today what filler and where !? hi guyswelcome back to the channel I’m here today tournaments up the Kishthat’s Euan and we’re gonna be discussing all kinds of dermalfillers mmm shall we start first of all by talkingabout the non hyaluronic battery-acid based dermal fillers because something that Iget asked in clinic all the time is is what you’re using dissolvable can we getrid of it so and the clinic we tend to use Sculptra and Radiesse the most butthere is also Elionce say that we have in the UK which we don’t tend to use andarticle as well which is the permanent filler I’ve never had an experience withthat one if you guys know it’s not really common him except having to takeit out oh yeah so so patient came to hospital where we used to work and hehad a collection of infection around the article and so I must be given to make him to thetheatre and drain the pus that was collecting so you scarcely neat experiencebut I think it really kind of diverged me towards exploiting things that weren’t quiteso problematic down the line and any believe on using any of the non hyaluronic acid fillers at all? I use Radiesse I have applied Ellanse Radiesse think is quite a nice gentle collagen biostimulator and Ellanse okay so this is Cards on table this is only what I’veseen from another patient from another doctor and I’ve seen some localizednodules develop on the face and that was a very difficult case to treat becausethe nodules didn’t go away despite whatever I did from that was recommendedto do so yeah probably wouldn’t exert that I think that’s a risk whenever you use oneof the non how hyaluronic acid fillers and can happen with sculptra can happenwith radiesse it can happen with hyaluronic acid as well but you can’t dissolve thesculptra or the radiesse I’ve never seen it personally I’ve never had aproblem myself when I’ve apply a non HA filler patently the majority of timeI’m squandering the HA fillers but you know this there is a place still for non HAfillers because they can’t do everything you might crave so for exampleif we were doing some of our body contouring procedures where you want toif you’re doing like the buttock orbit if you want to provide capacity it’s better andprobably I think to use something like a non HA filler begins with at leastto build some collagen most of them are about collagen stimulation so buildingthat publication in collagenisis and then if there’s any breaches you mightwant to use an HA over the top that the quantities of hyaluronic acid you’d use tocreate that capacity it’s gonna be an awful fortune and that has its own risk sothat’s what I think it would be for me the most useful to use a non HA and we’recertainly apply a lot more Sculptra now particularly for body so buttockenhancement exploiting a sculpture for scalp progress on the neck the dcolletage inner thighs which I hope it’s have done soon bingo wings tummy and you can’treally consider such enormous places consuming HA I mean you could use Profhilo forexample yeah and those areas but I think you probably get a bit more for yourmoney well you’re not going to get the volume are you at the Profhilo toimprove the skin character so if you’ve got well quite often dressers parties findladies with chests that there’s come crepey scalp from sun damage over theyears and Profhilo will help to kind of improve the scalp caliber that’s ahyaluronic acid based scalp better filler but yeah if you demand goodcollagen foreplay if the bark is there and then you want to provide somekind of more like a breath it out a little bit I expect it’s not gonna happen with thenon volumizing make like Profhilo is it so you’re gonna need to usesomething stimulating like Sculptra so it depends on the occurrence yeah becausesometimes we will use Profhilo yeah perfectly sometimes if it’s a skinconcern on exploit Profhilo up if it needs more work then yeah I’ll utilization somethingmore animating like Sculptra and the thing to remember about Sculptra isyou’re not gonna see the results straight away so it takes about sixweeks you should get your maximum benefit fromit and you have to do a few treatment sessions in order to see the improvementwe just opposes what you would expect really yeah yeah I’d say soso it truly appears shocking when you placed it in because there’s a lot of fluidwith the Sculptra you dilute it a few days before you come in have the productplace and it seems kind of like what you want it to look like and then it will goaway and you think where’s it gone yeah it’s not gone at that point sculptrapoly l lactic battery-acids so those particles that are going to stimulate yourcollagen are remaining is just the fluid that they were terminated and it’s goneand then the collagen stimulation starts and that’s what takes a few weeks tokick in and then over meter your results fulfilled I think that kind ofrebranding it now more like a bio stimulator rather than as a fillerper se yeah its a bio stimulater too and yeah it can take several sessions to getthe results you miss especially if you’re doing something like the buttwhere you want volume then yeah you’re gonna have to come back maybe three orfour times but patients understand that as long as you explain the reasons properly thatone therapy isn’t gonna give you your final care goal it’s a process towork towards something that gives you a bit of dominance as well because it’s notsuch a rule you know not such a big volumeisation in one go yeah and alsopatients fairly like well my patients seem to quite like that gradual gradualprocess so it’s not such a huge change in one go and even if they’re having ontheir face for example Sculptra