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Welcome to Skin Side Out - In this episode we discuss the world of hyaluronic acid-based dermal fillers. This episode covers different types of fillers and their mechanisms, suitable treatment areas, ideal candidates, and potential complications. Learn about the anatomy of hyaluronic acid, various brands like Juvederm and Restylane, and how specific fillers are chosen for different facial areas. Discover the importance of consulting with experts and having realistic expectations, along with tips on aftercare and managing side effects. Want to know how fillers can help volumize, lift, and refresh your look? Tune in to get all your questions answered!
00:00 Introduction to Dermal Fillers
00:56 Understanding Hyaluronic Acid
01:56 Different Types of Fillers
02:55 How Fillers Work
08:56 Areas to Treat and Good Candidates
14:43 The Art and Science of Filler Application
16:44 Strategic Use of Fillers
17:11 Common Complications and Side Effects
18:52 Serious Adverse Reactions
23:38 Consultation and Procedure Tips
27:21 Alternatives to Fillers
29:45 Final Thoughts on Fillers
Creators and Guests
Host
Host
What is Skinside Out?
Welcome to Skinside Out, where science meets beauty, the ultimate dermatology podcast! Dive deep into the fascinating world of skin health with expert insights, evidence-based discussions, and myth-busting truths. Each episode explores the medical, cosmetic, and surgical aspects of dermatology, while keeping you informed about trending skincare topics. Whether you’re a skincare enthusiast, medical professional, or just curious about how to achieve your best skin, Skinside Out is your go-to resource for staying informed and inspired.
[00:00:00]
Dr. Zain Husain, MD: Welcome to Skin Side Out Where Science Meets Beauty. I'm your host, Dr. Zane, with PA Heather and aesthetician Courtney to today we're doing a deep dive into dermal fillers, specifically hyaluronic acid-based fillers.
Courtney Carroll, LE: So we'll talk today about different types of filler. We'll talk about how they work, um, because they, um, can be different from one another. We'll talk about areas to treat and good candidates and what that looks like,
Heather Murray, PA-C: and then we'll also end on adverse reactions and potential complications. So what is a hyaluronic acid filler?
Dr. Zain Husain, MD: All right, [00:01:00] so let's first go and do a deep dive on what hyaluronic acid is. Hyaluronic acid is actually a sugar molecule, a glyco immuno glycan. And these are complex sugar molecules that, um, kind of give our skin its buoyancy. So it's found in our skin, it's found in our joints, in lia fluid.
Um, and this will. Allow us to, you know, have, you know, buoyancy, um, hydration and has a lot of structural integrity for our skin.
Courtney Carroll, LE: Yeah. And I think a lot of people have heard of topical hyaluronic acid. You see that in different products. So, um, this is, you know, different in the sense that it is being injected, to create that nice plump look.
Dr. Zain Husain, MD: Yeah. And it's a gel, um, when we're injecting it. Mm-hmm. So they're cross-linked. These molecules are cross-linked together in such a way that it's more of a firm product. Um, what differing, you know, amounts of, you know, viscosity that we're injecting into the skin to achieve the desired result.
Heather Murray, PA-C: Yeah, yeah.
So there are different options, different brands. Um, Courtney, do you wanna give [00:02:00] a rundown of.
Courtney Carroll, LE: Yeah, so just like different neuromodulators, there are different companies that have their own fillers. So some common names that I'm sure people have heard of are Juvederm Restylane Radius. Um, there are the RHAs.
Um, so versa is another one. Even within some of these lines, for example, the Restylane, there are different types of that filler. So, for example, you have Restylane define, you have Restylane kiss for the lips. You have Restylane L which just has some lidocaine in it.
So depending on what area you're treating, you'll be using a certain filler for that area.
Dr. Zain Husain, MD: Yeah. And they all have like different technology. Mm-hmm . So it allows for . Those different properties that we're looking for, especially for like areas where you want more dynamic expression or for areas where you want more structure.
The cross links and the technology are really what set them apart.
Heather Murray, PA-C: , so let's talk about more about how they work. Um, so there's this [00:03:00] term called radiology, which is used to describe different types of fillers. So that can include like G Prime, you might've heard of. That is a rating that we give different fillers based on their fluidity and their flexibility.
