Dermal fillers

Dermal fillers are gels based on hyaluronic acid, a substance the body already makes, placed under the skin to add volume where volume has been lost. They are measured and sold by the syringe. Irene works one area at a time and prefers to place less than the maximum, then look again at a follow-up, rather than fill everything in a single sitting. The areas asked about most often are the cheeks, the folds that run from the nose to the corners of the mouth, the lips, and the hollows along the jaw.

Placement is done with either a fine needle or a blunt-tipped cannula depending on the area and the depth she is working at. That choice is a clinical one, and she will explain which she is using and why. Numbing cream is applied first, and most fillers also carry an anesthetic in the gel itself. Because a filler adds volume directly, the area looks different as soon as it is placed, though the first few days include swelling that makes it look different again from where it will settle. Pricing is per syringe.

• Volume loss in one specific area rather than an overall concern
• Wanting a conservative amount placed and reviewed before anything is added
• Asking about lips or cheeks and wanting the options explained first
• Preferring a treatment that can be dissolved if you change your mind

Irene looks at the area in good light and talks through what she would place, where, and how much.

Numbing cream goes on and sits for about twenty minutes.

The skin is cleaned and the filler is placed in small amounts.

She sits you up to look between passes, and you will feel pressure more than pain.

Ice and written aftercare are given before you leave, and a review is offered a couple of weeks out.

A few days of swelling is possible.

• Expect swelling and the chance of bruising for a few days, more in the lips than elsewhere.
• Keep the area clean, skip the gym for a day, and sleep with your head slightly raised.
• Do not book filler within two weeks of a wedding, a photograph, or a flight.
• A two week review is offered so Irene can see the settled area before anything else is discussed.

• You are pregnant or nursing
• There is an active skin infection or a cold sore in the area to be treated
• You have a bleeding condition or take medication that affects clotting
• You have an autoimmune condition your physician is actively managing
• What you are asking for is more than the area can sensibly carry

Irene decides candidacy at your consultation.