What are FILLERS ?
FILLERS are flexible substances that can be injected into the skin to improve the appearance of fine lines and wrinkles, plump lips, fill hollow cheeks, repair various facial imperfections, improve scars, and elevate deep folds. The result is a smoother, more youthful appearance with minimal "downtime" and maximum safety.
Dermatologists use a variety of FILLERS, including human and bovine (cattle) collagen, hyaluronic acid, autologous fat (one's own fat), and donor tissue. The growing number of available FILLERS s has greatly expanded the anti-aging and skin-saving treatments that dermatologists offer. Since FILLERS substances do not involve major surgery and are generally cost-effective, men and women are using these youth-enhancing techniques more than ever.
What can FILLERS do?
The aging process generally causes a loss of volume as the underlying collagen, hyaluronic acid, and elastin fibers begin to deteriorate and fat stores in the face decrease. This most commonly occurs around the eyes, mouth, cheeks, jaw line, brow, and bridge of the nose, producing crow’s feet, laugh lines, folds and furrows on the forehead, and “hills and valleys” on the lower third of the face. FILLERS have the unique ability to fill and contour these changes.
FILLERS s can be placed into the lips to create a fuller, more youthful look, or in the hollows of the cheeks to reduce a gaunt appearance. Facial scarring from acne or injury also responds well to soft tissue FILLERS techniques.
How do FILLERS work?
A FILLER substance is injected beneath the surface of the skin where it corrects the line or wrinkle by temporarily plumping and smoothing out the skin depression. Most FILLERS replace the host components of the skin: collagen, hyaluronic acid, and elastin. Some FILLERS also can stimulate production of collagen.
What are the ABC's of FILLERS?
Dermatologists have developed a variety of FILLERS substances to address a wide range of cosmetic flaws and other needs of the individual patient. Each FILLER brings subtle, distinctive benefits. Sometimes more than one FILLER may be used to achieve the best results. Some FILLERS provide longer-lasting results; others allow for more precision with fine lines, and still others can gradually bring the face into better balance, creating an overall rejuvenated appearance. FILLERS are often considered the first line in the treatment of aging skin and are frequently used in combinations or with other techniques for facial rejuvenation. Filling substances commonly used by dermatologists are:
Collagen — Collagen products give structure to the skin and are used to add volume to lips, raise the corners of the mouth, and redefine the shape of the nose. Collagen FILLERS may be layered with hyaluronic acid FILLERS to diminish deep wrinkles. Introduced nearly 20 years ago, bovine collagen has proven effective. Some patients may be allergic to bovine collagen; therefore, test doses are given to determine if a patient has a sensitivity. Human-derived collagen offers an alternative and does not require a skin test.
Hyaluronic acid — Hyaluronic acid is a natural component of human skin and is the framework in which skin cells live. There are several hyaluronic acid products available. Each has various characteristics that the dermatologist will take into account when choosing a FILLER. All hyaluronic acid products bind water and give the skin volume. These FILLERS can be used to fill hollow areas of the face, including the cheeks, and to plump lips.
Poly-L-lactic acid — This FILLER is used to replace lost facial fat, giving the face a more youthful appearance.
Calcium hydroxyapatite — Suspended in an aqueous gel is a semi permanent FILLERS which holds promise for long-term soft tissue augmentation.
What happens during and after treatment?
Injections are usually given in a dermatologist’s office. Before beginning treatment, a skin test may be administered to determine if you are likely to have an allergic reaction to the filling substance; however, most of the new FILLERS on the market do not require skin testing. The dermatologist may ask about the use of aspirin, warfarin (coumadin), alcohol, and green tea, since these may increase a patient’s tendency to bruise. Prior to the procedure, the face is cleaned and a topical or local anesthetic may be used. The FILLER is injected directly into the area to be treated using a very small needle. There may be a stinging or burning sensation as the FILLER is inserted. A series of treatment sessions may be necessary to fill and smooth the lines and wrinkles, or raise a depressed scar to the level of the surrounding skin. After the procedure, there may be some temporary swelling, redness, or minor bruising at the injection sites. This usually subsides quickly. Makeup can be applied immediately after the treatment.