Um, there's also, like Dr. Zane mentioned, the viscosity. So how, how thick it is. Um, the resistance to flow is. What viscosity is, um, also the concentration of hyaluronic acid in it, the cos cohesivity. So how, how will it hold together versus kind of mold with your body and tissue. So there are definitely different.
Ratings and different numbers for different types of filler based on are you using the filler in your cheek or for a defined jawline, or are you using it where you want something more smooth like your lips or your nasal labial folds? So there are definitely a lot of different, um, characteristics for fillers.
Dr. Zain Husain, MD: Absolutely. And then you can use those [00:04:00] different products in different areas, in different depths. So that's why it's really important to know what you are treating, what you're trying to achieve. Then match the product as well as the injection type and technique, um, to achieve that desired result. So for instance, if you're looking at a person's face, the temples
The cheekbones and the jaw tend to be areas where there's more bony prominence or more of a reservoir to fill. So we use fillers that are structurally more viscous, have higher G prime, um, and that we inject on the bone. So we're injecting literally on the bone, the periosteum, that's what we'll call it, and that allows us to have really good structural integrity.
Where we have a little bit more dynamic movement, in the cheeks, on the nasal labial folds, um, you know, we want more flexible fillers that are a little bit more fluid, that kind of move with our [00:05:00] muscles. It doesn't look rubbery and we inject it in a slightly different depth. We don't inject down to the bone in those areas.
Um, you know, we generally kind of in the mid dermis to subcutaneous tissue. Then, you know, there are areas that you wanna inject a little bit more superficially. So like, say for instance, the lips, you know, you want those hydrated lips, a little bit of structure. You're not going too deep in that. Um, especially for like those barcode or smoker's lines.
Um, I really am very superficial, almost to the point where like it's just nearly coming out extruding from those pores that we're actually injecting because they're so superficial. And then in the tear troughs like we're injecting on the bone so that, you know, we get the best possible result. You don't get that abnormal swelling and lumps.
And then also avoiding that tyle effect too. So using the right filler with the right property so you don't get that bluish tinge, um, when you inject two superficially with some of these fillers. Yeah,
Courtney Carroll, LE: I know you see that more. Um, especially around the eye area, which I think that area is such a . Um, delicate area, you really wanna make sure [00:06:00] you're using the, the right filler and seeing the right injector for, for things like that.
Um, I think also, you know, I've said this before, but I feel like, um, with filler, it really is about having someone who does number one, have a great technique. Number two has that eye for it. It really is an art and I feel like you have to have both that artist's mindset to know symmetry and how things will look, as well as having the, obviously good technique too,
Dr. Zain Husain, MD: but also looking at the physics too.
Mm-hmm . So we're looking at vectors and how tissue moves. Mm-hmm . And how are we using these products to volumize and lift structures? So that's also part of it. There's physics involved.
Heather Murray, PA-C: Yeah. , who would've
Dr. Zain Husain, MD: thought we would need physics again? . Yeah.
Heather Murray, PA-C: I was actually listening to another podcast recently that was talking about, um, this plastic surgeon that got into, um, his field because he felt so creative when he was a kid and he loved[00:07:00]
You know, working with 3D mm-hmm . Materials and just loved that kind of vector standpoint on shapes and, um, I think that's why he enjoys his job so much. Mm-hmm.
Courtney Carroll, LE: So different fillers, um, depending on what filler. Can last different amounts of duration as well as the areas being treated too. Um, typically, you know, around the mouth, because we do move that area more, will have a shorter duration than, let's say somewhere like the temples where we are using that more viscous filler that's gonna hold up longer.
Um, some of the, you know. Filler types like for example, radius. Um, it typically is used more for that jawline in the temples. It has that higher vis viscosity. Um, and we tend to see that one lasting a lot longer than some of our other fillers.
Dr. Zain Husain, MD: Yeah, I mean, radius is not an hyaluronic acid-based filler.
It's calcium hydro appetite. But it is a great product with high G Prime, um, for that structure. [00:08:00] Um, I think it's a great product.
Courtney Carroll, LE: On average, what would you say you feel like your average filler is lasting for your patients? It
Dr. Zain Husain, MD: really depends on the product. Yeah. It really is product dependent. So like my be Terras and you know, the Ellas and I.
