Thinking about Lip Fillers?

As Love Island comes to an end, surveys have shown that as many as 40% of women watching the show feel bad about themselves after watching it. 40%! Combine this with reams of gorgeous, pouting women on social media, and you can be left feeling a bit flat! As a result, lots of women (and men too) are considering procedures to alter the way that they look. Lip fillers are everywhere. Odds are, you know someone who’s had some kind of aesthetic procedure done.

As I scrolled the comments section of an aesthetic clinic on Facebook recently, I saw girls tagging each other to consider “bargain” treatments, and one even suggested she’d “check *insert well known discount voucher site* to see if there’s any deals on”. But is price the first thing you should consider when thinking about having Lip Fillers? The answer – HELL NO!

What are Fillers?

The most common types of Filler are made of a synthetic (man – made) Hyaluronic Acid (HA). We have this in our skin naturally, but as we age, our production of it decreases, and the lower face starts to lose volume, and with it, that youthful appearance. There are other types of dermal filler, but most clinics use HA because it’s temporary, and easily reversed with Hyaluronidase , which is an enzyme which breaks down the filler.

Who can administer Fillers?

Short answer? Anyone. As scary as it sounds, there is currently no law in place to state that you need to be a medical professional to administer fillers. This is something that many groups and professionals are campaigning to change. The main reason for wanting this change, is that only a medical professional can administer the reversal agent, Hyaluronidase and sometimes, this can be necessary as an emergency (but more of that later) Many reputable insurance companies are now refusing to insure beauty therapists for administration of fillers. If you do choose to go to a beauty therapist for your procedure, it is worth checking a few things:

• Do they have a protocol in place in case of medical emergency? Do they have a prescriber available quickly? (This also applies to Nurses who are not Independent Prescribers)
• Are they insured?

Why are there such variations in cost?

There’s no set cost that people should charge. However, if someone is very much cheaper than others in the area, I would question why. I know that one online clinic who are offering crazily low prices, are using a filler which requires the client to massage it regularly, and other professionals in forums I am part of have had huge problems dissolving it when there has been a problem. I also don’t offer any “Special Offers” or periods of reduced cost, because this practice is against UK regulations (that’s not trying to throw shade at anyone who does do it! Each to their own!)

The things I take into account when pricing my treatments are

• Room cost – I rent a clinic room
• Stock cost – I only ever order from a registered pharmacy or direct from the company, and only ever use high quality products
• Aftercare – I am always available post procedure and deal with all complications quickly
• Insurance costs
• Further training – as medical professionals we are expected to maintain a professional portfolio which requires attending conferences and additional training, to make sure we are offering you the best possible service
• Injector Experience – myself and many other aesthetic practitioners are highly skilled professionals with years of experience and training outside of aesthetics as well as in the field. Now that might sound like we’re blowing our trumpet – but that knowledge and experience benefits you as a client.

As with everything in life – you get what you pay for.

What are the common risks?

Thankfully, it’s rare that things go wrong. But we’re all human! Having a complication does not mean that the injector isn’t any good – if you inject enough people, something will happen. What separates the bad from the good, is how prepared they are for the emergency, how quickly they recognise it, and how capable they are of treating it, and offering thorough aftercare instructions and contact details. Some of the common risks are:

• Infection – (this can be because of inadequate cleaning pre – procedure, or just bad luck!) You can help reduce this risk by following your aftercare instructions closely, avoiding touching the area too much, avoiding make up for 6 – 12 hours (longer if you can!) avoiding sunbeds, and letting your injector know if you suffer with coldsores. If you do have a history of coldsores, you should take a short course of Antibiotics pre procedure such as Aciclovir.
• Bruising – The face is incredibly vascular – it’s near impossible to inject someones face without hitting a small vessel or two! You can reduce the risk by avoiding alcohol for a couple of days before your appointment and avoiding tablets like aspirin and ibupofen. You can also take arnica tablets for a few days before and after the treatment (the evidence is purely anecdotal, but I hear positive feedback from clients)
• Swelling – for a day or two after, your lips are likely to swell. It’s your bodies response to the trauma of injections. I cannot emphasise this enough – DON’T PANIC! The swelling will subside, and you’ll likely be left missing the swell, and wanting more. You can help the swelling by using ice packs (make sure they are wrapped in fabric or muslin so you don’t cause an ice burn)
• Lumps – occasionally, filler can gather in one space causing small bumps. I always ask clients to come to me to massage them away, but your Injector may be happy for you to do this. I always worry about filler being massaged into the wrong space, or being left very uneven, so I prefer to take that responsibility on, rather than leave it to you to have to do.
• Asymmetry – If you have a good look at your lips, you’ll notice there is a slight uneven appearance. This can be down to lots of different things – your teeth, the way your natural volume is degrading around the lip area. It is rare that your lips will be 100% symmetrical following a lip treatment, but you definitely shouldn’t be left with very noticeable differences, and you should always contact your injector if you are unhappy with your treatment in any way.