on the face and not that I do a lot I think youguys are doing a lot more and again you’re having that sort of gradualgradual alter where people are looking better and better day by day yeah Ithink when we were talking about nodules before a Sculptra kind of got a badname for nodules it’s quite a long-established produce but theapproach calls for diluting the carve have changed over the years sothe use of diluted in a lot less solution local anaesthetic andsaline back in the day that was linked to more nodule shaping now if youdisperse the products and more liquids and I were dissolving in like 10 to 15 mils the instance of nodules has extended right down to almost zerosimilar to an HA hyaluronic battery-acid commodity you can still get a nodule probablya very small percentage same to scum turnover the brand-new protocols hmm okay solet’s move on and talk about hyaluronic battery-acid because that does even out the bulkof our dermal filler use and I would say um so there are consignments of differentbrands out there and I thought it would be amusing if we just kind of touched onmaybe a few of them well-known ones and talked about our favorite products fromeach of those so Kishan I know you use a lot of restlyane vital now so what isit that you’d like including about the restylane vital and is thereanything else that you would use out of the restylane stray so I do like besttoday first of all the syringes are quite long so you’ve got a lot morecontrol in the product transmission and but that’s purely really a technological thing interms of results I really like the town light for under the eye area somehowit’s just insidiou enough to lift out sort of dark or sort of apparently darkhollows and it just leaves individual patients searching naturally now when I saynaturally I mean they just look awfully very natural but they just look moreawake it’s nothing about anti-aging it’snothing about looking younger they just look more awake and more fresh and theyleave most of my patients leave the clinic really happy and just without anybruising so that’s sort of my go-to treatment for a tear ditch or you knowlike an under-eye hollow too have the benefit that when it breaks down it’sreleasing like single hyaluronic battery-acid molecule measurements which draw up to athousand times their own weight in ocean so you’re hydrating or moisturizing theskin from the inside so that’s for me that’s a benefit of vital you askedme what else I might use so recently we’ve been using Sunekos which isanother sort of hydrating highly gently collagen and elastin stimulating fillerI suppose and I likewise use redensity one for the same area as well a redensity one is anuncross-linked filler which has some added benefits ofoxidants like glutathione alpha lipoic battery-acid and amino acids to feed the skincells but I use I’ve applied the broad range of we’ve got pretty much everyfiller under the sun you know available at the clinic so I will use you knowfrom one family of fillers I’ll application one for for example lips I’ll use BelateroI quite like Belotero contour or intensive and for buttocks Ireally like Belotero volume or Juvederm volume I think it’s just horsesfor routes each area has its own needs and likewise every patient has their ownneeds and then I’ll only adopt out what I are necessary to that Beloter yeah notBelotero what do you call it I consider Bella Terra Terra Bella Terra I’m justthinking it clanged Italian so I got told off I got told you have to call itProfhilol well i was in Verona she’s there I was with the company that circulates Profhilo and there and I got told off by the surgeonwho was delivering the teaching he said it’s not the profiler okay um is there anything else that youwould use from the restylane collection and I quite like refine characterize I adore theirlyft make so actually I like most of the best yeah master no no do like andbut one commodity stands out above everything else apart from vitallight it’s called face-lift now lyft is the product out of all the HA fillers that weuse that has one of the highest G prime so if I have a patient who perhaps is ona bit of a plan or wants to try a lifting make for the first time Imight recommend this actually because for buttocks nothing gives quite as much of alift as that special commodity and it’s it’s it also looks very very subtle even which one would you like me to talkabout well just what’s your fave Oh again it precisely depends on the field in theUK we have so many fillers it’s almost exhausting isn’t it theamount of fillers we have to choose from so actually I have some favorites forareas so in a church for example it’s really hollow I’d boot after yousomething that’s really volumizing I really like the new volux make nowit was originally in the market exclusively for jawline chin but for me I don’t know ifyou guys are using it in the temples it runs really really well because it hasso much lift to it so you get a lot of thud for your buck whereas previouslyyou’d have to use a couple of syringes overtime of another commodity one syringewill supposed to do now for that so it’s pretty good review for a mid-face I would say there’sa couple of makes I really like but voluma is always like a workhorse and acosmetic clinic I visualize most clinics have a long-established exploits for themunless they’re not affiliated without again for whatever reason but it is agood it is a good product I think if you’re not missing something from theJuvederm range I do like Belotero volume it does hand nice kind of lift isquite soft so if you’re using in the fatty chambers and the buttock you couldreally