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The first two weeks post-procedure constitute the settling phase. The filler integrates with the native tissue, attracting water and hydrating. This can cause the volume to fluctuate slightly day by day.
The filler softens and feels less like a foreign object and more like the patient’s own bone. Any minor lumps or bumps usually resolve on their own as the swelling subsides. Patients are advised to avoid massaging the area unless instructed, as this can displace the product.
Unlike body surgery, compression garments are rarely used for facial fillers. However, sleeping position is critical. Patients are instructed to sleep on their back with their head elevated for the first few nights to reduce swelling.
Sleeping on your face or applying pressure to your cheeks can mold the filler while it is still settling. Keeping the head elevated helps gravity drain the fluid from the face, speeding up the recovery of the final definition.
Healing is a metabolic process. To clear bruising and support tissue integration, patients should maintain good hydration and nutrition. Arnica and Bromelain (pineapple enzyme) supplements are often recommended to speed bruise clearance.
Avoiding alcohol and high salt intake is crucial during the first week. Salt causes water retention, which can exacerbate swelling and make the face look puffy. Alcohol dilates capillaries and prolongs bruising.
The patient’s metabolism and lifestyle influence the longevity of the filler. High-impact exercise and rapid metabolic rates can, in theory, break down the product faster. While patients should not stop exercising, they should be aware of this correlation.
Sun protection is vital. UV radiation breaks down collagen and hyaluronic acid in the skin. Daily use of SPF 50 protects not just the skin but the investment made in the underlying structure. Keeping the skin hydrated also keeps the filler looking its best.
Cheek and chin fillers have a distinct maturation timeline. At 2 weeks, the result is considered “final” for the initial session. However, the product continues to stabilize over the course of months. High G prime fillers in the chin can feel firm for quite some time, intentionally mimicking bone.
Results typically last 12 to 24 months. The chin, being a high movement area due to talking and chewing, may metabolize filler slightly faster than the immobile lateral cheeks.
Expert practitioners often advocate for a “stacking” approach. Instead of injecting a massive amount of filler in one session, they build the result over 2 or 3 sessions spaced months apart. This allows the tissue to expand gradually, resulting in a more natural look.
Stacking also increases the longevity of the result. By layering a new product over the integrated base, the duration of effect is extended. This prevents “bolus migration,” which can occur when too much product is forced into a tight space at once.
Over time, filler can migrate, though this is less common with the stiffer fillers used in cheeks and chins than with those used in lips. If the cheek filler migrates medially, it can create a heavy nasolabial fold. If chin filler migrates, it can make a “witch’s chin” or droop.
Maintenance involves monitoring for migration. If it occurs, the solution is not to add more filler but to dissolve the migrated product with hyaluronidase and then re-inject correctly. This “clean slate” approach ensures the definition remains sharp.
For some patients, liquid augmentation is a stepping stone to surgery. After years of maintenance, a patient may decide they want a permanent solution, such as a chin implant or genioplasty (bone surgery).
Liquid augmentation allows patients to “test drive” their new face. If they like the projected chin, they can proceed to surgery with confidence. It is crucial to dissolve all fillers before surgical planning to ensure the surgeon sees the accurate bony anatomy.
The filler provides the volume, but the skin provides the finish. Patients are encouraged to maintain skin health with retinols, microneedling, or lasers. Good skin elasticity helps hold the filler in place and prevents sagging.
As the filler expands the skin, maintaining elasticity is key to ensuring that when the filler eventually dissolves, the skin retracts smoothly. Combining filler with skin-tightening treatments is a common multimodal therapy.
During the maintenance phase, there are a few restrictions. However, frequent exposure to extreme heat (like hot yoga or saunas) can cause temporary vasodilation and swelling. While it doesn’t melt the filler, it can make the face feel heavy.
Patients should be mindful of pressure. Wearing heavy motorcycle helmets or tight chin straps for prolonged periods immediately after treatment can cause indentations in the filler. Once settled, the filler is resistant to deformation.
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It is best to book a review appointment around the 9- to 12-month mark. You likely won’t need a complete treatment, but a small “top up” can maintain the lift before the volume returns to baseline.
If filled conservatively, the skin retracts as the filler dissolves. However, chronic overfilling over many years can contribute to laxity. This is why “less is more” and proper placement are critical.
You should wait at least 2 weeks before getting a facial, especially one that involves deep massage or microcurrent. You want the filler to be firmly integrated into the tissue before anyone manipulates it.
The body’s hyaluronidase enzymes naturally metabolize hyaluronic acid fillers over time. They break down into water and carbon dioxide and are excreted. Bio stimulators leave behind a scaffold of your own collagen.
Yes, but with caution. Deep-heating lasers (such as Ultherapy or Thermage) can accelerate the breakdown of filler when applied directly over the depot. It is usually best to do energy devices before filler, or wait a few months after.
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