What are the serious risks?

Dermal Fillers do carry serious risks. Thankfully they are rare, but they can happen and it’s important you are fully aware of them, and that your injector knows how to deal with them. Don’t be scared to ask your injector if they have a protocol in place for dealing with emergencies. If they skirt around the issue, or downplay it, that should be a “Red Flag”

• Anaphylaxis (Severe allergic reaction) – This is incredibly rare. Serious anaphylaxis can result in severe swelling, and difficulty in breathing and should be treated as a medical emergency. Your injector should be fully aware if what to do in this situation.
• Vascular Occlusion (Blocking a blood vessel/artery) This is the big one! It’s rare, but it’s serious. The good news is, it’s reversible. However, if your injector is a beauty therapist, or non – prescribing Nurse, they will not have a stock of emergency Hyaluronidase. As a Non – Medical Prescriber, I am also not able to keep a stock of drugs. So I prescribe a vial of Hyaluronidase for all clients attending a dermal filler appointment. It costs me slightly more, but I sleep at night a lot better so for me, it’s worth it. Major arteries surround the mouth and injecting one of these with filler, can cause a blockage. Blood carries oxygen to the tissue. Block the artery = block the oxygen getting to the tissue. This results in tissue necrosis if not treated quickly. This can result in serious damage, scarring and in worst case scenarios, the need for cosmetic surgery to rectify damage done. Usually this becomes apparent very quickly, but occasionally, it may happen after you leave the clinic. Sometimes, heat/aspirin and massage are enough to sort the problem. However, usually it will require the dermal filler being dissolved as soon as possible. Never be afraid to ask you injector what their plan is if this happens.

How much should I have injected?

Usually clients have anything from 0.5 – 1ml injected. For a first treatment, 0.5ml may not give you as visible a result as expected, but I always encourage clients to take it slowly if they’re anxious. It’s much easier to add in, than remove! Personally, I will never inject more that 1.2ml of filler per lip treatment. Injecting too much, too quickly, can result in the lips looking overstretched, overfilled, and un – natural. Some clients come to me having had lip treatments elsewhere and feel they have a “duck” appearance. This is usually because the filler has been injected in the tissue above the lip, rather than in the lip body itself.

What should I look out for/expect from my Injector?

• What does their work look like? Most injectors have a website or an instagram page – take a look at their previous work. Look out for all pictures being filtered/having lots of lipstick on – this make the work difficult to see. Is there lumps of filler above the border of the lip? Photos should be natural, without any filter. (Disclaimer – I occasionally post photos sent to me by clients which have lipstick on, because I am incredibly grateful for positive feedback!)
• Pre – Procedure Assessment – If you are unsure, you should be offered a “cooling off” period. You should never feel pressured into a treatment, or as if you are wasting their time if you decide not to go ahead. You are never obliged to go through with something you’re not 100% sure of. There should be a full assessment including your past medical history and any medications you take.
• Consent – Another biggie for me. I have lost count of the number of clients who have come to me, who have said they have never had an assessment or consent form before. This is to protect you and your injector. Insurance companies may not pay for any claims without a valid, informed consent.
• Insurance – Are they insured? Who with?
• Background – What is their training? Although it is not illegal for a beauty therapist to administer treatment, I would always recommend seeing a registered Nurse, Doctor or Dentist. Don’t be afraid to ask for their NMC/GMC/GDC number – there have been stories of people masquerading as nurses and doctors who aren’t!
• Where do they get their fillers from? I am planning a separate blog post on this – but where are your fillers coming from? There are a large amount of counterfeit fillers on the market – you won’t be covered by insurance and there is no guarantee of what is being injected.
• Keeping some filler back for a “top – up” –  While strictly speaking, this isn’t against any laws, all fillers are only sterile until opened. And they are all marked as single use only. Many come with 2 x needles – this is in case of dropping one, or to change halfway through the procedure as needles become blunt and this can improve comfort and reduce trauma. By keeping some filler in a syringe to use a week later or two later, you are increasing your risk of infection and complication. My rule – If it’s not in your face, it’s in my bin!
• Aftercare – Is there a clear set of aftercare instructions, and do you have contact details in case you have any immediate or delayed post procedure complications?

This post and list is by no means exhaustive, but hopefully it has given you an idea of things to ask and what to look out for. No injector worth their salt, will mind you asking these questions, and will have no issue answering them. Although fillers seem to be everywhere, and as common as getting your legs waxed, or your eyebrows done, they’re a medical procedure, with serious risks, and should never be entered into lightly, and certainly never as a result of a bargain deal! If anything about your injector or the process doesn’t feel right, back away and do some further research – never take risks with your face.

What have your experiences been? What other topics would you like me to cover in the blog? Let me know in the comments section, or drop me an email.

A huge thank you to my lovely client, for allowing me to use her image in the attached picture xx