The Down and Dirty on Dermal Fillers
If you are a woman who is at least 30 something, you know what dermal fillers are. However, do you have any of the inside knowledge that injectors use when deciding which of these fillers to offer in their medical spa?
When I started in this industry, I was a woman who had been injected with fillers, but had no clue which was the best, which company made what fillers, which were the most expensive, that there even was such thing as a “permanent filler” and an even better point, what in the world would you use permanent filler on?? So even though I didn’t get my nurse practitioner degree ONLINE or anything, I was as lost as I could be in this new world I decided to jump into eyes closed. It is my personality to know everything I can about what it is I am doing every day. So I set out on a mission before Landy HE opened in August of 2020 that I would know as much about any filler on the market as I decided I needed to depend on whether or not I chose to offer it in our spa.
Before I take you along on my journey, I want to clear up some answers to the questions listed and even some not listed that you may be wondering to yourself the answer to….
Q: Are Botox and fillers the same thing?
A: In short, the answer is no dermal fillers are injected in areas where a person has volume loss associated with aging to give the skin a more supple and youthful appearance. Botox is the brand name of botulinum toxin A that was produced by the company, Allergan. Botox is generally injected directly into a muscle to prevent a person from making the facial expression that once caused the wrinkle.
Q: Can dermal filler be removed?
A: Sort of, at least every filler offered at Landy HE, because they are all some form of hyaluronic acid and it can be dissolved with a drug called hyaluronidase BUT it burns very badly. So before you dissolve it, be sure that is definitely what you want to do.
Q: Does getting dermal filler hurt?
A: Well yes, you are having a needle put into your face, BUT most of the fillers on the market now have lidocaine inside of them so once injected one time, the pain usually becomes more tolerable.
Q: Which dermal filler lasts the longest?
A: That would easily be “permanent fillers” they can last up to 5 years because the body cannot break them down. The most popular one that comes to my mind is Belafill. Belafill is often used for the pitting acne scarring that patients present with. The longest-lasting temporary dermal filler is Voluma and it lasts about 2 years.
Finally, the most important question, in my opinion, is…
Q: What type of training or certification must you have to perform these types of injections on people?
A: Personally, I completed my MSN FNP degree at MUW in 2012 and then decided I wanted to pursue the beauty industry. I called the Mississippi Board of Nursing to find out which companies provided aesthetics certifications that had also been approved and endorsed by them. Once I received the list, I did some Google research and decided to go with Empire Medical Training. They seemed to be reputable and offer classes on all the subject areas I felt were important to this practice.
Now, the first leg of this trip was setting up accounts with all the main companies that offer “the best” fillers on the market. To Google I went, there I learned that the biggest lines of dermal fillers were offered from, of course, Allergan, now Abbvie, Galderma, and Merz. Now and again a rep would contact me to give her product a try. Back to setting up these accounts, a PAIN! If I didn’t LOVE Galderma’s products, I would’ve just skipped an account with them because you don’t even set up an account with them, you have to set up an account with a company named McKesson who had already made it to my blacklist. I do not use McKesson for anything except ordering my Galderma fillers. Allergan proved to be a shenanigan because Dr. Landy uses and has used for the past 20+ years more Botox for migraine than most plastics guys use for aesthetic purposes. Allergan was unsure if we needed 2 accounts, one for him and one for me, or if one would suffice. They are very much particular about the separation of therapeutic and cosmetic Botox.
Finally, after a few calls with our cosmetic representative, we worked out all the details and ended up with only one Allergan account. HOWEVER, in our refrigerator at the spa, Dr. Landy’s therapeutic botox is in an orange topped box in the bottom of our refrigerator while the cosmetic botox is on the other side of the refrigerator. ALSO, I am the only person here currently who reconstitutes our Botox and I am very aware of the difference between the Orange box and the others. I never ended up having to set up a Merz account because I didn’t particularly see any benefit to using their fillers versus Allergan or Galderma’s.
Next was the fun part; SAMPLES!!! I luckily have a fantastic consultant from Chicago, Rose, who pretty much has shared with me her infinite wisdom since she has been in this industry for years. Her job is to go all over the United States and create successful openings for medical spas. I cheated and got my personal representative’s contact info from her. I contacted the Merz, Allergan, and Galderma representatives and asked for samples from each of their most popular products to try them out and the reason you want to do this is that hyaluronic acid is a thick gel consistency, and pushing it out through the small gauge needles used to inject them can prove to be a difficult task for a new injector.
The samples I received early on were for Radiesse (Merz) and Beletero (Merz), Galderma sent me Restylane Lyft, Silk, L, Defyne, Refyne, and Kysse. Allergan sent me Juvederm Voluma, Ultra, Ultra Plus, Volbella, and Vollure. Let the fun begin!!!! All of the above except for Radiesse are hyaluronic acid fillers. Because our bodies make hyaluronic acid daily, there’s a very low risk of an allergic reaction to one of these fillers. Now, it is my personal preference, but when you come to our spa, you will always get a hyaluronic acid-based filler. The reason being, it can be dissolved with hyaluronidase (very painfully I might add) and it has proven to be the least likely to cause a reaction, and reactions can range from a slight rash to clumping and lumping of the filler injected. Once I had injected my samples and been able to observe them in friends’ faces from day 1 until even 6 months down the road, I had the confidence I felt I was looking for to make my decisions.
After I got to play with my samples, I had decisions to make, mainly do I use Allergan exclusively or do I offer 2 different companies options for filler. Since Allergan and Galderma both seem to offer the largest families of fillers, I chose them. Also, the fact that both Allergan and Galderma had fillers indicated for the areas I would mainly be injecting, helped too. It’s no secret that Allergan has earned its name in the aesthetic industry. The issue that arises when you use a “big-named” company, is the price that patients pay, and that sometimes tends to be the driving factor for many patients.
Thankfully, both companies I have chosen to carry in our spa offer rewards programs for patients and I will list those programs’ websites and how to register for the money-back offers they have in part B to come in a few days. So stay tuned…