Karl Swanson M.D. of Ultimate Image Cosmetic Medical Center, serving Clearwater, St. Petersburg, and the greater Tampa Bay area is making strides to both satisfy and educate his patients. "When it comes to filler injections, I would like you to feel as little pain as possible while helping you feel better about your appearance".

"The best way to make filler injections a comfortable experience is to have anesthetic dental blocks performed. This will nearly completely numb the areas injected prior to the injections. Prior to these dental blocks, a small amount of numbing gel is placed on the gums, which decreases any discomfort of the dental blocks". Dr. Karl Swanson performs dental blocks free of charge prior to the filler injection. "These blocks make the injections a more comfortable experience. If you are not having the lips injected, which is the most sensitive area, or if you're only having one syringe injected, and have a high pain tolerance, you can choose to not have the dental blocks and avoid more shots. Topical numbing cream is not very effective for blocking the discomfort of filler injections. It is however useful while injecting Sculptra".

BRUISING

The most common side effect of dermal fillers is bruising. "Because a needle is used to inject fillers unseen veins under the skin are punctured and this results in bruising . The doctor cannot see these veins so they cannot be avoided. Therefore, if you get bruising it is usually unavoidable and not the fault of the doctor's technique". Dr. Swanson does however use a technique that reduces bruising. While many doctors use a serial puncture technique, which requires several needle punctures, Dr. Swanson uses a technique called ‘threading’. Using this technique Dr. Swanson can inject a much longer length of a needed area with a single needle puncture. "This results in less bruising and also takes less time, making the procedure more comfortable and producing smoother results. Another factor in whether you bruise or not depends on how well your blood coagulates. If you are taking aspirin, Ibuprofen ,Advil, Vitamin E, any other prescription medications or over the counter products that decreases your blood's ability to coagulate, you may have more bruising. Certain areas of the face also tend to bruise more than others. "The lips often bruise because they are very vascular. Usually these bruises can be hidden by lipstick. However, sometimes these bruises cause one side of the lip to look slightly larger than the other. This will resolve over a few days to a week when the blood is resorbed and the swelling decreases". Bruising around the mouth is also common. Usually, the nasal labial folds do not bruise. The labial mental folds, also called marionette lines, often do cause bruising around though the lips. "Bruises may also appear in areas that were not injected. This is because the blood that causes bruising may flow downward because of gravity to a lower part of the face. You may not see bruises the day of the procedure. Sometimes they develop the following day. Bruises can last for a few days or up to a few weeks. Despite the fact you may develop bruises, they can usually be hidden with cover-up makeup".

LUMPS:

After the procedure you may feel lumps on the inside of the mouth. "This is not unusual. Sometimes to push out a wrinkle or skin fold a lump is necessary on the inside where you will not see the lump on the outside. The lumps almost always resolved as the filler wears off. In very rare instances, if the skin forms fibrous tissue a lump may persist. But this will probably help keep the wrinkle pushed out and less noticable. So it is not necessarily a bad thing to have happen. Again, this is rare".

SYMMETRY:

Our entire bodies are asymmetrical including our face. The left side does not match the right side. Wrinkles and lines on one side of our face are always deeper or longer than the other side. Our lips are also asymmetrical side to side and top to bottom. "After your injection, you will be looking very closely at the areas injected. You will notice asymmetry that you never noticed before. This is not due to faulty injection technique. The asymmetry was there before but you may not have noticed it. In fact, it is a good idea to look closely at your lines, wrinkles and lips and note the asymmetry you already have. Study other people and see their asymmetry. You'll come to learn that we are all quite asymmetrical. Sometimes this asymmetry can be made better with injections and injections can also create new small areas of asymmetry. Trying to make both sides of the face perfectly symmetrical is not a realistic goal. In fact perfect symmetry has been shown to be less appealing than asymmetry. Obviously, if the two sides are dramatically asymmetrical, more filler can be used to even things out. However, this usually should be done after waiting two or three weeks when the swelling and any bruising has resolved.

Otherwise the asymmetry can be made worse because it is not clear until the swelling has gone down, where additional filler is really needed. Remember, you are probably the only one that sees the asymmetry, because you are looking at it so closely after the procedure. People looking at you expect to see asymmetry, and probably don't see what you see".