Question 1

What is Filler?

Accepted Answer

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Filler is a type of substance known as Hyaluronic Acid (HA). It is produced to mimic a naturally occurring substance in the body and is used to replace essential components of the skin's structure, such as collagen and hyaluronic acid, which the body loses as it ages.

Human skin contains collagen fibers, which are crucial for maintaining skin strength, elasticity, and firmness. When these fibers decrease, the skin becomes thinner and more prone to wrinkles and sagging.

Injecting Hyaluronic Acid into areas with wrinkles, such as under the eyes or around the mouth, can help to smooth out these lines and make the skin appear firmer. Therefore, filler injections are effective in addressing various signs of aging.
In addition, a key property of fillers is their stability, allowing them to be used for enhancing the nose and chin. They also help the skin retain moisture down to the deeper layers, improving skin texture, reducing pore size, and making the skin more elastic and naturally smooth.

Question 2

Are filler injections and hyaluronic acid injections the same?

Accepted Answer

Filler is a broad term that refers to all types of injectable substances. In Thailand, when doctors refer to "filler," they usually mean pure Hyaluronic Acid. However, some clinics may use the term "hyaluronic acid injections" instead of "filler injections" for marketing reasons.

Question 3

Where can fillers be injected?

Accepted Answer

Fillers can be used to inject almost any part of the body that lacks volume. While they are most commonly used on the face, they can also be injected into areas such as the ears, hands, genitals, and hips.

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1. Under the Eyes: To reduce dark circles and hollows.
2. Cheeks: To add volume and lift sagging skin.
3. Nose: To enhance the shape or correct imperfections.
4. Chin: To improve contour and balance facial features.
5. Jawline: To define and strengthen the jawline.
6. Nasolabial Folds: To smooth the lines between the nose and mouth.
7. Marionette Lines: To reduce lines running from the corners of the mouth to the chin.
8. Lips: To add volume, shape, and definition.
9. Forehead Lines: To smooth out horizontal lines on the forehead.
10. Temples: To restore volume and improve facial contour.

Question 4

How many CCs of filler are needed for each injection site?

Accepted Answer

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The amount of filler needed for each injection site is determined by the doctor based on the patient's issues and desires. The doctor will recommend the appropriate amount of filler to achieve clear and natural results. It is not necessary to use a large amount of filler in a single session; it can be gradually added over time until the desired outcome is achieved.

Question 5

what are Benefits of Filler Injections?

Accepted Answer

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1. Immediate Results: Filler treatments typically provide instant improvement in volume and appearance.
2. Non-Surgical: The procedure is minimally invasive and does not require surgery or extensive downtime.
3. Volume Restoration: Helps restore lost volume in areas such as cheeks, lips, and under the eyes.
4. Wrinkle Reduction: Smooths out wrinkles and fine lines, leading to a more youthful appearance.
5. Facial Contouring: Enhances facial contours, such as the jawline, chin, and nose, for improved symmetry and balance.
6. Hydration: Some fillers, like hyaluronic acid, attract and retain moisture, improving skin hydration.
7. Customization: Treatments can be tailored to individual needs and desired outcomes.
8. Long-Lasting Effects: Results can last from several months to over a year, depending on the type of filler used and the area treated.
9.Minimal Recovery Time: Most people can resume their normal activities immediately after the procedure.

Question 6

Dangers of Injecting Fake Fillers

Accepted Answer

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Injecting fake fillers, such as substandard, illegally imported, or unapproved fillers, can be extremely dangerous. These fillers may not break down naturally and are often administered by unqualified practitioners. Potential risks include allergic reactions, inflammation, infection, swelling, and redness, which can result in uneven skin texture. In severe cases, it may lead to tissue necrosis or even blindness.

These adverse effects may not be immediately noticeable. Often, the results look good right after the injection, leading many people to choose cheap treatments from unqualified practitioners or low-cost clinics. However, problems can begin to emerge months or even years later, including hardened lumps, migration of the fake filler due to gravity, and infection.

