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Aesthetic ultrasound and filler dissolving

Ultrasound is a non-invasive tool that is now being used by a small number of trained  injectors to help assess and assist in treating their patients. Using ultrasound can add a significant extra layer of safety when examining specific areas of the face.

 

It's important to stress that Dr Jake does not use ultrasound routinely for every injection and no injection is 'safe'. (The safest treatment is no treatment!) But ultrasound is incredibly helpful to visualise certain blood vessels, to locate problematic older filler injections and can help in emergency situations.

Before booking for this service, please email drjake@drjakesloane.com and provide:

 

- what the issue is exactly (photos if possible are much more useful)

- a full history of your previous injectable treatments, what products and amounts were used

- what has been done to try and rectify the problem.

 

Filler dissolving is not suitable for all products or all situations and without a detailed history, Dr Jake politely declines this service.

 

If Dr Jake thinks he can help with the information provided, a consultation and ultrasound assessment will first be performed. If it looks like old filler can be dissolved and is in your best interests, filler dissolving will be offered on the day.

 

What is aesthetic ultrasound?

There are three main reasons that Dr Jake uses ultrasound:

1) To identify the main blood vessels of an area before placing fillers - this process is known as 'vascular mapping'.  (This isn't done routine but is reserved for specific areas of the face such as the nose)

2) To assess old fillers that may have become problematic. If you've had a sub-optimal result by an injector in the past, for example the filler is lumpy, you get on/off puffiness or the area looks discoloured (often 'blue'), the old filler is usually visible using an ultrasound device to look inside the tissues. This may then help plan a dissolving treatment.

3) To treat filler emergencies known as 'vascular occlusions. If a filler has been injected that inadvertently compromises the blood supply to the skin,  it must be dissolved to avoid death of the skin known as 'necrosis'. Using ultrasound is now accepted by many experts to be the gold standard in managing these complications.

Key features of aesthetic ultrasound & filler dissolving

Consultations

New patient filler consultations = 60 mins

(This includes the consultation, ultrasound examination +/- filler dissolving)

Improving safety

Even the best injectors will experience complications - they are medical procedures. But embracing technology like ultrasound can help reduce the risk of vascular occlusions and blindness.

Accurate dissolving

We now know that the most commonly used fillers can remain in our tissues for 10+ years. If problematic, they can usually be seen using ultrasound to localise a filler dissolving treatment.

Emergency treatments

Injectors without experience in treating vascular occlusions will often struggle to locate the problem area. Ultrasound can help make filler dissolving quicker and reduce harm to patients.

Downtime & aftercare after aesthetic ultrasound & filler dissolving

  • Some swelling or tenderness at the injection sites is very normal. This can take a few days to recover.

  • Bruising is possible after filler dissolving and for the lip area this can occasionally be extensive.

  • After dissolving fillers (and particularly ones that have been in the tissue for a long time), visible hollowing, 'emptiness' and sagging of the area is likely to be seen.

  • There is no evidence that filler dissolving affects the natural tissues of the face, despite the scare mongering seen online and on social media.

  • As a result of the volume loss after a significant dissolve, sometimes patients panic and request that their fillers are re-done. Dr Jake never promises that he will re-do any future fillers. The tissues need to recover after often several years of distortion and swelling and the lymphatics of the face need time to recover.

 

  • How do wrinkle treatments work?
    Wrinkle treatments are performed using tiny injections. They work by temporarily and reversibly blocking nerve signals to specific areas of the facial muscles, allowing the muscles to relax. As a result, the skin overlying the muscles also relaxes, smoothing out the visible lines. Over a period of on average 4 months, the treatment wears off and wrinkles slowly return.
  • How should I prepare for my wrinkle treatment?
    As for all injectable treatments, please come with no make up, foundation or similar on your skin. This will reduce the risk of an infection. To reduce the risk of bruising: - avoid alcohol for 24 hours prior - stop any fish oil supplements at least 5 days prior - stop any garlic, ginger, gingko biloba or ginseng in high doses - avoid any anti-inflammatory medicines (neurofen, ibuprofen, naproxen, etc) for 5 days before your treatment if possible. Prescription medicines that can make bruising much more common include warfarin or other anti-coagulants. If these are prescribed by your GP, it's not recommended to stop them. You can still have injectables but you should expect bruising to be much more common and obvious.
  • What can't I do after a wrinkle treatment?
    You can go back to your normal daily activities after a treatment except for two simple rules: 1) Don't massage, rub or wash the areas injected until the next day after your treatment. This also includes not doing things like having a massage, facial or similar straight after an anti-wrinkle treatment. (for at least 12 hours afterwards) 2) Avoid sports, exercise or vigorous activity for 12 hours afterwards. These rules help prevent the anti-wrinkle product spreading and affecting other muscles of the face that we don't want to treat. Failure to follow these increases the chance of complications, most importantly eyelid or eyebrow drooping. These are both avoidable and reversible side effects but can take several weeks or even months to settle. Avoiding alcohol after any injectable treatment until the following day also reduces your risk of worsened bruising.
  • What are the potential side effects?
    The most common side effects include: - Mild discomfort during the procedure - very temporary swellings and redness (that disappear within minutes) - bruising (always a risk when a needle is used) Rarer side effects include: - In less than 1% of cases, patients can very rarely experience eyebrow or eyelid heaviness (called a 'ptosis'). This is very rare, temporary and often resolves in three or four weeks on it's own. This might be caused by a failure to follow the after care rules described above. In this scenario, some special eyedrops might be prescribed to you to help lift the heavy eyelid but you'll need to be reviewed in person first.
  • Do anti-wrinkle treatments hurt?
    The injections only take minutes to perform and no special measures are needed. Dr Jake uses the smallest needles available and most patients are pleasantly surprised at how easy the process is.
  • Are there any people who shouldn't have a wrinkle treatment?
    There are just a few but important conditions that are contraindications to wrinkle treatments: - Pregnancy or breastfeeding. (Patients trying for a baby, undergoing IVF or who are unsure if they are pregnant will also be refused treatments) - Rare neurological diseases such as Myasthenia Gravis Those taking the following medicines should also not have these treatments: - Aminoglycoside antibiotics (Gentamycin, Neomycin, Streptomycin, etc) - Penicillamine (used to treat Rheumatoid Arthritis) - A known allergy to human albumin A detailed medical history will be taken prior to your treatment but it is your responsibility to declare any medical problems to us in good time.
  • How often should I have treatments?
    If the recommended dose is done on the day of your treatment, the results will last 2-4 months on average. Most people therefore come every 3-4 months to help maintain a consistent appearance.

Aesthetic ultrasound & filler dissolving FAQ's

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