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Dr Ravindra Dargainya

Dr. Ravindra Dargainya

Dermatologist, Cosmetologist, Trichologist, Allergy Specialist, STI/AIDS Consultant

Dr Prachi Dargainya

Dr. Prachi Dargainya

Physiotherapist & Nutritionist

Skilled in Orthopaedic injuries, Aches and Pain, Bell's Palsy, Paralysis, Ante/Post natal Consultation.

Dermal/Skin Filler

  • Dermal/Skin Filler made from highly purified form of hyaluronic acid that mimics the effects of natural hyaluronic acid. When injected just below the surface of the skin,Dermal/Skin Filler adds volume to skin, smoothing unwanted lines and wrinkles.
  • Role of Hyaluronic Acid

  • However, with time, sunlight and other factors, the Hyaluronic Acid in your skin diminishes, your skin loses volume, and lines and wrinkles appear. Hyaluronic Acid is a natural sugar. It is found in the human body in the skin, cartilage, joints and the eyes.
  • In skin tissue, Hyaluronic Acid fills the space between collagen and elastin fibers.
  • The role of Hyaluronic Acid in skin is to deliver nutrients, to hydrate the skin by holding in water and to act as a cushioning agent.
  • Use of Dermal/Skin Filler

  • Smile lines
  • Marionette lines
  • Lip lines
  • Frown lines
  • Enhance and define lip borders
  • Increase lip fullness
  • Benefits of Dermal/Skin Filler

  • Immediate treatment – No pre –testing required
  • Immediate results
  • Long-lasting
  • Proven safety – used in international markets for nearly a decade
  • Mild adverse post-treatment responses (such as redness, bruising ad swelling).
  • How Does Dermal/Skin Fillers Work?

  • Dermal/Skin Filler is injected just beneath the skin’s surface temporarily adding volume to the layers of the skin that have deteriorated due to age and other factors.
  • Dermal/Skin Filler when injected is used to raise depressions in the skin, providing temporary correction of wrinkles and folds.
  • Dermal/Skin Filler provides immediate, natural-looking results. Treatment and recovery usually take as little as one hour.
  • How Long Dermal/Skin Fillers Last?

  • Over time, Dermal/Skin Filler gradually breaks own and is naturally reabsorbed by your body; therefore, your physician may recommend touch-up treatments two or three times a year to maintain optimal correction.
  • Do The Injections Hurt ?

    In general, injections may cause some mild discomfort. Dermal/Skin Filler is injected directly into the skin using a fine needle to reduce injection discomfort. One may choose to anesthetize or numb the treatment area to further minimize discomfort. When creating sensuous lips, he may choose to use a dental block, which ensures a more comfortable procedure.

    Is the Product Safe ?

  • Yes, for most people. The primary ingredient in Dermal/Skin Filler is Hyaluronic Acid, which is a component of skin. In humans and other mammals, the compound is primarily found in connective tissue, in the eyes, the umbilical cord and in joint fluid, where it acts like a cushion.
  • Dermal/Skin Filler is produced in laboratories by a natural fermentation process – hence it is bio compatible and bio degradable.
  • Dermal/Skin Filler has undergone extensive testing including scientific clinical trials to establish its safety and effectiveness. Dermal/Skin Filler is FDA-approved for treatment of moderate to severe facial wrinkles and folds (such as smile lines)
  • Precautions

    Avoid taking aspirin, non-steroidal anti-inflammatory medications, and high doses of Vitamin E supplements one week prior to procedure. This will help minimize any bruising or bleeding at the infection site.

    Comparison with other Dermal/Skin Fillers

  • Dermal/Skin Filler temporarily adds volume to your skin by mimicking the hydrating effects of your skin’s natural Hyaluronic acid.
  • Treatments with CosmoDerm and CosmoPlast (and bovine collagen) replenish your skin’s lost collagen, restoring skin structure.
  • Collagen treatments do not last as long as Hyaluronic products, but also have the least side effects.
  • Collagen is frequently referred to as the “Camera-Ready” filler as it produces either no or almost no swelling or redness.
  • What is the Best Dermal/Skin Filler?

  • At this time there are basically 4 FDA-approved filler types. These are bovine collagen (used for the last 20 years), human collagen, Hyaluronic Acid and poly- lactic acid.
  • The only filler requiring a skin test prior to injection is bovine collagen. Unless you have had bovine collagen within the last year you will be required to take a skin test which is completed over a period of 28 days. All other fillers can be injected on your first visit.
  • Each of the fillers have different capabilities, staying power and potential skin response.
  • Marionette Lines

    Treatment procedure

  • Welcome the patient and advise the client of the procedure and the possible outcome.
  • Answer any questions or queries of the client.

