Restylane

Restylane and Juvederm improve fine wrinkles and provide fuller lips and more volume in the face.

• Improvement of wrinkles
• Improvement of the lip contour and lip lines
• Fuller lips
• Volume recovery and contour improvement
• Improvement of drooping corners of the mouth

A filler, also known as hyaluronic acid, occurs naturally in the body and is responsible for the flexibility and resilience of the skin. As one gets older, the production of hyaluronic acid decreases. This causes the skin to become weaker and can cause wrinkles to occur. This filler replaces the natural hyaluronic acid. It is a gel that forms small pads in the skin that fill up irregularities. We use it for improving wrinkles, the Liquid Facelift, lip enhancement, and removing bags under the eyes.

What is it?

Hyaluronic acid fillers are our tools in the fight against volume and shape loss. After a treatment, the volume in the treated place(s) is immediately restored and the skin is smoother. Depending on what treatment you selected, your facial contours will be improved, puffiness and dark circles will be removed, wrinkles will fade, lips will be filled, and scars can be reduced. All with a natural result.

The fillers we use at Kliniek Dokter Frodo have the great advantage of providing an immediate but non-permanent result. The hyaluronic acid in the filler is broken down naturally, just like our own endogenous hyaluronic acid. Depending on the type of treatment, the results may be visible for one and a half to two years. Should you not be satisfied, the injectables can be remodelled or even removed in a non-surgical way.

To prevent a yo-yo effect, we recommend undergoing a touch-up treatment in time, thereby realising a long-term treatment effect. It may also be necessary to undergo a repeat treatment 9 to 12 months after the initial treatment, whereby, for example, a smaller amount of hyaluronic acid is injected.

The flexibility and resilience of our skin is due to hyaluronic acid. As such, it is an acid with sweet properties. Unfortunately, hyaluronic acid has one great disadvantage: its production decreases as we age, causing our skin to become weaker and wrinkles to occur. If you are not up for this, we can fortunately do something about it: fillers.

The fillers we use at Kliniek Dokter Frodo are all made from hyaluronic acid. We use it as the natural answer to the aging of the skin for, for example, non-surgical facelifts, eliminating puffiness, filling up lips, and treating scars and irregularities.

Fillers are further used at Kliniek Dokter Frodo for:

· Improving wrinkles
· Our lifts: Liquid Facelift, X-lift, V-lift, & Angel lift
· Enlarging lips
· Removing bags/dark circles under the eyes
· Filling up/strengthening nasolabial fold
· Filling up volume of cheekbone

What fillers do we use at our clinic?

Permanent fillers consist of substances that do not occur naturally in the body and cannot be broken down by the body. Potential risks (which can even occur after several years) are infections, hard lumps, and (excessive) capsular contracture around the injected filler. If the skin ages further, or for example, after considerable weight fluctuations, the injected substance may become visible as lumps under the skin. The Health Inspectorate (IGZ) does not recommend the use of permanent substances, which is why we at Kliniek Dokter Frodo do not work with non-degradable fillers.

We do work with the filler types listed below, based on natural, degradable, and endogenous hyaluronic acid:

Juvéderm

Juvéderm has a soft composition and gives a long-lasting and natural result. For the treatment of bags under the eyes and lips, we use Juvéderm Volbella because of its natural shape and the property that it results in virtually no swelling. We usually treat other areas with Juvéderm Voluma. Voluma gives a lot of ’lift’ and corrects volume loss near the cheeks, cheekbones, temples, nasolabial fold, corners of the mouth, and jawline.

Restylane

Restylane is a bit less soft than Juvéderm, which makes it ideal for filling up finer lines and for larger volumes. With Restylane, the size of the hyaluronic acid particles varies. The smaller ones (Restylane Vital) are more suitable for fine lines, and the larger ones (Restylane Perlane) for deeper grooves.

Radiesse

Radiesse restores contours, deep wrinkles, and volume loss. It can be used for:

• Softening deep wrinkles/folds
• Cheekbone volume improvement
• Jawline improvement
• Chin augmentation
• Nose correction
• Hand rejuvenation

Radiesse is a long-lasting but non-permanent filler. It is a gel with calcium hydroxylapatite (CaHa) particles. CaHa particles occur naturally in each person’s body. The gel around the CaHa particles dissolves within a few weeks and is replaced by the body’s own tissue. The CaHa particles are then naturally broken down over a period of approximately two years. The filler is then no longer visible.

Macrolane™

In our clinic, we mainly use Macrolane™ for treatments in which scars and body contours are reduced. With Macrolane™, we are able to change the shape of your body in a natural, non-permanent way. Macrolane™ is a thicker version of Restylane, which we also work with in our clinic.

Sculptra

Sculptra is a 100% biodegradable polylactic acid, a synthetic and hypoallergenic material. Scuptra stimulates the body’s own collagen production in the skin. The polylactic acid is broken down over a period of several months, while creating new collagen tissue during that same period. Even when Sculptra completely disappears from the body, the effect of the newly formed collagen tissue remains. Sculptra is special because it is not only suitable for reducing the effects of aging, but also tackles the cause of wrinkles and lines: collagen and bone loss. Sculptra restores volume by, where necessary, stimulating the body’s own collagen production, causing wrinkles and lines to be reduced and a youthful appearance to return naturally. In our clinic in Amsterdam, we use Sculptra for:

• Contour improvement;
• More volume in the cheeks and near the temples;
• Reducing marionette lines (folds at corners of the mouth)
• Reducing the nasolabial fold (folds between nose and mouth);
• Restoration of contours of jaw and chin line.