Even the Restylane ls, they don't last as long. Yeah. Um, whereas my Voluma, um, Restylane lift, um, you know, those, those tend to last a while. Mm-hmm . So, and it also depends on the patient and what they're doing with their skin. Right. Agreed. So a lot of our patients are really invested in their skin, their appearance, and they are.
Not only doing fillers, they're doing tox. The neurotoxins such as Botox, um, they're also doing good skincare and that goes a long way with collagen induction and, you know, structural integrity of your skin. Um, they're doing lasers, resurfacing, microneedling. So it really varies too, because we're seeing patients who are doing multimodal treatments.
Heather Murray, PA-C: Yeah, that's true. Yeah. So let's dive in a little bit more to areas to treat and who's a [00:09:00] good candidate.
Courtney Carroll, LE: Yeah, so I think, um, one area that tends to be neglected is the temple region. So under, yeah, we see it all the time. Um, it really does give indication of aging just because, like we've talked about, that ization, when you're losing that volume, you don't have that round face that we all think of as a youthful appearance.
Um, so we do use it there. I think the main area most people know it for is that cheek area, um, nasal labial, . Folds, which we'll kind of get into, um, how to inject that area properly. And then as well as the lips, which we obviously have seen a lot of the past few years.
Heather Murray, PA-C: Other areas to treat, like the nose, the chin, um, the tear troughs or the under eye area.
Um, also, Dr. Zane kind of already touched on the etched in lines, so using different fillers to kind of fill those. [00:10:00] Static wrinkles, um, that we're, we're noticing. And it depends on the product that you're using.
Courtney Carroll, LE: I think the nose is underrated. Um, I'm glad to see us doing more of those, what they call liquid nose jobs, um, where we're able to actually correct different, you know, shapes of the nose essentially, and kind of create that more straight appearance just to give that illusion of a, um, more symmetrical nose.
Yeah.
Dr. Zain Husain, MD: But we have to be careful about those. Mm-hmm . Um, there is a high incidence of vascular occlusion. Yeah. Or. Other complications, um, and non-skilled hands. So it is a very risky area and should only be done, you know, by your board certified dermatologist or plastic surgeons who are very well versed in the anatomy and injection technique.
Because, you know, last thing you wanna do is like, I. Get a non, you know, surgical rhinoplasty with filler and end up getting like necrosis or blindness and I'm losing
Courtney Carroll, LE: your nose and eating a prostate. . Yeah. Not,
Heather Murray, PA-C: not a good one. Yeah. So who are good candidates? So that is kind of your classic, [00:11:00] um, volume loss patient, somebody who's likely aging.
I mean, we're all aging, but, um, aging is definitely a kind of predisposing factor for needing. Killer. Um, genetics plays a role. Lifestyle plays a huge role. Um, that really depends on your metabolism. If you're a huge runner or anything mm-hmm . You're not as likely to have as much fat in your face. Those can definitely play a role.
And I think too, also just, it doesn't have to be somebody who's in their, you know, fifties or sixties. It can be anybody who doesn't like the look of . Part of their face or wherever. Um, if you want your lips to be a little bit plumper, you know, that's totally fine. And it doesn't have to be from an aging standpoint,
Courtney Carroll, LE: I think the contouring is, um, very important because like Heather mentioned, um, certain insecurities people might have mm-hmm
For example, I've seen a lot of people have, um, phenomenal changes. I, I had a friend that I had recommended, um, her get some [00:12:00] jawline filler and some chin filler be before her wedding, and I. The difference was just amazing. I mean, it just gave structure to her face and that a little bit of the chin filler really helped to elongate and just give that, um, proportional um, you know, value of things.
Dr. Zain Husain, MD: Yeah, it's amazing what a little filler can do. Um, even low volumes. You can change certain features that you have and the fact that you can go. Do a procedure like this within an hour and have a transformation is incredible. You don't have to go under the knife. Mm-hmm . Um, you know, you don't have to risk all those surgical complications you can get with plastic surgery.
I mean, don't get me wrong, I mean, plastic surgery has its place. Mm-hmm . But it's not for everyone. Mm-hmm . Not everyone, um, you know, is a good candidate. Not everyone wants to go through the downtime and recovery and not everyone can afford it. So this almost kind of gives people more options to pursue some of these, you know, areas of insecurities that they have and actually do something about them.
And, [00:13:00] you know, patients, it's remarkable that confidence that you can restore on their faces, um, they just feel better about themselves. It's just incredible.
