Hyaluronic Acid Dermal Filler Injections (Ultrasound-Assisted)

Over time, our faces lose volume and hydration, leading to hollows, sagging, and deeper lines. Hyaluronic acid (HA) dermal fillers are a popular non-surgical solution to restore that lost volume, enhance facial contours, and smooth out wrinkles. HA is a substance naturally found in our skin; when used as a soft gel filler, it attracts water and provides plumpness and support under the skin. Common treatment areas include the cheeks, lips, nasolabial folds (smile lines), marionette lines, chin, jawline, and even under the eyes (tear troughs). The result? A refreshed and rejuvenated look that still appears very natural.

At Dermanom Aesthetic, we take dermal filler safety to the next level by employing ultrasound guidance during filler treatments when appropriate. Ultrasound imaging allows us to visualize the underlying facial structures – including blood vessels – in real time. This advanced technique significantly reduces the risk of complications such as accidental injection into a blood vessel (which can cause occlusion):contentReference[oaicite:9]{index=9}. By mapping your unique facial anatomy beforehand, Dr. Tokman can plan the safest injection points and depths for precise filler placement. This is especially beneficial for high-risk areas like the tear troughs (under-eye) and nose.

What to Expect During Treatment

After a thorough consultation and facial assessment (often including ultrasound scanning of the area), we’ll cleanse the skin and may apply a numbing cream for comfort. Many modern fillers also contain a local anesthetic (lidocaine) to minimize discomfort from within. We use either fine needles or blunt-tipped cannulas to administer the filler, depending on the area and technique. With ultrasound assistance, the procedure might take a little longer than standard filler injections, as we will periodically scan the area for guidance – but the added safety and accuracy are well worth it.

You might feel a slight pinch or pressure during injections, but most patients tolerate the procedure well. We mold the filler gently with fingers to ensure it’s evenly distributed. Immediately after treatment, you’ll see an improvement in volume and shape, though there can be some initial swelling. For lip augmentations, swelling can be more pronounced but usually subsides within a couple of days. Bruising is also a possible side effect; using ultrasound and cannulas can help minimize this, but if it occurs, it’s temporary and can be covered with makeup after 24 hours.

Pre- and Post-Care Instructions

Before Your Filler Appointment: Avoid blood thinners (aspirin, NSAIDs like ibuprofen, high-dose fish oil, vitamin E, gingko) for around a week prior if possible, as these can increase bruising. It’s also best to skip alcohol the day before and day of treatment. Stay well-hydrated and eat something before you come (to avoid any lightheadedness). If you have a history of cold sores and we are treating the lip area, inform us – preventive antiviral medication may be advised, since needle injections could trigger a cold sore outbreak. Arrive with a clean face if you can; we will thoroughly cleanse the treatment sites here as well.

Aftercare for Dermal Fillers: You’ll receive specific instructions, but general guidelines include: Do not rub or massage the treated areas for at least 24-48 hours (unless we specifically instruct you to do gentle massage for certain areas). Avoid strenuous exercise, heavy lifting, or anything that increases your heart rate significantly for 24 hours – elevating blood pressure right after fillers can worsen bruising. Stay out of saunas, hot tubs, or very hot showers for a day, as excessive heat can increase swelling. We recommend sleeping with your head slightly elevated for the first night and try not to put pressure on the treated side of your face while sleeping. Arnica supplements or topical arnica can help resolve bruising faster if you do bruise. Also, avoid dental appointments or other facial treatments (facials, massages) for 1-2 weeks after filler, especially if you had injections around the mouth – this reduces the risk of the filler moving or of infection. Swelling is usually mild (except lips, which can swell more) and mostly gone by day 2-3, with any minor bruises taking up to a week to fade. We’ll schedule a follow-up check in about two weeks to ensure you’re happy with the results; at that point, a touch-up can be done if needed once everything has settled.