  • Full medical history including skin analysis, history of allergies, anaphylaxis, bleeding disorders, herpes, hypertrophic or keloid scarring and prescribed medications.
  • Management of patient’s expectations. It is recommended that you discuss the reason for the patient seeking the treatment and the suitability of the treatment modality for the site and indication.
  • Pre-treatment photo is always a must. It is necessary to counsel the patient and discuss the appropriate indication, risks and benefits and expected outcome.

  • The information discussed with the patient will be reinforced by having the patient read the brochure.
  • Dermal/Skin Fillers treatment is on-going and requires at the minimum yearly follow ups for desired result to be maintained.
  • The time duration for the effect to stay of Dermal/Skin Fillers is very individual. It depends on structure of the skin, lifestyle, age and the perfection demanded by the individual.
  • For majority of clients treated, 50-80% of the effect remains after 6 months.
  • Some areas of the face experience continual use (e.g. the mouth) or the skin may lie over strong muscles (the glabellar area), hence affecting the duration of the product.
  • The treatment approximately 30 mins.
  • The result directly after the treatment may not be the final result depending on the localised swelling.
  • Dermal/Skin Fillers injection technique Nasolabial and glabellar through a 30-32 gauge needle in the dermis layer of the skin. It adds volume to the skin in order to obtain the desired level of correction.
  • The linear threading technique, the serial puncture technique or a combination of the two can be used depending on preference and desired treatment area.
  • Linear Threading Technique

  • The full length of the needle is interested in the middle of the wrinkle/fold. Dermal/Skin Fillers is injected while pulling the needle slowly backwards.
  • The “threads” each approximately 10 mm long are injected length ways in the wrinkle fold.
  • Together, the threads will form a single string, lifting the wrinkle/fold to the desired level of correction.
  • Serial Puncture Technique

  • Multiple injections are serially placed along the length of the treated wrinkle/fold. The serial placements of the product within the skin should join together into smooth continuous line.
  • There should be no spaces between the injected material.
  • Volume Augmentation

  • Dermal/Skin Fillers works by volume augmentation.
  • Small amounts of the products are injected directly into the dermis.
  • No active tissue reactions or spontaneous improvements will occur after the injection.
  • Steps

  • Assess the patient’s need for pain relief, bearing in mind the sensitivity to pain that the patient has. Normally no pain relief is necessary.
  • If the patient needs pain relief, Topical Aesthetic Cream can be applied to the area quite
  • thickly at least 30 minutes prior to the appointment.
  • Clean the area to be treated with alcohol or another antisceptic.
  • The needle (30g, 1⁄2”) is inserted at an approx. angle of 33 angle parallel to the length of the wrinkle/fold. The eye of the needle should face upwards and the substance should be injected into the middle/bottom of the dermis. Using the linear threading technique, the needle is inserted further (the full length of the needle) than when the serial puncture technique is used (3-5 mm).
  • Once the needle is in the skin the Dermal/Skin Fillers material has to be injected into the skin

    slowly pulling back the needle.

  • The wrinkle/fold should be lifted and eliminated by the end of the injection. No spontaneous improvement will occur over the next couple of days.
  • Follow Up

  • With patients who have a localised swelling, it is sometimes difficult to judge the degree of correction with absolute accuracy.
  • In these cases it is better to invite the patient to a new treatment sessions after 1-2 weeks.
  • Periodic touch ups may be required to sustain the desired degree of correction.
  • It is important that the injection is stopped just before the needle is pulled out of the skin to prevent material from leaking out or ending up too shallow in the skin.
  • When the injection is completed the treated site should be massaged so that it conforms to the contour of the surrounding tissues.
  • If there is an overcorrection, it should be massaged firmly in between the fingers or against am underlying superficial bone to obtain optimal results.
  • If the wrinkle or fold need further treatment, the same procedure is repeated with several punctures of the skin until a satisfactory result is obtained.
  • Lip Augmentation

  • The lip augmentation should be initiated from the upper lip at the vermilion border i.e. where the lip turns from red to white.
  • Before starting, the pain management has to be done properly. Usually an infra orbital nerve block is sufficient.
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