Dermal Filler Dos.

lyzahLyzah, Registered Nurse

Dermal fillers are used to correct volume loss in the face.  We can use these in cheeks, lips, tear troughs, temples, nasolabial folds, jaw line, ear lobes,chin… almost everywhere really.  When injecting dermal fillers, there are several guidelines I like to share with my patients to help them to achieve their best possible outcome.

First, I like to advise patients how to prepare to receive the injections.  I suggest that you discontinue the use of Aspirin, Fish Oil, and Vitamin E supplements 10 days prior.  This does not mean you can’t have filler if you took Aspirin that day or the night before.  It simply means you may experience some bruising associated with the blood thinning effect of these products.  I would also recommend taking Arnica (homeopathic for bruising) and Bromelain (homeopathic for inflammation) tablets 3 days prior (continue for 7 days after).  Again, if you don’t, it is not a deal breaker.  You just may experience more bruising and swelling.

Next, I like to give my patients a realistic idea of what to expect.  Many fillers are temporary hyaluronic acids that your body will eventually absorb naturally between 6-12 months.  Initial treatments, may require a ‘touch-up’ in 4-6 months to prolong results and/or increase volume for best results. This also depends on which product and how much product you choose initially.  The initial volume with Sculptra (polylactic acid) will diminish after the first 3-5 days. PLLA particles will then work to stimulate your own collagen to replenish lost volume. It is then important to follow up every 6-8 weeks until you achieve ‘FULL correction’ with this product. I stress that it is common to have swelling, redness, and even bruising after treatment. Following the instructions above and icing the area can help diminish one’s chance of experiencing these undesirable side effects.

Lastly, I recommend that you avoid direct exposure to heat and sunlight, excessive manipulation and rubbing of the treated area(s) for 48 hours, chemical peels and laser treatments immediately after.   Apply ice to the treated area(s) for the first 48 hours as well as Arnica cream and continue taking your Bromelain.  I also recommend drinking plenty of water for the next 5 days as this will help hyaluronic acid to ‘hydrate’.

I welcome my patients to call me if they have any questions post procedure.  This will help me when administering your next treatment.

Swelling after Surgery

By far the most common questions I field in my Aesthetic Surgery practice following a surgery concern swelling. This is true for facial surgery, breast surgery and body contouring. “Is this normal ?” and “When will it go away ?” are usually the main ones. Well, it is completely normal for your tissues to swell after surgery and it will go away at different speeds depending what was done and the body part. Here’s why…

When you have surgery, your tissues are ‘injured’, albeit in a very controlled, sterile environment. But all the same, the tissue does undergo an injury. Our body responds to that with an “inflammatory response”. Now the term ‘inflammation’ has gotten a bad rap of late but in reality the inflammatory response is the normal pathway by which the body heals. Part of this response is that the blood vessels in the area of the surgery will get more ‘leaky’. Blood vessels are not solid tubes, they are porous to let the cells that promote healing access the area. With this movement of cells come shifts of fluid from inside the blood vessels to to injured tissue, thus the swelling. As the healing process progresses the swelling will subside.

In general, swelling in the face resolves more quickly while the breasts and body take longer. The thighs and legs will stay swollen the longest because of gravity. So, in the face it is not unusual or unexpected to have swelling for several weeks. The breasts and torso will show swelling for 3 to 6 months typically.

There are methods to minimize the swelling that your surgeon will include as part of your aftercare so check with him/her as you prepare for your procedure. But in the end, Yes it is normal to swell and it always goes away.

Lee E. Corbett, MD

Medical Director, Corbett Cosmetic Aesthetic  Surgery and MedSpa


Post Operative Swelling: When does it go away?

I was on Real Self answering more patient questions today and I am amazed by the number of questions that come in about swelling. Many of these patients have had surgery in the last week or two and are concerned because there is still swelling.

Any time you have surgery, particularly surgery on soft tissues (breasts, tummies, fat) , swelling is an expected normal reaction. There isn’t an operation in plastic surgery where you will see your final results in the first week or two. It just doesn’t work that way. It will usually take at least 4 to 6 weeks for most of the swelling to go away but it can also take between 3 to 6 months depending on what was done. Liposuction for instance will leave you swollen for 3 to 6 months. Now Smart Lipo laser lipo may leave you less swollen than traditional lipo, and you may swell less than your cousin, but everyone swells no matter the technique or the person. That’s just the way the human body heals.

So, if you are reading this and you are swollen post op you are probably healing completely normally. But, and this is the other thing I don’t get, if you are worried, call your doctor! Why turn to the internet for answers? You’ve researched and interviewed your surgeon and ultimately trusted them enough to let them operate on you. Listen to what they have to say.

3 to 6 months. That is normal.

Lee E. Corbett, MD

Board Certified Plastic Surgeon

How long will the swelling last after my surgery?

Well, it obviously depends on what type of surgery you have and on what part of the body, but there are some general guidelines that we can talk about. First, any time we operate on soft tissue be it a breast surgery, liposuction, or a tummy tuck or any facial surgery, we are wounding your tissues. Now we are wounding them under the most ideal circumstances e.g. anesthesia, sterility etc… but we are still doing surgery and this causes some trauma to the tissues. Our bodies are programmed to heal via a pre programmed cascade of which Inflammation is a key component. Now, the irony is that most hear the word ‘inflammation’ and have negative connotations, but inflammation is a normal and very critical component of tissue repair. What happens is that within and adjacent to the area where the surgery occurred, the blood vessels become leaky, like a soaker hose. Blood vessels are tubes with lots of holes in them to allow the cells that promote healing to be delivered to the injured area. As the cells escape the blood stream to heal, they pull water with them. That is called osmosis, think back to Biology 101. So there is extra water in the area. Now, to compound the problem, when there is extra water/swelling fluid the body gets rid of this via the tiny venous and lymphatic channels that course through our body. Well, the surgery usually disrupts these channels and new ones have to form. This process usually takes a several weeks to months. That’s why after cosmetic procedures, your surgeon will usually caution you to expect some swelling for at least 6 weeks and probably for 3-6 months post operatively. Areas that are particularly prone to swelling are the extremities, especially the legs. Anatomically, your leg is technically from your knee to your ankle. Because of gravity, this area swells the most and heals the most slowly. The head and neck areas also swell because the blood supply to this area is very robust and so there are just more ‘soaker hose’ vessels to leak during the inflammatory phase of wound healing. The take home message here is that swelling is a normal healthy part of healing. Your surgeon will discuss how much swelling and for how long based on your planned procedure and area to be treated.

Lee Corbett, MD