sculp that and get a really nice natural looking outcomes lips depends onthe cheeks doesn’t it because everyone’s cheeks are so different you know if you’vegot a really skinny cheek you don’t want to use something original really thistoo rigid because it will merely appear spuriou but then some of the skinny fillersgonna have to come back a few days you know over such courses of a few months tojust gently build them up you might start with something a bit softer andthen do some sculpting eventually once the lip publication is there so it’s reallytough I visualize for most cases if you’re a younger patient who wants thatmore modelesque kind of pouty lip belotero intense is pretty good if you are someone that was a really really naturalresult but you simply dont want work I relatively like Volbellammm from to Ubud oh yeah yeah I likewise like the volbella from juvederm do youfind that sometimes it utters like this almost like quite attractivepuffy look to the lip I make some people attribute Juvederm fillers on thenegative side like apparently they absorb more water and can sometimes looka bit more puffy but actually use that to your advantage you know in the rightcase of the right filler so one sizing doesn’t fit all that’s quite difficultto choose favorites because everyone’s face is so different but Volbella doesgive that cut off like not more overdone seem but it time does the lips a littlebit more volume I like it when you’re doing the contour like like I supposethe border we’re exploiting a needle procedure and that volbella just seems to givea really sort of crisp outline yeah cuz the more conglomerate make would end upgiving that dreaded like cheryl appear you time don’t wanna have so yeah hmm I amgonna say something I guess it’s not contentious but um I really like theJuvederm for glowing delightful scalp improved and good sticking hydration and I’mconvinced this is on utterly no clinical study whatsoever but I’mconvinced that it gives you more enlivening and brightening than I’veseen with profhilo or with doing restylane vitalit’s just how I feel about when that product volite came out as a skinimprovement concoction isn’t it I know you guys and I have occasionally tried it ina lip just for hydration but the point was it was to give that kind of glow to theskin hmm and it get to work because I’ve had it on myself and I did find that myskin was a bit more kind of resilient it was a bit more kind of glowing um theydidn’t really like market it well did they when they made it I know manypeople know about it considering the Juvederm range is so popular you don’tget a lot of parties coming in and asking for it yeah that’s true it is it’s agood product in the privilege in the title instance selection you guys make love with thesort of needle technique yeah yeah would you ever expend cannula nono application of entrusts as well syringe and eyesight for the hands I think it worksreally well there yes it’s really interesting actuallybecause profilo did a much better job of marketing the skin improver profilerjust sells itself because yeah friends talk about lunch chocolate breath you knowpeople come in asking for it yeah it’s really popular care and I think theresults are good yeah and parties seem to cherish it I have slightly differentbenefits than the claim he’s best is that everybody wants provider I think inthe neck if I’ve got horizontal pendant row I prefer to use the voliteand then if it’s just for general bark improvementI will tend to use the profile oh yeah they’re so different in the structurearen’t they because profhilo is an uncross joined hyaluronic acid so it’snot bound together it doesn’t stay in your body for long it spreads itselfunder the tissues and it energizes collagen whereas the lighters cross linksso it does stay in the body a bit longer so you can target those fine texts andwrinkles I know she built them I whereas for document is not going to do that evenfor someone who’s got say near that Bridal line that sometimes people getall the way around here and if it’s really fine I think it’s good for thatif it’s a little bit deeper I should favor use the vol Bellayeah so this is like virtually parallel to the necklace wrinkles yeah so you use bothlight for there and I shun bone ight there as well and it is good it is goodunlike you say don’t the skin does become a little bit light and for a bitbrighter and it brightens as well but I have to say there’s one make which is fromthe same family as profhilo and this is called shape and reinstate from aliaxin is it with a cannula procedure and I have to say it’s really reallyforgiving it’s really nice and those sort of shallow but sometimes deep linesof the cervix it moves very well with the cervix skin and I find for me that’s oneof the best makes for the pendant excavations I truly really wish that they wouldput lidocaine in because picture – what lidocaine in any ofthe products including profhilo and that for me is a bit of a deal-breakerso yeah it’s interesting because I did ask the company why do we not havelidocaine in such products and while they’re saying that it’s coming and theymay acquaint it their position in Italy where these productshave been launched the patients they don’t need it what they don’t want itthat’s us wimpy british people isnt it I would want it yeah okay chaps so that’s all we’ve got timefor this week I hope that members can enjoyed our mutual intelligence drop about different typesof dermal fillers if you’ve got any questions or commentaries cause us know in thecomment section below and we will see you guys here again next week for moreof the same bye bye
