Austin McCormick

                                                  Consultant Ophthalmic and Oculoplastic Surgeon MBChB, FRCOphth

Links


Restylane -
www.restylane.co.uk

Q-MED - 
www.q-med.com


http://www.restylane.co.ukhttp://www.q-med.comshapeimage_2_link_0shapeimage_2_link_1
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Tel: 01517098442                             Fax: 01517097509                                Email:  liverpool.eyesurgeons@virgin.net                               Address:  86 Rodney Street  L1 9AR UK

Click here to see before and after photographs

Non Surgical Cosmetic Treatments - Restylane Facial Fillers

Click here to see before and after photographs                                                                 Restylane-photographs.html

What is a facial filler?

  1. A facial filler is a man made product that is injected into or deep to the skin, to smooth out creases and folds.

  2. They are often jelly like in consistency, giving volume in the skin where the fold or crease is to fill out the area and smooth the contours of the face.

  3. It is usually used on the face but may also be used in the neck and decolletage area.

  4. This is done for cosmetic reasons to hide some of the signs of aging.

  5. Many people think they look older than they feel and the area around the eyes is a key factor in this.

  6. While many of us want to look younger, many simply want to get rid of a tired look, to look refreshed rather than younger, although the two often go hand in hand.

  7. There are many different types of filler on the market, made up of different chemicals.

  8. Some are permanent and others temporary.

  9. Some may cause scarring and inflammation, others cause very little tissue reaction.


What is Restylane?

  1. Restylane is range of facial filler products.

  2. It is a temporary filler which means that after 6-9 months the effects will have worn off.

  3. Although this may seem at first to be a negative point, it is in fact one of the reasons Restylane is so popular.

  4. If you don’t like the results of your treatment, which is rare, you know that eventually it will completely go away.

  5. Permanent fillers are more likely to cause complications due to inflammation.

  6. Permanent fillers are almost impossible to remove. Removal would be required if they caused inflammation and would involve surgery.

  7. Restylane can be removed with the injection of an enzyme called Hyalase, a quick and easy process although one which is seldom needed.

  8. It is for this reason that the Restylane range are the only fillers that Mr. McCormick uses and that they are the most popular dermal filler for soft tissue augmentation worldwide.

  9. Restylane is made from Hyaluronic Acid.

  10. This is a naturally occurring substance in the body and is found naturally in the skin.

  11. For this reason it causes very little tissue reaction or inflammation which is beneficial.

  12. Q-MED (the company that make Restylane) have developed their own unique patented system for making Hyaluronic acid.

  13. It is called NASHA - Non Animal Sourced Hyaluronic Acid. This means that it is created from a fermentation process, eliminating the risk of disease transmission from animal products.

  14. For further details click on the link Restylane.



What parts of the face can be treated?

  1. Q-MED have developed a range of products to allow what is called tissue tailoring.

  2. This means using different products for different parts of the face and different types of skin crease.


  3. Restylane Vital - Skin rejuvenation (fine wrinkles)

  4. Restylane Touch - Forehead worry lines, crows feet lines, lines around the mouth

  5. Restylane - Tear trough, nasolabial fold, glabella frown lines

  6. Restylane Lipp - Volume restoration in lips

  7. Restylane Perlane - Tear trough, nasolabial fold, cheek volume restoration

  8. Restylane SubQ - Cheek and chin volume restoration





(Diagram courtesy of Q-Med)



  1. The different products have different viscosity

  2. In general, the more viscous the deeper the product is placed



The normal structure of the skin. (Diagram courtesy of Q-Med)




Tissue tailoring: lighter, finer products superficial in the skin whilst heavier, coarser products are deeper. (Diagram courtesy of Q-Med)



What is a non surgical eye-lift / tear trough treatment?

  1. The tear trough is a groove that develops between the eyelid and the cheek

  2. It occurs because of loss of fat just beneath the skin and is exentuated by orbital fat above it bulging forwards.

  3. In some people the cheek fat may also reduce or even descend

  4. An eyebag is a common term for these signs of aging in the lower eyelid.

  5. Tear trough treatment is the injection of Restylane filler into the tear trough to fill the groove and smooth the junction between the eyelid and the cheek.

  6. The product is injected deep to the skin and muscle over the bony orbital rim.

 


What is cheek augmentation?

  1. With age the cheek fat pads that give the cheek its fullness, reduce in size.

  2. A full cheek is a youthful feature

  3. Restylane Perlane and Restylane Sub-Q can injected deep under the cheek to restore volume and youthful fullness of the cheek



How is the treatment performed?

  1. Anaesthetic cream will be applied to the skin area over the fold that is to be treated.

  2. This is left for 10 - 15 minutes

  3. Local anaesthetic injection will be used for lip augmentation, cheek augmentation and  nasolabial folds. It is not usually used for other areas as the local anaesthetic will distort the tissue making the injection more difficult.

