Last month I had a middle-aged lady at my consultation. She looked groomed and had a beautiful classic head with high cheekbones, full lips and a nice open gaze. She wanted a little filler under her eyes and at the corners of her mouth because there was slight wrinkling here. However, the intake interview revealed that she had been treated with wrinkle filler in these areas once in the past. She didn’t know which one, but didn’t think it was a permanent wrinkle filler, considering the wrinkles had returned. Upon closer inspection, I saw and felt a small thickening under the eyes.
This is a common misconception among clients: Just because wrinkles come back does not mean that a temporary remedy has been used. Also, the small thickening under the eyes indicates a complication of a permanent filler rather than a temporary one. Permanent in the term permanent wrinkle filler means that this substance remains permanently in the skin and does not mean permanent results. Since my maxim is that I do not treat anyone unless I know which wrinkle fillers were used in which places and when, I kindly asked this lady to request her information from the clinic where she was treated. Doctors are required to keep a record of everyone (although far from every doctor does this) and this record is always accessible to the client.
Upon return, this lady was found to have Bio-alcamid in the treated area. This is a permanent wrinkle filler where it is not wise to use with other wrinkle fillers in this area. I created an injectables passport with Ms. so that any misconceptions can be avoided in the future. An injectable passport is a document in which client keeps a record of past treatment.
This example outlines one of the many disadvantages of permanent wrinkle fillers. Often clients are unaware that a doctor has used a permanent wrinkle filler and certainly not aware of all the disadvantages associated with it. In addition to the disadvantage described above, more frequent and more serious complications occur with permanent wrinkle fillers than with temporary wrinkle fillers. Finally, beauty is a fad and subject to change. The thick puckered lips and heavily accentuated cheekbones of the ’80s-’90s, have given way to more subtle natural corrections of the present day. So a problem arises when these corrections are done with permanent fillers, given that you are now left with thick lips and heavily accentuated cheekbones.
Fortunately, wrinkle fillers do become more durable. Did you used to have several months of results, nowadays wrinkle fillers give 1-3 years of results. We are also seeing a trend of wrinkle fillers becoming cheaper to buy and therefore relatively larger volumes can be used for the same price. Radiesse (a commonly used wrinkle filler) has syringes of 1.5cc (instead of 1.0cc) and there are now hyaluronic acids on the market sold by 10.0cc. This allows a so-called liquid facelift (see next column) to be performed at a reasonable price.
List of common permanent fillers in the Netherlands:
PMS (silicone oil)
Dermalife (!no other wrinkle fillers possible in same area!)
Bio-Alcamid (!no other wrinkle fillers possible in the same area!)
Aquamid
Artecoll
Outline (Beautycall)
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