Types & use

Fillers can be divided into two groups: the ones we do, and the ones we don’t use at our clinic in Amsterdam South. The most important choice is whether or not the filler is safe. Because we only work with fillers that are broken down by the body over time, permanent fillers (which are encapsulated by tissue) are not available with us.

The biodegradable fillers we mainly work with are Juvederm and Restylane. The injected filler immediately provides volume and also stimulates the production of new collagen. Depending on the type of treatment (e.g. a Liquid Facelift or (anti-)puffiness treatment), the breakdown of the hyaluronic acid in the filler may start after a year and a half, at which point a touch-up treatment can prevent a yo-yo effect.

Injectables we work with at Kliniek Dokter Frodo include Juvéderm and Restylane.

Fillers that are not biodegradable and which we therefore not work with are encapsulated by tissue, causing them to remain where they were injected. Because the aging processes in the skin continue, new wrinkles will naturally occur in the treated area. The speed at which this occurs can vary from two to five years. The risk of complications and hardening of the skin is so great with non-degradable fillers that, in combination with the irreversibility of the treatment, Kliniek Dokter Frodo does not work with these products. Because we find education very important, we will provide you with a few examples of non-degradable fillers so that you are well-informed:

PMS (We do not work with this)
This is the best known and most popular non-biodegradable filler. PMS (polymethyl siloxane), also called IPS (injectable purified silicone), is also known as silicone oil. Silicone oil has acquired a bad reputation because it is encapsulated and increases over the course of time, making it harder and larger.

Bio-Alcamid. Aquamid (We do not work with this)
Bio-Alcamid is used to give the skin more volume. Like Aquamid, it is a transparent sterile gel which consists of 96% water that is bound to 4% polyalkylimide. It causes problems of encapsulation and irritation, especially in the long term. Bad news in the media about fillers is almost always about these substances.

Permanent fillers consist of substances that do not occur naturally in the body and cannot be broken down by the body. Potential risks (which can even occur after several years) are infections, hard lumps, and (excessive) capsular contracture around the injected filler. If the skin ages further, or for example, after considerable weight fluctuations, the injected substance may become visible as lumps under the skin. The Health Inspectorate (IGZ) does not recommend the use of permanent substances, which is why we at Kliniek Dokter Frodo do not work with non-degradable fillers.

Information table

History

Hyaluronic acid traces back to the ancient Greeks. Not because they knew what it was, but because of the word ‘Hyalos’, which is Greek for glass. Hyaluronic acid was first isolated from vitreous (a jelly that fills up most of the eye and is behind the eye lens), and contains a high concentration of uronic acid.

In the second half of the last century, the properties of hyaluronic acid were further and further identified. Hyaluronic acid is a glycosaminoglycan that is found in different tissues and body fluids such as connective tissue, epithelial tissue, and nerve tissue. It also became clear that it plays a part in cell division and migration.

Only in the last decade was this knowledge of hyaluronic acid converted into applied medicine. For example, the acid has been injected into diseased joints since the 90s, and around the turn of the century, we started using hyaluronic acid preparations for cosmetic purposes, e.g. for reducing wrinkles and filling up the lips.

One of the latest innovations in the field of hyaluronic acid fillers and injectables after the development of Juvederm, Sculptra, and Restylane is Macrolane™. This is a body contour filler that was introduced in early 2008 by Q-Med in the United Kingdom and has also been available for treatments in the Netherlands since the establishment of Kliniek Dokter Frodo.

Side effects and complications

After treatment with hyaluronic acid, light reactions may occur. The most common are redness, light swelling, itching, bruising, pain, and tenderness. The reactions are usually mild and they disappear shortly after the treatment. Lips may be swollen for a few days after treatment.

Generally speaking, injectable treatments such as the Liquid Facelift, the eyes/puffiness treatment, and the lip augmentation are short treatments with which, if desired, local anaesthetic can be applied. The recovery time is short and you can resume your daily activities right after the treatment in most cases.

We recommend avoiding direct exposure to sunlight after each treatment, or to properly use sunscreen and wear a sun hat.

Safety

Restylane and Juvéderm are the most used injectables worldwide. In our clinic in Amsterdam, we have been using this filler since our establishment. Worldwide, there have been over 20 million treatments with these fillers, which means a wealth of experience has been gained.

The hyaluronic acids we use at Kliniek Dokter Frodo remain in place after their injection and if used properly, the risk of complications is virtually zero.

Juvéderm, Restylane, Sculptra, Radiesse, and Macrolane have all been extensively tested in clinical trials in which their safety for cosmetic use has been proven. Because all fillers used in our clinic are biodegradable, adverse reactions rarely occur. Should this still be the case, we can, unlike with permanent fillers, simply remove the filler again.

Side effects and complications

After treatment with hyaluronic acid, light reactions may occur. The most common are redness, light swelling, itching, bruising, pain, and tenderness. The reactions are usually mild and they disappear shortly after the treatment. Lips may be swollen for a few days after treatment.

Generally speaking, injectable treatments such as the Liquid Facelift, the eyes/puffiness treatment, and the lip augmentation are short treatments with which, if desired, local anaesthetic can be applied. The recovery time is short and you can resume your daily activities right after the treatment in most cases.

We recommend avoiding direct exposure to sunlight after each treatment, or to properly use sunscreen and wear a sun hat.