Courtney Carroll, LE: On the flip side, I do wanna mention too, that I think it's important, especially for . The older subset of patients who might be looking for filler, um, that sometimes filler might not be enough for them.
And that's sometimes a tough conversation. I've ran into that where people have gone to injectors and spent boatloads of money when they truly did need a facelift. Yeah. And I think absolutely being able to have an honest injector who is looking out for your best interest is so important because.
Sometimes filler is not enough.
Dr. Zain Husain, MD: No. And sometimes not appropriate. Yeah. It's not enough to actually anchor and suspend this tissue. You literally need to cut out tissue. Mm-hmm . And re suture it and suspend it. Like you need to go in there and make some structural changes, otherwise you're not gonna get a result.
And honestly, [00:14:00] like if you don't have the foundation for getting a good non-surgical result, it's just waste of money. A lot of wasted money. So, um, I do think honesty is really important, having realistic expectations because, you know, you could get a great result doing plastic surgery and have it last for like 10, 15 years and patient will be a lot happier, um, than having.
Poor results or really minuscule results with the amount of money that they're spending. So I do think that, um, you know, also partnering, um, with a good facial plastic surgeon, I mean, I think that's really important, um, to discuss all your options.
Heather Murray, PA-C: Yeah, I think there's a little bit of a flip side to that too, for especially the younger patients, there is definitely that art of subtlety.
Um, there are ways that you can use filler to not look. Um, overdone or even look like you [00:15:00] had anything done. People just can get that sense of, oh, you look, you know, rested or refreshed. Yeah. That's
Dr. Zain Husain, MD: what we're going for. We want you to look like you, but just more refreshed. Um, I think a lot of people are scared of filler because they see in the media what bad work looks like.
And you know, you see your Madonna's out there. I mean, Joan River, I love her music. Yeah. . But I mean, she was such a beautiful woman. Mm-hmm. And I just really don't understand why she went the route that she did. And it's sad, um, because. She looks distorted. Yeah, looks like a caricature.
Courtney Carroll, LE: Yeah. And I think people would be surprised to know how much filler is truly in a syringe.
Because That's a good question. You know, I think people think, oh my gosh, one, even just one syringe filler. That's so much, it's
Dr. Zain Husain, MD: one fifth
Courtney Carroll, LE: of
Dr. Zain Husain, MD: a teaspoon.
Courtney Carroll, LE: It's one. It's one. A chickpea, a size of a chickpea. So a blueberry. Yeah, a blueberry . So when you think about that, you know, it's, it's. [00:16:00] Gonna be more syringes than you might be initially thinking.
Mm-hmm . So it's not crazy to say two syringes, three sur. I had a training session years ago where I had six syringes in my face. I mean, you
Dr. Zain Husain, MD: got six in one setting.
Courtney Carroll, LE: Yeah. Wow. Chin, I treated chin, um, jaw, line lips, um, and then some, some cheeks. So, um, yeah, it was, you know, at the time just, um, it, it couldn't tell, especially on the chin.
I felt like my chin was really, um. You know,
Heather Murray, PA-C: recessed,
Courtney Carroll, LE: recessed at the time. So, and then same with the, the jawline as well. So, um, it, you'd be surprised to know how much essentially filler really is,
Dr. Zain Husain, MD: but on the flip side, it's amazing what one syringe can do. Yeah.
Courtney Carroll, LE: Done well. Yeah, it's
Dr. Zain Husain, MD: done well. Yeah.
Strategically in the right places, like you can dump filler in the wrong places and just waste a lot of product. It's not gonna do anything.
Courtney Carroll, LE: Yeah.
Dr. Zain Husain, MD: And that's where that expertise comes into play. Where can you inject to get the best bang for your buck? Mm-hmm . And execute. [00:17:00] That's really what I'm looking for because, you know, this is expensive stuff.
It's an investment, so I wanna maximize result and the best ROI is achieving those results with the least amount of product. Yeah.
Courtney Carroll, LE: So going into that, um, complications that can occur with filler. Um, you know, there's the adverse reactions or the side effects, I guess most commonly we see is bruising.
Mm-hmm . Um, especially I think people who are on any aspirin or blood thinners. Um, some, but is that really
Dr. Zain Husain, MD: a complication? No, we injecting a patient with a needle.