Correcting these issues typically requires surgical removal or scraping of the filler. Even with surgery or scraping, it is often impossible to remove all of the fake filler, as it may have integrated with the body’s tissues.

Question 7

Which brand of filler is good? How long does each brand last?

Accepted Answer

Choosing the right filler brand depends on the area you want to inject. No single filler brand or type is suitable for every area or skin condition. Therefore, when you visit a clinic, the doctor will assess each patient’s specific issues and choose the most appropriate filler for the case.

Neuramis
It is a Korean filler imported by Medyceles Thailand and has been certified for safety standards by the US FDA, Korea FDA (KFDA), Europe (EDQM), and Thailand FDA (THFDA).

Neuramis filler is produced using SHAPE Technology, which stands for Stabilized Hyaluronic Acid & Purification Enhancement, developed by Medytox in South Korea. This technology creates cross-links through a two-step process, resulting in a longer-lasting filler with high durability, reduced degradation, and excellent elasticity. Additionally, Neuramis fillers undergo thorough sterilization, making them highly safe and non-toxic, and they dissolve naturally without leaving residual substances in the body. It is essential to use genuine Neuramis fillers and choose a clinic with expertise to ensure safety. Therefore, careful selection of the clinic is crucial for a safe treatment.

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E.P.T.Q
E.P.T.Q (Epitique) filler is a South Korean filler. it is imported and distributed correctly in Thailand by Aestema Thailand. E.P.T.Q filler is highly safe and has received certifications from the Thai FDA (TH FDA), CE Mark, Korean FDA (KFDA), EDQM, and the U.S. FDA (US FDA).
     
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   E.P.T.Q. stands out among other fillers in the market for its safety and competitive pricing. E.P.T.Q. is produced under strict quality control standards.  
Regarding safety, E.P.T.Q. places great emphasis on the MoD (Molecular Distribution) value. This value indicates the proportion of BDDE present in the filler. A lower MoD value means less BDDE is present. E.P.T.Q. fillers have a MoD of approximately 1%, which is relatively low. 
What is BDDE? BDDE (1,4-Butanediol Diglycidyl Ether) is a chemical used to create cross-links in fillers. More cross-links result in better shape retention, slower degradation of the filler, and longer-lasting results. The structure of these cross-links affects the filler’s plumpness, viscosity, and elasticity. 
For fillers that require good shape retention, having more cross-links is advantageous. However, adding excessive BDDE can increase the risk of allergic reactions and leave more residual BDDE in the filler, as not all BDDE bonds with hyaluronic acid. 
E.P.T.Q.’s technology allows for effective shape retention while using less BDDE. This results in a lower MoD value and minimal residual BDDE. The technology also enhances the bonding of BDDE with hyaluronic acid, resulting in a firmer and more durable filler while maintaining safety.

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How does E.P.T.Q filler differ from Neuramis filler? 
Both E.P.T.Q and Neuramis are Korean fillers with similar price ranges, but they differ in their characteristics. Neuramis fillers are firmer across all types, making them suitable for shaping areas such as the chin and jawline. However, their firmness can sometimes lead to the formation of lumps.

In contrast, E.P.T.Q fillers offer a variety of textures, allowing for use in multiple areas. They are less likely to form lumps after injection and generally provide a more natural-looking result.

Juvederm 
Juvederm is a highly popular and globally recognized filler brand from the United States. The manufacturer is Allergan Aesthetics, the same company that produces Allergan Botox. In Thailand, Juvederm is imported and distributed by Allergan Aesthetics Thailand. It is certified by international agencies for its effectiveness and safety. Juvederm offers several versions, each with different filler characteristics. 
    
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 Hylacross Technology 
This is the original technology used for Juvederm fillers. Fillers made with this technology are known for their high water retention capacity, resulting in a fuller appearance after injection. They are ideal for filling deep wrinkles or areas where fat has significantly diminished, such as sunken cheeks or nasolabial folds. 
        
