Hyaluron for wrinkles / for volume

Hyaluron for wrinkles/for volume – synonyms & principle

synonyms: Hyaluronic acid, hyaluronic acid

Products and Examples: Saypha – croma, Juvederm Ultra 3 – Allergan, Restylane – Galderma, Profhilo

principle: more volume and moisture for about 1 year
Side effect of volume: lifting of the structures in the area (to a certain extent)

is often combined with…

• Botox
• blood plasma (vampire lift)
  
• Operations such as eyelid lift, facelift, etc.

efficiency

theoretically in the direction of wrinkle filling and a firm surface 100% - BUT: this effect on volume is logically not always useful. In the cheek/jowl/middle face area, volume is often exaggerated - in my opinion, many negative examples in aesthetic medicine come from this area. - Less is often more, especially in this area!

There are many different types of hyaluronic acid, from very fine to firm, with biostimulation (Profhilo etc.) or even maximum lifting effect for certain regions such as cheeks, eyebrows, chin line, etc.

A precise analysis of the overall picture and the possible alternatives is important in order to adapt hyaluronic acid as well and individually as possible to each face and its specific needs.

In the cheek/cheek area (depending on age and degree of excess skin and tissue sagging) usually no more than 10-20% natural improvement using hyaluronic acid is useful. From a certain level of excess skin, a facelift with approx. 50-80-90% effectiveness and improvement potential is more effective and also more natural.

Hyaluron often presents a negative example in the form of “moon faces” – in my opinion, facelifts are simply superior in terms of naturalness and effect in this region once the skin reaches a certain level of suppleness.

treatment duration

On average, a treatment with hyaluronic acid only takes a few minutes. It is more time-consuming to create a precise, meaningful concept before treatment in the sense of clarifying the regions, dosages, possibilities and limitations…

repetition of the treatment

For a good effect, treatment intervals of approx. one year realistic. The duration of the effect depends on a number of individual factors and is not always the same - the duration of the effect of classic hyaluronic acid can range from 5-6 months to 15-18 months. However, there is also finer hyaluronic acid with an effect lasting only a few weeks to months and more strongly cross-linked hyaluronic acid with an effect lasting several years.

Very often hyaluronic acid is combined with Botox and this results in useful Repetition intervals of approximately half a year – According to the motto, it is better to treat less and more often (=prophylaxis) than to wait a long time and then try to force everything with a treatment.

Regular use of hyaluronic acid usually works as a wrinkle preventative (i.e. wrinkles do not develop as pronounced in the first place) – but on the other hand, as people get older, excess skin may grow, which can reduce the effectiveness, make it necessary to repeat the treatment more frequently, or make additional treatments or operations useful.

The disadvantage that the treatment has to be refreshed at least once a year is also an advantage: where volume is lacking at the moment, it does not necessarily have to be lacking in 10 years. However, that would be the case with permanent fillers (some of which were used in the past) or the patient's own fat. With hyaluronic acid, the effect can be ideally adapted to the needs from time to time. Approximately 10% of the structural improvement and new collagen formation remain even after the year of the volume and moisture effect.

Application in which body region

• nasolabial fold
• corner of the mouth
• frown lines (usually as a supplement to Botox)
• forehead wrinkle (usually as a supplement to Botox)
• brow region, cheek region, chin line
• nose correction with hyaluronic acid
• in case of asymmetries of the bone or skin surface
• for scars or indentations
• classic 10 points for biostimulating hyaluronic acid
• and much more – As you can see, hyaluronic acid can be used in many different ways – and is often part of an overall concept – hyaluronic acid always stands for moisture, volume & freshness

decision-making aids

Essentially, these are fundamental decisionsthat make up a hyaluronic treatment.

Should I have the hyaluronic treatment do it at all? – Sometimes it is better not to do something at all.

Good advice highlights all the advantages and disadvantages of a treatment – and thus helps you make the right individual decision.

Regions: A classic and one of the most common regions – with which you can also start very well and safely – is the treatment of the nasolabial foldOther regions may be added later.

Dose: an individually perfectly adjusted dose is crucial

where not? - there are regions where other products are more suitable - an example of this is the upper third of the face (frown lines, forehead, side of the eye) - here Botox is an extremely easy-to-dose and precise product that works over a large area and can be used to create very harmonious transitions. Classic hyaluronic acid is used more for points, lines or small areas. It is more difficult to spread over a large area and therefore always carries a certain risk of an irregular surface. Biostimulating hyaluronic acid spreads more easily than classic hyaluronic acid and is therefore also better suited for large-area treatments.

Every treatment is different: In my opinion, individual adjustment to the face and its anatomy is crucial for maximum harmony and balance.

What should you have heard/read before a Botox treatment?

bruises: are simply not to be ruled out. Every prick (no matter how small the needle) can theoretically cause a bruise. And just like when you hit yourself somewhere, a bruise takes several days to slowly disappear.

Asymmetry: Whenever there are two sides, there will be an asymmetry before and after the treatment. No two halves of the face are the same, and eye sockets are often a few millimeters different in height. It is impossible and unrealistic to promise a symmetrical result. But of course the goal is always to achieve the most symmetrical result possible. This can be optimized, for example, in the eyebrow area with different amounts of hyaluronic acid (= volume = lifting) or Botox (= relaxation = lengthening).