Courtney Carroll, LE: I'll take bruising any day of the week because it will go away. Away. It's just a side effect.
Dr. Zain Husain, MD: Yeah. I feel like I don't even consider it a side effect.
I think it is expected. Okay. That's true. We have blood vessels in our skin. It is a part of our tissue. We're jabbing it in there. . We're jagging there with something sharp. It's going to bleed. You're going to get a bruise, so expect a bruise. Yeah. Although, you know, we're gentle with our techniques and I try to minimize bruising, I don't think patients should be left to think that they're not gonna bruise.
Yeah.
Courtney Carroll, LE: I think that's fair because I think a lot of people put more [00:18:00] emphasis on bruising Yeah. Than needs to be, as something that goes away in a few days. It's, yeah. Yeah.
Dr. Zain Husain, MD: You know, like we always counsel our patients. Take your arnica on Brolin. I do think it helps, um, try to reduce taking any blood thinners before your procedures or after
Heather Murray, PA-C: alcohol intake afterwards.
Yeah.
Dr. Zain Husain, MD: I mean, there are ways to kind of reduce the risk of bruising, but bruising in itself is not a complication. I wanna get that through. Yeah. Because patients are hot. Yes. ,
Courtney Carroll, LE: bruising's normal. Yeah. Um, a little bit swelling. Swelling again is also normal when you think about . Any kind of procedure to the skin, you're creating a little bit of that inflammation and that's what's causing that swelling.
So swelling is very normal. Um, but also
Dr. Zain Husain, MD: hyaluronic acid attracts water molecules. That's right. That's right. Every like molecule of hyaluronic acid, it detracts a hundred thousand times, um, the number of water molecules around it. So that's part of it. So you get
Courtney Carroll, LE: that, yeah. That swelling and that does dissipate.
Mm-hmm . In days.
Heather Murray, PA-C: Other kind of serious adverse reactions or even potential complications. Um, infection is always [00:19:00] a risk. Um, I think that depends a lot on technique. Mm-hmm .
Dr. Zain Husain, MD: Um, cleansing the skin.
Heather Murray, PA-C: Yeah, exactly. Allergic reaction. Um. We don't know if you're allergic to it until we know that you're allergic to it. So, um, but you know, going back to the hyaluronic acid, we all have hyaluronic acid in our bodies. So, um, that is safe in that standpoint.
Dr. Zain Husain, MD: Many hyaluronic acids are, um, compounded with lidocaine.
Mm-hmm . So I guess there is a rare instance where if you have a true lidocaine allergy, um, you know, that's something to disclose to your injector. Prior to injection.
Courtney Carroll, LE: Yeah. Yeah. And vascular occlusion, um, which. Tends correct me if I'm wrong, tends to be maybe a little bit more injector error or I like not aspirating.
Dr. Zain Husain, MD: Not really. I've, I've heard of the, some of the best injectors in the world come across as complication. In fact, most people say that, you know, if you haven't gone a vascular occlusion, you're truly a busy injector. You haven't been injecting enough. Yeah. Um, it's [00:20:00] likely going to happen at some point, some point in your career.
Yeah. And it's scary. Um, it's humbling. You can, I mean, studies have shown that even with aspiration, that doesn't mean that, you know, you haven't cannulated a vessel.
Heather Murray, PA-C: Yeah.
Dr. Zain Husain, MD: And, um, it's, it is scary and I think that you just have to be very mindful and knowledgeable of anatomy, knowing where the danger zones are.
Um, I have one patient at my practice in New Jersey, I'll never forget, she was a nurse practitioner, . She went to another physician, not a dermatologist or plastic surgeon, I think just an internist, um, who does aesthetics on the side. And they were injecting the glabella lines with filler.
Courtney Carroll, LE: Very dangerous.
Yeah, very
Dr. Zain Husain, MD: dangerous. Very dangerous.
Courtney Carroll, LE: Can be done with the right person, but, but
Dr. Zain Husain, MD: you know, it's a risky spot. It's a very risky spot and you know. The funny thing, it's not funny, but she started getting a lot of remnants and swelling, like streaks, um, you know, going up those where those blood vessels were mm-hmm
Um, and, you know, you could see the [00:21:00] duskiness of her skin and it was impending necrosis. And she went back to her injector and the injector said, oh, this is an infection. I'll give you an antibiotic. She did not feel right. She's a medical professional herself, so she did not feel easy about that. She literally called offices around in the area.