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            The administering physician must be very precise because overfilling can lead to facial swelling. It is recommended to inject to achieve about 80% of the desired result initially, allowing for the filler to swell slightly as it settles. The fillers using Hylacross Technology include:

Vycross Technology 
This is the latest technology, designed to reduce water swelling in the filler and offers exceptional lifting properties. It is suitable for filling all areas of the face and provides a smooth, natural-looking result. Physicians can achieve more precise outcomes with this technology compared to the Hylacross versions. The fillers using Vycross Technology include:

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Neauvia 
Neauvia Filler is a new generation filler produced in Italy. The name 'Neauvia Filler' translates from the local language as 'New way Filler.' This innovative filler was developed in 2012 and is widely used in over 80 countries. 
Neauvia Filler, or Neauvia Hybrid Filler, is different from other fillers as it not only helps reduce wrinkles but also stimulates the activity of fibroblasts in the skin. These fibroblasts are responsible for producing collagen and elastin. Therefore, injecting Neauvia Filler helps improve skin elasticity, smoothness, and also reduces wrinkles.

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How does Neauvia Filler differ from other fillers? 
Neauvia Filler is distinct from other fillers due to its unique use of crosslinking between the biocompatible molecules Polyethylene Glycol (PEG) and Hyaluronic Acid (HA). This creates a gel structure that is both strong and flexible. Even with a small amount, it effectively adds volume. 
Additionally, Neauvia Filler contains Calcium Hydroxyapatite (CaHA), a natural collagen-stimulating substance already present in the body. CaHA promotes better fibroblast function, leading to increased collagen and elastin in the skin. This results in natural-looking facial enhancement and contouring. 
Neauvia Filler also includes special components like L-Proline and Glycine, which are essential for the body. These components help balance the body’s water levels (osmolytes), reducing the likelihood of post-injection swelling and serving as precursors for collagen production.                                                                                                                                                                                                      
                                                                                                                                                                                                                                                                                                                                                           
      Furthermore, Neauvia Filler maintains its stability during the facial contouring process. It is more resistant to heat up to 65 C and degradation within the body compared to conventional fillers, resulting in longer-lasting results.

In summary, Neauvia Filler can effectively fill in the skin layers and enhance facial contours while stimulating collagen production in the body. It is safer than typical fillers, does not leave harmful residues, and has anti-inflammatory properties under the skin.

Question 8

How much does filler injection cost? Why do prices vary for different areas?

Accepted Answer

The cost of filler injections varies depending on the brand of filler used. Some areas may be more expensive due to the complexity of the injection and the need for specialized techniques. In contrast, areas that are less difficult to inject may cost less.

Question 9

How to Identify Real and Safe Fillers? What Should You Look For?

Accepted Answer

With many fake fillers on the market in Thailand, it’s crucial to ensure the fillers you receive are real and safe. Before getting an injection, check the following to confirm the product is genuine and legally imported:

-FDA Registration Number: Verify this number on the box. 
-Documentation in Thai: Ensure there is documentation in Thai language. 
-Matching Lot Numbers: Make sure the lot numbers on the box, packaging, stickers, and syringe match. 
-Verification: Contact the importing company to confirm the lot number. 
Note: It’s especially important to check that the syringe used for the injection matches the box. Some clinics may show you the box but use a different syringe for the actual injection. You should always ask to see both the box and the syringe every time before getting an injection.

Question 10

What are side effects of filler?

Accepted Answer

Filler injections, while generally safe, can have some side effects. Here’s a rundown of potential side effects:

Common Side Effects: 
Swelling: Temporary swelling at the injection site, which usually resolves within a few days. 
Bruising: Small bruises may develop around the injection area. 
Redness: Mild redness or irritation can occur at the injection site. 
Tenderness: The area might feel sore or tender for a short period after the injection.

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Less Common Side Effects: 
Infection: There is a risk of infection at the injection site, though this is relatively rare with proper technique and hygiene. 
Allergic Reactions: Some individuals may experience allergic reactions to the filler material, which can cause itching, swelling, or rash. 
Lumps or Nodules: Hard lumps or nodules might form if the filler is not evenly distributed or if there is an unusual reaction. 
Discoloration: Occasionally, there might be changes in skin color around the treated area. 
Serious Risks (rare): 
Vascular Complications: If the filler is injected into or near a blood vessel, it can lead to blockage, resulting in serious issues such as tissue necrosis or even blindness if it affects the eye. 
Asymmetry: Uneven results may occur, leading to asymmetry that might require correction. 
Filler Migration: The filler may move from the original site, which can alter the intended results.

