I'm Dr. Gavin Chan from the Victorian Cosmetic Institute
today we'll be talking about fillers
dermal fillers and how they can be used in facial rejuvenation
today we have Judy who is one of our patients
and she'll be having some dermal fillers
in her face to make a little bit more youthful
a bit more rejuvenated especially around the midface area. Now
if we have look at Judy's face whats happened
over time is she's lost a bit volume and you can see that
is a quite a bit of volume loss especially in the cheek over here
where the volume has been depleted
and by refilling this area it's actually going to make her a bit more youthful
also there's a bit of volume depletion
around the eyes, around the orbital rim
and that volume has actually been depleted
also there's also been some gravitational movement of the fat
down to here, so what we're going to do
is replaced the volume through this area here and that will give the illusion
of a lift and also it will give her a more youthful appearance
same on the other side so we can actually
just mark out some areas we're gonna fill, and most of volume loss
was in the cheeks, so we're going to focus on that today
the mouth corners another area which tend to
benefit from volume replacement. What tends to happen
as you get older is the cheeks tend to sag
they tend to form these jowls here
so you can see a little bit of a jowling effect here
and by filling the mouth corners and what you call the oral comissure here
we're actually smoothing the transition between the cheek and the chin
so that will give you more of this sort appearance where there is no transition and that's
what we see really will we replace volume we're aiming to
remove the transitions between one area to the next
whether it be from the cheek to the chin
or from the eyelids to the cheeks, and by smoothing the transitions
we get a very very nice youthful, rejuvenated appearance
without looking over the top. The other areas we can look at filling
are the pre-jowl sulcus, which is this area here,
and the same on the other side. She's actually got a little bit more on this side here
but if you actually and fill this area
its lowering the level the chin to match the level
of the jowl, so what you doing here is essentially you're straightening the jawline
if you look at someone in it twenties, they have a straight jawline
and it looks very youthful. As you get older you tend to become a bit more jowled
and this lowers thiis part of the cheek whilst this part of the chin remains
high, so by
lowering this level a bit you get a straight jawline
and that can add a lot to the overall appearance
someone's face. Now if you look at Judy's
side profile, she's got a little bit of a bump there
and a little bit of a hollowing here, and a little bit of a hollowing there
so if we put a little bit of filler here, and put a little bit of filler there, it's actually going to make the nose more aqualine
and you're not going to see this bump as much
so without surgery, without having rhinoplasty, you can give the nose a very nice
aqualine and straight appearance. And that can be done for noses
which have a slight deviation to the left or right, as well,
by putting a bit of filler on the opposite side of the deviation
so we're going to do this
Judy today and we'll see how it all goes
are you ready? Yes. Let's do it.
this is the actual filler itself and it's actually a clear gel
I'm which is injected into the into the
skin and I'm just squirting a bit out there. You can see it's
actually quite a gel-like substance
and it's also reversible this one in particular
so if you don't like something or if there is a lump or problem you can actually
dissolve it straight away
The first step is I'll be giving Judy some
nerve blocks to numb up the areas is for the injections of the fillers
and I use a machine called 'the wand', which you can see here
which delivers the anaesthetic very very slowly
and this way it's not painful this nerve block will
numb up the cheeks , under eye area
and a little bit of the
side of the nose as well, by painlessly injecting
the local anesthetic it's possible to
inject dermal fillers with pretty much no discomfort at all
and this will numb the cheek area here that we're gonna fill with some
dermal fillers
now this side
okay, you feel alright Jude?
okay, so little sting here
we're going to actually fill this area here which is a bit volume deplete
and the filler I use is injected through a cannula, which actually has a blunt end
It's got a blunt end.
So it will actually
pass through the tissues and
it will pass through quite quite easily and actually
move any blood vessels that comes across
out of the way so this helps reduce bruising significantly
as opposed to and fillers used with
injected with a needle
needles can often cause a higher rate of bruising
so by using cannulas we can get a really nice
effect without too much down time for Judy
so just
systematically and evenly putting the filler in, into her cheeks so it just looks like
a part of her cheeks
it doesn't look like an implant something it's been stuck on
it looks very natural that's one the advantages of dermal fillers
is that they really do look natural
and then you can just mould
that
into place
Probably have a look
at from the top there so if you look at the left side to face you can see
this fewer wrinkles here as a result of the fillers
because it's been revolumised on the right you can see a few wrinkles
there
and and also the
shape for the face is more youthful because there's a nice curve here now
as opposed to this side where it's little bit flat
just filling her nose there
and what we're doing here is we're filling into the
I'm into the hollows of the nose to make it more aqualine
You can see from the side view, the nose looks quite straight
I've filled this mouth corner, and it's quite smooth
from the cheek to the chin. Whereas this mouth corner which i haven't filled
there's a bit of a hollow in there and the transition from the chin
to the cheek is not a smooth so that gives the appearance of jowling
so this really hides the jowls and
makes it look a little bit more rejuvenated.