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Fillers as bistimulators

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hey I keep reading that sculptra or radiesse are used not for volume only but diluted as biostimulators for more collagen growth. the same goes for ha fillers. i was wondering what your experience is with them. do they really stimulate collagen or is it just a marketing trick by the filler companies? has this effect been shown in publications? i'm interested in sculptra but at the same time i keep reading how often fillers get inflammed months after and i wonder if they are worth the money and the risk. anyone had good long term results from the above fillers? 

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Comparing to other treatments, I think HA filler is the safest treatment for certain acne scars. I do see people claiming that they need less fillers in the long run, for example may be 2-3 syringes in the very beginning every year, and then may be 1 syringes every 1.5 years.

But I don't see any publications to support this though. 

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33 minutes ago, Jack817 said:

Comparing to other treatments, I think HA filler is the safest treatment for certain acne scars. I do see people claiming that they need less fillers in the long run, for example may be 2-3 syringes in the very beginning every year, and then may be 1 syringes every 1.5 years.

But I don't see any publications to support this though. 

yeah. are there publications to support this? ok, lets say I get the fillers, but what if they get inflammed months or years after? won't that cause more scarring? i read on this forum that ha fillers, even radiesse can get diffusly inflammed. 

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It's been known for a long time that dermal fillers stimulate new collagen via fibroblast (eg. neocollagenesis). There is a ton of documentation about the effectiveness of cross-linked hyaluronic filler and collagen stimulation. Just Google 
"cross-linked hyaluronic filler and neocollagenesis" (include the quotes).

 

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I watched a video on Dr Weiner's Instagram page about the use of hyaloronidase, a treatment that breaks down ha fillers if something goes wrong. My Q is why is Dr Weiner so interested in this to make a 15 mins detailed lecture about it? I thought HA fillers giving complications is rare but is it so? Or is it more often than doctors tell us?? what's more important and i didn't understand from hus lecture is how they can guarantee that the hyaloronidase won't dissolve my heathy hyaluronic acid around the scar making the scar bigger if my HA fillers get inflammed and need to be dissolved? 

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The Hyaluronidase only acts on breaking down HA. It speeds up what would have happened naturally. The dosage and concentration that is injected should be sufficient to break down the excess HA and no more. It doesn't dissolve collagen. HA complications do happen. The biggie being vascular occlusion from injecting into a blood vessel or the filler compressing it. But the dissolver is mostly used for when you've overfilled, or filled in the wrong bit, or down the line when the filler has moved of its own accord. The last point is why hyaluronidase is important. Recent studies have shown that temporary fillers last waaaay longer than the advertised 6 months-2 years, in fact they can go as long as 7 years.  The reason why people think the filler has gone is because it migrates in the face. Ie if you get filler in your cheeks it can migrate upwards to form a puffy looking eye-bag 7 years later.  

There was an answer on realself which explains  the dissolving process further:

"Answer: Hyaluronidase and native tissue

The answer to your question is that hyaluronidase does not typically dissolve enough of your native hyaluronic acid (HA) to show as a depression at the strength and concentration we use. Think of it this way.  HA as a filler is injected in a bolus, or larger but discrete deposit that sits outside of the cells of our body.   When HA'ase is injected to dissolve this, the total dose and concentration are chosen to provide enough drug to access and rapidly dissolve that defined collection.  The antidote is placed in direct or near direct contact with the undesired deposit.  Two, normal HA is throughout our body, both inside and outside of cells.  Our homeostatic mechanisms are constantly degrading and restoring it, so we have active mechanisms at work at all times to keep those levels roughly the same.  HA'ase will have less influence on this active, steady state part of our body. Three, HA'ase is used as an addition to other drugs like lidocaine in order to increase their diffusion after injection.  With that use, we do not see depressions or furrows or irregularities due to localized HA'ase degradation of normal HA.  So the summary is that we do not expect to see any obvious effect on normal native HA with HA'ase injections." - MD K Robertson

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3 hours ago, F1racer said:

 HA complications do happen. The biggie being vascular occlusion from injecting into a blood vessel or the filler compressing it. But the dissolver is mostly used for when you've overfilled, or filled in the wrong bit, or down the line when the filler has moved of its own accord. The last point is why hyaluronidase is important. Recent studies have shown that temporary fillers last waaaay longer than the advertised 6 months-2 years, in fact they can go as long as 7 years.  The reason why people think the filler has gone is because it migrates in the face. Ie if you get filler in your cheeks it can migrate upwards to form a puffy looking eye-bag 7 years later.  

 

Interesting and informative read. Thanks for sharing. 

However, I am still not sure hyaluronidase can be used safely without risk of further damage. OK. Let's say the docs choose dosage and concentration but how do they know how much HA filler was injected in the first place if let's say my filler migrates under my eyes in 6 months or so. How will they know how much HA has dissolved already naturally to choose the proper dosage? I mean I'm not even sure how many ml were injected in the first place? This doctor Robertson merely "expects to see no obvious effect on normal HA with HA-ase injections". He cannot give a guarantee. There's no way the HS-ase can differentiate between filler HA and native HA, it dissolves everything around if the dosage is not chosen properly.

Fillers lasting up to 7 years in your face with 0 plumbing effect due to migration sounds terrifying to me. So u basically get little benefit and multiple risks of having a late onset inflammation if you get sick at the high price for fillers?? 

Why don't docs tell us about that beforehand? 

if i get puffy eyes in the next few years I'll know its from my HA filler that has migrated. 

Does anyone know if this super diluted radiesse filler dr emil uses  has any volluminizing effect at all or is it just used for collagen stimulation? 

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Dr Mobin Master and Dr Gavin Chan have just published a research paper on it in Plastic and Reconstructive Surgery.  Mobin Master has a previous paper out already on filler complications. You could try asking Mobin Master a question about hyaluronidase and natural HA on his instagram - he tends to answer. Looks like he uses ultrasound imaging while he dissolves it. 

https://www.instagram.com/drmaster_md/

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54 minutes ago, F1racer said:

Dr Mobin Master and Dr Gavin Chan have just published a research paper on it in Plastic and Reconstructive Surgery.  Mobin Master has a previous paper out already on filler complications. You could try asking Mobin Master a question about hyaluronidase and natural HA on his instagram - he tends to answer. Looks like he uses ultrasound imaging while he dissolves it. 

https://www.instagram.com/drmaster_md/

Thanks that's really helpful. Of course if he uses ultrasound while dissolving it it's another story. Even better is not having to use HA-ase at all :)

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