Frequently Asked Questions

How long do HA fillers last?
Hyaluronic acid filler longevity depends on the product used and the area treated. Generally, results last anywhere from 6 months up to 18 months. For example, lip fillers tend to dissolve a bit faster (around 6-9 months) due to the area’s movement and metabolism, whereas cheek or jawline fillers can last closer to 12-18 months. Over time, the body gradually breaks down the filler naturally. We can schedule maintenance treatments to keep your look consistent. One benefit of HA fillers is that they are reversible – if ever necessary, an enzyme called hyaluronidase can dissolve them.

Are the results immediate?
Yes, you will see an immediate improvement in the treated area right after the injections – this is the volume of the filler providing an instant lift or plump. Keep in mind there may also be some swelling, which can make the area look a bit more “filled” than the final result. Once any swelling subsides (over a few days up to a week), you’ll see the true result. In areas like tear troughs, it can take a couple of weeks for the filler to fully integrate and settle into the tissues, so subtle enhancements continue during that period. We usually schedule a follow-up at around 2 weeks to evaluate the outcome.

What makes ultrasound-assisted filler different?
Traditional filler injections are done “blind,” relying on the injector’s anatomical knowledge and technique. Ultrasound-assisted filler treatment adds an extra layer of safety by visually confirming what’s beneath the skin in real time. This is especially important to avoid injecting into blood vessels; an occlusion can lead to complications like tissue damage. By using ultrasound, we can see where vessels lie and plan injection paths that circumvent them:contentReference[oaicite:10]{index=10}:contentReference[oaicite:11]{index=11}. Additionally, ultrasound can be used if there’s ever a question after treatment (for example, to distinguish filler from swelling, or to guide dissolving a filler with hyaluronidase if needed). Not all clinics offer this technology – we’re proud to incorporate it for safer outcomes and peace of mind.

Are there any side effects or risks I should know about?
Dermal fillers are generally safe when administered by experienced practitioners. Common side effects include swelling, redness, and bruising at injection sites. These usually resolve within days. More uncommon, but possible risks include lumps or nodules (often avoidable with proper technique and massage; if they occur, many can be gently massaged out or dissolved with enzyme), infection (we use sterile techniques to prevent this; it’s very rare), or asymmetry (one side might not match the other perfectly – we usually correct this at the follow-up if it occurs by adding a bit more filler). Vascular occlusion is the most serious risk – this is when filler inadvertently blocks a blood vessel, potentially affecting circulation to the skin. This is a medical emergency in aesthetics, but we mitigate this risk by careful technique, aspirating before injecting, using cannulas in certain areas, and of course ultrasound guidance:contentReference[oaicite:12]{index=12}. We also keep emergency protocols and antidotes (like hyaluronidase) on hand just in case. You will be educated on signs to watch for (like unusual pain or changes in skin color after treatment), but these complications are exceedingly uncommon in skilled hands.

Do fillers hurt more than anti-wrinkle injections?
The sensation is a bit different. Neuromodulator (Botox-like) injections use a very tiny needle and just a few injections, feeling like small pinches. Fillers involve a slightly larger needle or cannula, and sometimes multiple passes. However, most dermal fillers contain lidocaine, an anesthetic, which numbs the area from the inside as we work. Plus, we often pre-numb the skin with topical cream. You might feel initial pinching and a bit of pressure or a stinging sensation, but many patients say it’s quite tolerable. Lips can be more sensitive, so we take extra care there (including possibly a numbing dental block for lip filler if needed). We strive to make you as comfortable as possible, using techniques like very slow injection, distraction, and of course, a gentle hand.

Will I look “overfilled” or unnatural?
Our aesthetic approach is “less is more.” The goal is to make you look like a fresher version of yourself, not someone else. We begin conservatively – you can always add more later, but dissolving excess filler is an unnecessary hassle we avoid by doing it right from the start. We carefully assess your facial proportions and discuss your goals: whether it’s a subtle lip enhancement or restoring a bit of cheek volume that’s been lost with age. The best compliments our clients get are that they look great or well-rested, not that they had work done. If you desire a more dramatic change, we can achieve that too, but always within the realm of what looks harmonious for your face. Our use of advanced techniques (like cannulas and ultrasound) also helps avoid tell-tale signs of filler, such as major bruises or filler in the wrong plane (which can cause visible lumps). Rest assured, we’ll prioritize a beautiful yet natural outcome.