If there is already filler that has shifted to an area that is not desirable, further filling will not rectify the problem. You need to be strong, explain your diagnosis, and how to remedy the appearance of the features that are not right. Filling over existing poor filler, will simply lead to a poor outcome. Dermal Distinction academy have seen this gap in injector knowledge. We do offer a filler dissolving course so that you know how to look after your patient when overfilling has occurred, or if there is an emergency event. More details later. 2. Choose the right filler: Not all fillers are suitable for all areas; trust your injector’s recommendation for the right filler. From a practitioner point of view, using a filler with dynamic properties would be a good decision, as lips are highly dynamic and we need to ensure that we follow the laws of physiology. Aside from this, as an injector, you need to ensure that you do not overfill the lips or any other area of the face. Overfilling will always inevitably lead to filler redistribution or the skin looking distorted. It is much better as an injector to inject small increments over more than one visit. This allows you to assess progress, and importantly allows your patient time to become accustomed to their new look. Once they see the enhancement, they will often be balanced by the feelings of their friends and family, and not seek out further treatment where it is not needed. 3. Follow post-injection instructions: As a practitioner, it is important that your patient adhere to aftercare instructions diligently to minimize swelling and bruising. Instructions to your patient should include a. Avoid touching your face postprocedure to prevent complications. From a practitioner point of view, this means that we need to ensure our patient understand what to do after filler, but also what not to do too. I would recommend: b. Do not ask your patient to ice their lips c. Do not ask your patient to massage their lips d. Ask your patient to return one week after treatment so that you can review their lips, and massage the result if needed. It is also a mandatory requirement that you provide your patient with an implant card post-procedure. The card will contain information such as: u the patient name and date of treatment u Your name and after hours phone number. If the patient experiences a complication, you must provide the first stage of care. u The filler used so that you or your emergency support team are able to understand and deal with complications. Unfortunately, in the past patients were not provided with implant card information, and presented to emergency departments in general hospitals with little details about treatment undertaken. This may be due to distress or simply because they were not told what filler was used and the patient was unable to provide the information to the emergency care team. What resulted from this poor level of communication was poor outcomes for patients. So in 2021, it became a mandatory requirement to provide these details to eliminate poor aftercare of patients. In conclusion, ensuring a positive outcome starts with careful planning and choosing experienced professionals who prioritize your safety and satisfaction. If you would like to learn about dissolving filler, Dermal Distinction Academy provides training to help you look after your patient. u www.dermaldistinction.com Dr Giulia D’Anna Dermal Distinction Academy WWW.PROFDENT.COM.AU #SUPPORTAUSTRALIAN LUBRICATION FOR LOW & HIGH SPEED? LOOK NO FURTHER ROTAGEN
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