Are there any possible risks?
All medical procedures carry some risk. However, FILLERS are generally considered safe and effective. Apart from an allergic reaction to the injected substance, side effects are few and typically due to the local injection.
How long does the improvement last?
This depends on the type of FILLERS used, the areas treated, and the ability of the patient's skin to absorb the materials. Results are generally long lasting with maintenance treatments performed after 3 to 6 months. Occasionally, touch-up treatments may be needed sooner. Correction of acne scarring, as well as the use of combination techniques, tends to last longer.
What are other treatment options?
As experts on skin aging, dermatologists are uniquely qualified to employ a variety of corrective and preventive techniques to keep skin looking its best. In fact, dermatologists pioneered many of the dermatologic surgical treatments used today to preserve and maintain healthy, youthful-looking skin, particularly, FILLERS. The dermatologist will discuss alternative and complementary treatments to enhance the outcome of FILLERS procedures.
Wrinkles and Frown Lines
Years of squinting and frowning can leave deep wrinkles that form between the eyebrows and may extend to the bridge of the nose. Wrinkles and frown lines also may appear across the forehead and at the corners of the eyes (“crow’s feet”). Dermatologists can quickly and safely inject BOTOX during an office visit to diminish these wrinkles and lines that create an angry or sad look and detract from a pleasant facial appearance.
What is BOTOX?
BOTOX are purified substances that block muscular nerve signals. Injecting very small amounts into specific facial muscles blocks the muscle’s impulse. This temporarily weakens the muscle and diminishes the unwanted lines.
For optimal results, BOTOX may be used in combination with other cosmetic skin procedures such as chemical peels, laser resurfacing, and FILLERS. Using BOTOX and FILLERS in the same area may achieve longer-lasting results. Combination therapy also can help prevent the formation of new lines and wrinkles. BOTOX is less useful for the smile lines around the mouth because muscle action in this area is needed for important functions such as eating and talking.
Before treatment, the dermatologist obtains the patient’s medical history, including any medications taken. Treatment involves injecting very small amounts of BOTOX directly into the underlying facial muscles to relax them. A tiny needle is used; the procedure is well tolerated and takes just a few minutes with no “down time” or prolonged recovery period. BOTOX takes effect about 3 to 7 days after treatment. The improvement generally lasts about 3 to 6 months; the effect gradually fades as muscle action returns. Patients require re-injection at various intervals. With repeated treatments, atrophy (thinning) of the muscle may occur. This usually produces longer-lasting results.
- Vertical lines between the eyebrows and on the bridge of the nose
- Squint lines (crow’s feet) at the corners of the eyes
- Horizontal lines on the forehead
- Muscle bands visible on the neck, commonly known as “turkey neck”
Are there any side effects?
Side effects are generally minimal, temporary, and typically relate to the local injection. Soreness or mild bruising, while uncommon, may occur around the injection site. Makeup may be applied after the treatment, but care should be taken to avoid pressing or massaging the area for several hours. A temporary headache is not uncommon after injections in the forehead area, especially after the first treatment. In rare instances, patients may develop weakness of the neighboring muscles leading to a temporary droopy brow or eyelid. All of these possible effects are mild, reversible, and self-limiting.
Hyperhidrosis (excessive sweating) can be treated with injections of a highly diluted form of BOTOX which is superficially injected directly into the underarm skin, skin on the palms of the hands, or on the soles of the feet. This weakens the action of the skin’s sweat glands which are responsible for excessive perspiration. A single treatment session can provide months of relief, and injections can be repeated when the excessive perspiration returns. Twitching muscles also can be treated by injecting BOTOX into the appropriate muscle.
