Australasian Dentist Magazine Nov Dec 2021

Category 98 AustrAlAsiAn Dentist marked out and then treated. this may involve the use of more than one thickness of filler to achieve the result discussed step 4: Once treatment is completed, i will give post treatment instructions (the dos and don’ts), and also take post-op photos. step 5: i will set up a review appointment. this may be to assess the treatment, but we may also do additional treatment too. Are dermal fillers safe? Dermal fillers are safe when you understand anatomy, have the right equipment and protocols in place, understand your patient’s wishes and has a deep understanding of the complications and how to deal with them. Minimising risk by staying in the safe injecting zones and within your scope of practice is also important. no medical or dental procedure is without risk. it is important that those risks are discussed, along with other options. Dermal fillers used should be listed by tGA, who test and research all drugs used in the Australian market. their policies on approval are amongst the strictest on the planet. this exhaustive process is important to keep the public as safe as possible, when the drug reaches the approved status. it is also important that the patient understands when treatment is called “off-label” and that they consent to this. Off-label treatment must be in accordance with accepted standards of treatment, where there is peer reviewed research and journal articles to support the use. For example, the use of a cannula is considered off-label as the delivery method of the dermal filler is alternate to that supplied with the dermal filler. the patient must be informed of this. How long does it take to see results? Dermal filler results are immediate, but can sometimes be magnified with swelling. the best time to truly assess the outcome is about 14 days after treatment where the tissues have settled, hydration is improved and any swelling or bruising has resolved. Often i stage treatment. in other words, where there are multiple areas to treat and multiple fillers required, i will do sections of treatment at a time to slowly reach my end result. this helpsmy patient see the result take shape, and less dramatic to friends and family that are often left in the dark about procedures that are taking place. Are there any side effects? the most common side-effects are swelling, bruising and tenderness. these are transient and will resolve quite quickly. sometimes small lumps can form in the filler after placement, and these are easily manipulated and removed if your injector reviews the treatment a week later. there are ways of reducing these side effects, and the injecting dentist must be across these techniques. What type of after-care is involved? Aftercare is pretty low key actually. i ask that my patients do not massage the area injected as this has the risk of moving the filler around. it is also wise to avoid sleeping on the area for around a week too. this is for the same reason. Heavy pressure can change the result. i do prefer that my clients only use mineral makeup. Mineral makeup sits on top of the skin, so there is less chance of makeup making its way into the injected area through the injection site. Finally i always review my patients a week after treatment. this allows me to review the treatment area, modify the result, and possibly add further filler if required. i am a little over-the-top with aftercare for my patients, and i like to make sure that everything sits just right. this is particularly the case with lips, which move a lot between my treatment appointment and my review appointment. i really want to be able to make sure that both my patient and i am happy with the final result. How much do dermal fillers cost on average? Filler costs vary widely from injector to injector. Aside from that, the cost of thicker styles of filler is generally higher too. reputable injectors use fillers that are sourced from tGA listed suppliers. We also use filler brands that are well established on the Australian market and have a great safety record. Filler is not a cheap treatment. Most cosmetic injectors will have price guides listed on their websites, but should really give you more precise outlines of costs when you have your consultation. the cost will also vary based upon the amount of filler needed to achieve the end result. to give you a rough idea, lip filler can be anywhere between $395-950, depending upon the injector, the volume of filler required and the technique they employ. the actual cost of the product to the dentist varies too, according to brand and so on. But there is generally a healthy profit for the dentist, as the overheads are low, and no special equipment is needed to undertake these procedures. What’s the difference between dermal fillers and botox? Anti-wrinkle injections – a.k.a. botox – is a neuromodulator. this means that it is a pharmaceutical that is injected that alters the way a nerve works. so if the nerve is unable to send a message to a muscle, the muscle lies flat and cannot contract. this is great news for the skin, as the skin does not wrinkle when you smile. Anti-wrinkle injections do not work like filler. they will not enhance your proportions or fill out a wrinkle. However they do work extremely well with dermal fillers. By relaxing the muscles, the skin will become smoother so that the filler will have a nicer effect on the skin. in addition, dentists can use them for functional changes, such as when there is an uneven smile due to muscle weakness on one side, or when the mentalis is hyperactive. Aside from this, in some areas, anti- wrinkle treatment can extend the lifespan of the filler, as the filler is less mobile. An example of this is the use of anti-wrinkle injections to create what has become known as the “lip flip”. Part of the muscle around the lip relaxes, so that the lip sits lower and fuller in the middle. this makes the lip less mobile, and therefore reduces the “wear and tear” on the lip itself. Keep in mind that this may not be for everyone, but it is certainly worth discussing with your patient. u To learn these techniques and treatment planning strategies, or to find out more, head over to www.dermaldistinction.com liniCal