Dermal Fillers – Preventing Issues & Dissolving with Ultrasound

Dermal fillers are a very safe and effective way to restore facial volume loss and create more balanced features. These procedures have become very popular, as they have very little downtime, and the results can be seen almost immediately. Like all medical procedures, complications and poor outcomes are possible. These are best avoided by choosing an injector with experience, excellent aesthetic sensibility, knowledge of anatomy and someone who continues to enrich their knowledge through continuous education. Even in the best of hands, sometimes problems arise and sometimes people just change their minds. Fortunately, hyaluronic fillers can be dissolved.

Hyaluronic fillers like Juvederm, Restylane, Versa and RHA can all be dissolved with an enzyme called hyaluronidase. It is injected and causes dispersion of the filler. (Not all fillers can be dissolved. Silicone, PLLA, CaHA  or PMMA fillers are permanent and complications with them need a different management approach.) The results are fairly instant as the hyaluronidase has a short half-life but then some swelling sets in, which lasts for a few days and obscures the results. In two weeks, bruising and swelling is fully gone, if any bruises occurred.

Much conversation is seen on social media about filler migration. Fact is, ALL FILLER MIGRATES. Our faces move and the fillers move with it. The muscles bend and stretch the filler to look more like part of our face, rather than a foreign body embedded. That is not a problem. The problem develops when too much filler is placed and it either creates visible lumps or bumps, or under eye swelling, or makes the jowling worse or makes us look like a puffer fish.

With filler, less is more. Many places say that filler lasts only for a year. That is not the case. Fillers have FDA approval as an implant and can be seen on ultrasound and MRI for many years. They do break down and we humans also break down, losing bone and muscle and deep supportive fat but over time filler builds up. Confined spaces like the lips and tear troughs are particularly prone to issues. Lips can be ducked, ledged, lumpy, sausage like – all from too much filler, not enough support to surrounding structures, poor technique, and other factors. Under eye area requires the greatest level of care, as it is highly visible and prone to swelling. Many people are not good candidates for under eye fillers. Proper assessment is key. If under eye filler is performed, the right filler, depth and quantity, support to temples and malar fat pads in the cheeks is very important.

Dr. Ilona ShternfeldDr. Shternfeld is a Board-Certified Ophthalmologist and has trained extensively in the US, Canada, London, Paris, Costa Rica and Sweden with the world’s top experts in anatomy, injection techniques and ultrasound guided filler dissolving. She was trained in Botox use in 1998 for medical conditions such as uncontrollable blinking- hemifacial spasm and blepharospasm, as well as eye movement disorders. She opened Inner Glow AestheticsMD in Avon, CT in 2017 and people from all over the country have flown in for her to create elegant, balanced, subtle and safe results, as well as correct poor outcomes.

Since she has trained in ultrasound with several of the top experts, more people are coming to undo filler that is not pleasing. Getting facial aesthetic treatments has a deeply personal and psychological component. We all have our reasons to get treatments that are utterly unnecessary but so satisfying when done well. Nobody needs fillers and Tox, but people surely want them. Looking good and feeling good are very linked in our brains. Feeling positive changes our behavior patterns, choices and outcomes that make our lives better. So if you want to do it, great. If you don’t, great, but no need to judge. Everyone is on their own journey. When things go awry, it can be very distressing. Dr. Shternfeld is keenly involved in the care of the whole human, mind and body. Being a physician is a responsibility and a privilege.

Thank you for your trust.

Please call 860-999-4865 to schedule your consultation with Dr. Shternfeld, a Board-Certified Ophthalmologist.