  4. In areas where local anaesthetic injection is not used the cream works well to numb the area.

  5. Mild discomfort may still be felt when the injection is given

  6. You will be reclined in a treatment chair in a well lit treatment room where a mirror will be available for you to observe as the treatment is carried out, step by step.

  7. The injections may take up to 15 minutes to carry out.

  8. After the injections Mr. McCormick will massage the area to smooth the product within the skin for best effect.



Are there any risks?

  1. Any substance injected into the body may cause an allergic or inflammatory reaction.

  2. Mild inflammation characterised by redness, swelling, itching, pain and bruising may occur but should settle within the first few days after treatment.

  3. More prolonged allergic reactions are extremely rare occurring in less than 1 in 10 000 cases. An allergic reaction might cause a small firm lump, swelling, discolouration and scarring.

  4. Infection is an equally low risk and might present as a lump which turns yellow and discharges pus.  



What will happen before the treatment?

  1. Mr. McCormick will see you in a consulting room. He will ask about your past medical history, current medication and any allergies you have.

  2. He will ask about any other cosmetic facial treatments you have had including: Botox, fillers, chemical peels, laser resurfacing and surgery.

  3. If your treatment is to be around or near the eye, he will examine your eyes on a slit lamp to complete a thorough ophthalmic examination.

  4. Options, risks and benefits of treatment will be discussed with you

  5. You will be asked to sign a consent form before treatment commences



Who should not have treatment?

  1. If you are or think you may be pregnant

  2. If you are breast feeding

  3. If you have an active skin condition like: eczema, psoriasis, herpes simplex (coldsore), herpes zoster (shingles), infection.

  4. Roaccutane treatment in the last year

  5. If you suffer from keloid scarring

  6. Previous allergy to a dermal filler

  7. If you have recently had another dermal filler at the same injection site

  8. Skin resurfacing (chemical or laser) within 6 weeks

  9. Current medical illness

  10. People with unreasonable expectations of treatment

  11. Recent sun or sunbed exposure (treatment may proceed once redness has gone from the skin)



What should I expect after the treatment?

  1. Most people have no problems after treatment

  2. Mr. McCormick will see you in a week to ensure that you are happy with the outcome and to top up the treatment if necessary.

  3. If there is redness this may be concealed with light make-up after 6 hours from treatment

  4. There may be mild swelling after treatment. You should avoid intense heat (solarium or sunbathing) for a week after treatment to reduce risk of swelling.

  5. Cool packs may be applied in the first 5 days to the treated area, 5 times a day for 5 minutes at a time.

  6. A Non Steroidal Anti Inflammatory Drug (NSAID) such as Ibuprofen may be taken to reduce swelling. People with asthma and stomach ulcers should not take these medicines and everyone should read the label before taking them. NSAID’s may increase bruising.

  7. Bruising is unavoidable in some cases. It takes 10 - 14 days to settle and you should think of this if you have a public appearance after treatment.

  8. To reduce bruising you should avoid taking aspirin or NSAID’s for 2 weeks prior to treatment. You should also avoid herbal remedies or alternative medicines as some may increase bruising.

  9. You should only stop taking aspirin if it is safe to do so. You should discuss this with Mr. McCormick or you GP.

  10. Make-up may be applied to bruising after an initial 6 hours.

  11. If the treated area is uncomfortable or painful you may take simple ‘over the counter’ analgesia.

  12. Itching may occur in the first 1-2 weeks. This will usually settle but antihistamine tablets that are available without prescription should help this if required.







Nasolabial / Nose to mouth line

Glabella frown lines

Tear trough

Tear trough

Area for injection of Restylane shaded

Tear trough

What is nasolabial fold treatment / nose to mouth lines?

  1. The nasolabial fold is the groove that occurs from the bottom of the nose to the outer angle of the mouth.

  2. Either Restylane or Perlane may be used here. It is injected into the skin to fill the groove and smooth the junction between the cheek and upper lip area.

What is lip augmentation?

  1. A number of aging changes occur in the lips that can be addressed with fillers.

  2. The volume of the lip reduces.

  3. The vermillion border (junction between red lip and skin) becomes less well defined.

  4. The philtrum ridges become less prominent.

  5. Fine lines occur, particularly in the upper lip.

  6. A combination of Restylane, Restylane Lipp and Restylane Touch can be used. Product is injected directly into the lip, along the vermillion border and into fine wrinkles.

Loss of philtrum ridge

Lines around the mouth

Loss of definition of vermillion border

Loss of lip volume

What is glabella frown line treatment?

  1. In between the eyebrows (glabella area) lines occur when we frown. Over time these dynamic lines form permanent creases.

  2. Restylane can be injected into these creases to smooth them.

  3. This is often done in conjunction with Botulinum Toxin treatment.