Prejudices

Hyaluron is harmless and a completely natural product (unlike Botox): that's not true...

facts

In comparison, hyaluronic acid is certainly the “riskier” product. With Botox there are no comparable problems with intolerances, injections of material into vessels and possible necrosis (=destruction of tissue)

The risk of Botox is extremely easy to calculate and is therefore smaller than that of hyaluronic acid.

most common possible side effects/complications

• Swelling (especially in the lower eyelid area, which is difficult to predict)
• bruises
• Asymmetry (always present on two sides to a certain extent)
• Granuloma (= nodule formation) or hardening - very unlikely with modern hyaluronic acid of good quality - but in the case of nodule formation or hardening, there are ways to dissolve the hyaluronic acid prematurely or to slow down the body's reaction to the hyaluronic acid
• Infection – very unlikely
• Pain or pulling – very unlikely
• Necrosis (tissue destruction due to the introduction of hyaluronic acid into vessels) – can never be ruled out, but is extremely rare – theoretically even the eye can be at risk – so in comparison, Botox is less risky in terms of possible side effects.

Hyaluronic acid and Botox are among the tried and tested classics that have been used millions of times around the world for decades with an extremely well-calculable residual risk. However, no treating doctor can or should completely rule out a risk.

details Information on possible complications can be found in the information documents

In summary, good preparation (information, explanation, facial analysis, analysis of wishes), the experience of the surgeon and the material used are the most important factors for the success of a treatment with hyaluronic acid. When it comes to materials, we focus on quality and safety.

You should avoid…

• excessive amounts of volume – the overall harmony of the face is more important than individual wrinkles
  
• too much hyaluronic acid at once Sometimes wrinkles can be stubborn. When a certain volume is reached per area, it is simply not possible to add any more volume. It is better to let the hyaluronic acid work once (hyaluronic acid absorbs moisture, builds collagen, swelling goes down) and then add more volume after at least 3-4 weeks.

anesthesia

Pain reduction during treatment with hyaluronic acid:

• ice cooling
• Local anesthesia (usually mixed with hyaluronic acid – this means that the more an area is treated, the less it hurts)
• In some cases, an anesthetic cream can also help
• Nerve blocks were done more frequently in the past – but are theoretically also possible

Hyaluron can of course also be administered during an operation under anesthesia. Anesthetizing the patient specifically for the treatment would certainly be excessive, but is theoretically also possible.

the treatment to clarify:

• No blood thinners for one week (if possible) – but always discuss stopping prescribed medication with your doctor!
• no acute herpes infection
• no pregnancy, no breastfeeding
• Allergy to local anesthesia?

the treatment

• light rest for about 1 week
• no dirt, no chlorine on the fresh bites
• For severe swelling, you may want to use a Parkemed
• Swelling and the resulting asymmetries in the first 2-3 weeks are normal – before adding volume anywhere, always wait for this time to pass!
• If everything is fine, don't touch it - to improve the evenness of the volume and for fine optimization, you can gently flatten or smooth it out in the first few days afterwards - for a few seconds in the morning and evening. Do not massage for longer, otherwise the hyaluronic acid can be broken down more quickly.

our preferred technique/recommendation

• Hyaluron where it makes sense – overall concept!
• Ice & local anesthesia mixed with hyaluronic acid to reduce pain
• prefer more frequent and less frequent breaks than long ones and then want to force them (in the sense of prophylaxis)
• There are very large price differences for hyaluronic acid – good quality material pays off (longer durability, better tolerability)

Cost

Guidelines:

360-450 hyaluronic acid per ampoule with the treatment – depending on the hyaluronic acid used – depending on the actual amount and effort

90-110 per point pair biostimulating hyaluronic acid (e.g. Profhilo) – depending on the actual quantity and effort

450-550 classic 10-point lift with biostimulating hyaluronic acid (e.g. Profhilo)

10 blunt cannula (usually used for the extensive application of hyaluronic acid or for the lower eyelid area)

approx. 180-360-450 Nose correction with hyaluronic acid – depending on the actual amount and effort

reasonable budget

Basically, you always determine the price or your budget yourself. Depending on the quantity and quality of the material used, an individually tailored treatment budget is created. This budget is discussed in detail with you before each treatment.

A final cost estimate is only possible and meaningful after a detailed on-site analysis and clarification of individual wishes.

downtime

In general, one week (especially on the day of treatment) gentle rest be taken into account – this means specifically:

• on the day of treatment, no dirt or bathing in public chlorine pools, no extreme sun or heat exposure
• Do not apply extreme pressure or irritation to the treated areas during the first week
• In the first 1-2 months, heat treatments (e.g. at the beautician) should be avoided – nothing can really happen, but it would be a shame to lose the hyaluronic acid, which can be broken down more quickly

But you don't need to be overly afraid of anything. With common sense and a good sense of your body, you won't do anything wrong anyway.

Important to know…

• it is always about a overall concept – a well-combined treatment is crucial for a good and natural result.
• combinations are often better than maximizing just one component of the treatment

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You can also find valuable information at hyaluronic acid