BOTOX can make a great difference in a person’s life.
Its uses in combination with other modalities achieve successful results.
Apa itu melasma?
Melasma adalah kelainan pigmentasi berupa bercak warna coklat, atau abu-abu atau biru keabuan pada wajah. Umumnya dikenal awam sebagai flek hitam.
Apa yang menyebabkan melasma?
Faktor yang berperan antara lain keturunan (predisposisi genetik), kehamilan, KB hormonal, kelainan hormon, terapi hormonal, pajanan sinar UV. Selain itu kosmetik & obat - obatan yang mengandung bahan fototoksik (misalnya: obat antikejang) juga berperan. Menurut beberapa ahli, stress juga berperan karena saat stress dilepaskan hormon MSH (Melanocyte-stimulating hormone).
Melasma pada pria serupa dengan melasma pada wanita, namun hormon tidak berperan penting, umumnya pajanan matahari dan riwayat melasma di keluarga lebih berperan.
Apa saja jenis melasma?
Berdasarkan kedalamannya melasma dibedakan menjadi:
- tipe epidermal (dangkal)
- tipe dermal (dalam)
- tipe campuran.
Sedangkan berdasarkan area wajah yang terkena dibagi menjadi:
- pola sentrofasial (pipi, dahi, atas bibir, hidung, dagu)
- pola malar (pipi dan hidung)
- pola mandibular (sepanjang rahang).
Saya sendiri lebih menyukai pembagian jenis melasma berdasarkan kedalamannya, karena pembagian ini lebih sesuai dan berhubungan dengan terapi dan prediksi hasil terapi.
Bagaimana terapi melasma?
Prinsip terapi adalah proteksi terhadap sinar UV, menghambat aktivitas melanosit dan sintesis melanin, serta merusak dan menghilangkan granul melanin.
Terapi terpenting melasma adalah menghindari faktor yang berperan, terutama pajanan sinar UV dari matahari.
Pemakaian sunblok/sunscreen secara rutin dan teratur adalah penting.
Dokter akan meresepkan berbagai krim untuk perawatan rutin di rumah. Bahan aktif yang digunakan bervariasi jenis dan konsentrasinya bergantung kebutuhan dan kondisi kulit masing-masing pasien.
Terapi alternatif meliputi Chemical Peeling dan Laser/IPL. Terapi ini bertujuan untuk membantu upaya menghilangkan melasma, namun tidak dapat mencegah kekambuhan melasma. Untuk mencapai hasil optimal, baik Chemical Peeling maupun Laser/IPL harus dilakukan secara rutin dan teratur sesuai petunjuk dokter. Jenis dan konsentrasi cairan Chemical Peeling , juga jenis Laser/IPL yang digunakan bervariasi bergantung kebutuhan dan kondisi kulit pasien.
Apa yang dapat dicapai dengan terapi?
Karena sukar dihilangkan dan cenderung kambuh, melasma seringkali sulit untuk diobati.
Tujuan terapi adalah mencegah atau mengurangi keparahan melasma, mengurangi area/luas kulit yang terkena, mempercepat hilangnya melasma bila kambuh kembali, tentunya dengan efek samping seminimal mungkin.
Apa yang dapat membantu keberhasilan terapi?
Rekomendasi umum untuk membantu hasil terapi adalah :
- menghentikan KB hormonal (KB Pil, KB Suntik)
- hindari produk kosmetik yang mengandung pewangi
- hindari obat yang bersifat fototoksik
- proteksi dari sinar UV (sunblok/sunscreen UVA/UVB)
Pajanan matahari akan membuat melasma kambuh. Penting untuk selalu menggunakan sunblok/sunscreen UVA/UVB minimal SPF 30 setiap hari selama terapi dan juga setelahnya seumur hidup untuk mengurangi kambuhnya melasma.
Jadi setiap pagi sebelum beraktivitas, jangan lupa sunbloknya ya..