I've never seen her before. She called, Hey, can you just take a look at this? And I brought her in. I'm like, whoa, this is, you know, this is vascular occlusion. And we could see like the, it's called a reticulate or net like pattern. You can kind of see that happening, um, when you block a blood vessel and the oxygen supply, 'cause the blood's not flowing there, it's starting to be compromised.
So what we did was we immediately flooded the area with hyaluronidase, specifically Linx, to help . To kind of break up that hyaluronic acid and, you know, hopefully restore some of that, um, that blood flow to the area. And thankfully it helped and we did it serially over multiple sessions and we were able to save her skin.
She did have some [00:22:00] discoloration in that area, which we used some vascular lasers to improve and it really looked amazing afterwards. Um, and she was so thankful, became a loyal patient of ours. It just goes to show you, even like medical professionals, like, you know, they may not be educated or knowledgeable.
Like, hey, you can get vascular compromise in that area. Same thing with like, you know, nasal injections. That's another hot area for, you know, vascular occlusion or, you know, kind of injecting around, you know, the eyes and around the, you know, angular artery. There are so many networks of blood vessels, and if you get into the wrong one, um, you can even get blindness.
Like if it gets into, you know, the wrong blood vessel, it's gonna migrate and literally cause blindness. And there are multiple reports of that happening in the literature, so you have to be really careful.
Courtney Carroll, LE: Yeah, and I think going into that, it's if you're ever having questions after your filler appointment.
Be safe. Don't be sorry. Mm-hmm . Contact your provider because we don't
Dr. Zain Husain, MD: mind. Yeah. , we're here to help you. We want you to be safe and healthy. [00:23:00] So even if you're, you think it's silly and you're just uneasy about it, just call
Courtney Carroll, LE: us. Yeah. Sometimes we get the calls with more of a, you know, the lumps or bumps, which that can, um, happen after swelling.
The swelling. Yeah. So. Again, I think we would much rather you, um, ask us than, than not. We, we don't know unless you tell us.
Heather Murray, PA-C: Something that most people don't really think about. Just, um, the filler has the ability to move. Um, I think it depends on the depth of the injection too, but, you know, once it's, it's placed in, it can still move with your skin as you age.
Dr. Zain Husain, MD: Mm-hmm .
Courtney Carroll, LE: For those who have not had filler before, you definitely wanna do a consult you know, with a. Um, educated provider , someone who's been doing this, um, where they'll be able to give you an idea of what you want to achieve and kind of speaking earlier to what your requests are and finding that provider that kind of works with you.
Um, again, [00:24:00] some people want the really big duck lips, um, that we say it all the time. That's not like Dr. Hussein's wheelhouse. Um, so don't come to us for that, but, um, . But, um, I know some
Dr. Zain Husain, MD: good practice I can send you to. Yeah, .
Courtney Carroll, LE: So finding a provider that is in, in line with your views as well. Um, once they are able to do that consultation, um, you know, making sure that, um, they're using sterile equipment, typically will numb a patient depending on what areas we're treating with a topical lidocaine.
So you always wanna express any allergies that you may have specifically to lidocaine. Mm-hmm . Um, at that point, typically we'll get the syringes ready and then clean you off with typically HIPAA cleanse is what I use. Um, and at that point you can expect. A little bit of, um, you know, discomfort, but I think overall it's really well managed.
I know we use different tools in our practice like vibration devices to help distract, um, squeezy balls just to, you [00:25:00] know, kind of hold onto and then obviously ice as well. So I think overall it makes it a pretty easy experience. Um, and then at that point he'll go home, he'll, ice, avoid alcohol, avoid, um, exercise,
Heather Murray, PA-C: kind of going off of that, laying on your side afterwards, ideally you don't wanna sleep on your side, especially if you have filler in like your temples, your cheeks, your jawline, because if that filler is not quite, you know, set in place yet, you could move it or push it somewhere else.
Dr. Zain Husain, MD: Yeah. And a lot of patients, especially if it's their first time, it feels. A little tender. Mm-hmm . It feels sore. Mm-hmm . That is normal. You can take Tylenol if you need it. You can even take ibuprofen. It's fine. Your skin is getting used to . Having a product there that has not been there before and it's kind of integrating into the tissue. So it's going to feel a little weird, especially like, you know, your [00:26:00] temples, like you haven't had volume there. It's going to swell a little bit. You may get a headache, it might be tender.
