There are a variety of fillers that are used in the face and neck. Generally speaking the hyaluronic acid fillers are temporary and dissolve over a period of time. However, many other filers do exist and some of them cause severe reactions resulting in both aesthetic and functional problems. Often, the only treatment is surgical removal of the filler.
AM I A SUITABLE CANDIDATE FOR FILLER REMOVAL
Surgical removal of the filler can be a complex procedure, and requires adequate investigations such as scans. There is no ideal age group for this procedure but good general health including psychological stability and realistic expectations are prerequisites.
BENEFITS OF THE PROCEDURE
Filler removal will result in recovery of the facial tissues, and avoids further and ongoing reactions thus reducing pain, inflammation and discomfort. When function is affected such as restricted mouth opening, reduced eye closure etc. filler removal results in recovery of the functional deficit.
LIMITATIONS OF FILLER REMOVAL
Not all the filler may be removed, as sometimes the filler may wrap around the nerve where in some cases nerve damage may worsen functional deficit. Surgical scars are inevitable to access the filler and sometimes visible depending on the location of the filler. Multiple procedures may sometimes be required.
CONSULTATION FOR FAT TRANSFER PROCEDURE
During the consultation all your cosmetic and functional concerns will be addressed in detail. The affected area is assessed and the pros and cons of the procedure, including the possible scars and recovery will be discussed. Multiple investigations may be performed to include CT and MRI scans and fine needle aspiration biopsy as required to plan the surgical procedure.
Establishing the type of filler used is a very helpful aspect of the procedure. It is worth finding out from your previous provider as to what filler was used where possible, although we are aware this information may often be difficult to obtain. Possibility of nerve injury often limits the extent of the procedure. Multiple procedures may be necessary to obtain the best outcome, and may incur significant costs.
HOW IS FAT TRANSFER PERFORMED?
The procedure may be performed either under local anaesthetic with or without sedation (twilight) or general anaesthesia. Pre-operative antibiotics and steroid injections may used where required. Every attempt is made to hide surgical scars in skin creases and behind the ear etc. to reduce visibility. Nerve monitoring is often used using special equipment to avoid nerve damage. Filler removed will be sent to the laboratory for analysis and plan further treatment if required.
WHAT TO EXPECT POST-OPERATIVELY
Some mild pain and discomfort are common immediately after the procedure. Bruising may be significant which may take a while to settle. Avoid intense physical activity for about three weeks and report any undue discomfort. Recovery usually takes two to three weeks following which normal activity may be resumed. Normal make-up may be applied after one week. Swelling and bruising may take up to three months to settle, but usually lasts for approximately three weeks.
POTENTIAL COMPLICATIONS OF THE PROCEDURE
Complications are infrequent but include bleeding, infection, unfavourable skin tethering, nerve damage, altered sensation, lumpiness, change in skin colour, and cosmetic irregularities. Some filler may be left behind because of a variety of reasons already discussed and further surgery may be required.
Please ask all questions you may have, and ascertain that your questions and concerns have been addressed to your satisfaction before you proceed to surgery. Understand that this may not be an essential procedure depending on your situation.
|Procedure time||Depends on the extent of the filler problem (30 minutes-many hours)|
|Anaesthetic||General/ local with or without sedation|
|No. of nights in hospital||Depends on the length and complexity, generally day case procedure.|
|Time off work||2 - 3 weeks|
|Restricted routine:||3 weeks|
|Back to full normal activity||6 weeks|