Um, on bony prominences. It can be pretty tender.
Courtney Carroll, LE: I felt that with my chin for sure. Oh yeah, that tightness, it's pretty, it's pretty,
Dr. Zain Husain, MD: yeah, it can be pretty painful. Um, but it's manageable. Yeah. And I think that, you know, just with over the counter, you know, pain relief, usually sufficient, um, other things that patients are, you know, sometimes concerned about.
The bruising like we talked about. But you know, arnica, Brolin, other anti-inflammatories can be helpful. We also have tools in our office to help reduce the bruising. So using vascular specific lasers, or IPL, um, can be very helpful for reducing the length of time you have that bruising. So we offer that complimentary to our patients if they have any, you know, bruising, um, where they're, they can always walk in the next day and just we can get that taken care of for them.
Courtney Carroll, LE: Yeah.
Make sure you feel comfortable during your consultation. If there's any type of feeling that you're not, um, seeing eye to eye with your provider. [00:27:00] Maybe they're pushing you to do a little bit more than you're comfortable with, or maybe there's.
Courtney Carroll, LE: Don't know areas that you are not ready to treat yet, like lips or things like that. You know, always feel comfortable enough to say, eh, maybe this isn't the practice for me. Um, you wanna feel comfortable and confident during your consults and have that translate into your treatment. For sure. And
Dr. Zain Husain, MD: if you're not comfortable with filler or the thought of filler, there are other alternatives.
Yeah. So we've been using PRP Microneedling and other devices to help. Um, so, you know, you can get subtle and nice improvements with that. Um, it's not gonna be as extreme, I'm just being realistic with patients. Mm-hmm . But. You will see some improvement in your skin quality, texture, and you will probably notice a little bit of volumization over time, but it's not gonna be as immediate.
Like the immediate satisfaction, gratification of seeing those results right away is incredible with filler. But you can over time kind of get closer to that.
Courtney Carroll, LE: I always say filler is like the quick fix. It's,
Heather Murray, PA-C: I really like the kind of, [00:28:00] um, during treatment, if you do one side a
Dr. Zain Husain, MD: half face, yeah. Mm-hmm .
Heather Murray, PA-C: Give them a mirror.
Yeah. See what kind of changes they're already noticing. I think that's a huge, huge benefit to get the, um, patient just realizing how filler can be used. And there's definitely, um, you know, fillers for different areas. There's always a, if you are going down that route for filler, um, there is a type of filler for your specific need and we can help you find that.
Dr. Zain Husain, MD: And there's a filler for every skin type. And, you know, there are patients that can benefit from it at, you know, various ages at different ethnicities. Um, you know, and just kind of maintaining whatever beauty ideals that you wanna strive for, we can achieve that. Um, you know, but it's very customized.
Heather Murray, PA-C: Agreed, yeah. The consultation is, should take a while. It shouldn't be this very quick. [00:29:00] Process, I think, you know, you do have to spend time getting to know your provider and like Courtney said, seeing eye to eye and making sure that your desires fit what they're, um, you know, expecting to give you.
Dr. Zain Husain, MD: The nice thing is about these hyaluronic acid fillers is you don't like them for any reason.
They can be dissolved. So that's the beauty of Hyaluronidase. Um, also known as Linx or Vitra. can break those cross links with the hyaluronic acid molecules and it just makes it more liquid and just reverse it instantaneously.
So it's a nice option that we have, especially if you're scared about it, you can reverse it.
Courtney Carroll, LE: Good point. Yeah. Awesome. That was pretty good.
Dr. Zain Husain, MD: Yeah. So I mean, fillers, um, you know, have a lot of different opinions. Yes. people have, are very opinionated about them. Some people love 'em, some people hate 'em. But I think it's another tool that we have to help patients feel more confident.[00:30:00]
Done with the right training, with the right knowledge and education, I think patients can achieve really nice natural aesthetic that they're looking for.
Courtney Carroll, LE: Agreed. Yeah.
Dr. Zain Husain, MD: All right. Well this was a great discussion. Um, hopefully you enjoyed this episode and please like and subscribe and until then, skin side
Courtney Carroll, LE: out
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