It’s crucial to follow aftercare instructions and consult with a licensed and experienced practitioner to minimize risks and address any concerns promptly.

Question 11

Guidelines to Follow Before Getting Filler Injections

Accepted Answer

-Research: Gather necessary information, including selecting a reputable clinic, choosing a qualified doctor, understanding the techniques used, and learning how to identify genuine fillers for each brand. This will ensure safety and confidence in achieving good, worthwhile results.

-Avoid Certain Medications and Supplements: Some medications and vitamins should be avoided before getting fillers, such as aspirin, NSAIDs, vitamins, collagen, ginkgo biloba, evening primrose oil, ginseng, Vitamin E, etc. These substances can increase the risk of bleeding, which may lead to more swelling and bruising after the injection. It is advisable to avoid them about one week prior to the procedure.

-Avoid Laser Treatments and Facial Massages: Refrain from undergoing laser treatments and facial massages at least 3 days before the injection. Residual heat from these treatments can potentially break down the filler.

-Inform the Doctor of Any Health Conditions or Medications: Always inform the doctor of any pre-existing health conditions or regular medications before the procedure.

Question 12

Steps for Getting Filler Injections at Bodifly clinic

Accepted Answer

-Consult with a Specialist or Doctor: Discuss your concerns to assess the issues you want to address. 
-Filler Recommendation: The specialist or doctor will recommend the appropriate brand, amount and price of filler for the injection sites. 
-Face Cleaning: Clean your face thoroughly. If you are wearing makeup, we will remove it from the areas where the filler will be injected. 
-Reducing discomfort from the needle: Apply a numbing cream and leave it on for about 30-45 minutes. Alternatively, or additionally, use ice packs before an injection. 
-Verify the Filler: Before injecting, we will open the filler box in front of you to verify that it is genuine. 
-Post-Injection Care: After the injection, we will provide instructions on how to take care of yourself. Follow these recommendations to help the filler settle properly and last longer.  In some cases, a follow-up appointment may be scheduled.

Question 13

Post-Filler Injection Care Guidelines

Accepted Answer

-Cleansing and Makeup: You can wash your face, apply makeup, and use creams as usual after at least 2-3 hours post-injection. However, be gentle when touching your face and avoid pressing or massaging the injection sites for 1-2 weeks. 
-Bruising and Swelling: Some swelling, redness, or bruising is normal, and it may be more noticeable, especially around the mouth. Swelling is usually most significant during the first 2-3 days and will gradually decrease by day 4. If swelling worsens after 3 days, contact the clinic immediately. 
-Avoid Heat: While heat won't necessarily worsen the results, it can shorten the duration of the filler effect. For the first 2 weeks, avoid direct heat on the injection areas, such as saunas, steam rooms, and hair dryers. You can take warm showers, but avoid washing your face with hot water; use room temperature water instead. After 2 weeks, if you really want to use a sauna, cover your face with a cold towel. 
-Beach and Sun Exposure: You can go to the beach and be in the sun but try to protect your face from very strong sunlight. 
-Exercise: Avoid exercise for at least 48 hours after the injection, as it can cause the filler to migrate to unwanted areas. However, you can still go for a walk.   
-Avoid laser: Avoid all types of hot laser treatments for at least 1 month. 
-Alcohol: Alcohol does not directly worsen the results of filler injections. However, alcohol can cause blood vessels to dilate, which may lead to more pronounced bruising, swelling, and inflammation, and these issues may take longer to resolve. Additionally, for some people, alcohol can cause a rise in body temperature, which can also reduce the lifespan of the filler. 
-Flight: flying after dermal fillers can worsen bruising, swelling and migration. Changing in cabin pressure and oxygen levels as causing this. For short interstate flights this is less critical but could be a big inconvenience. It is long haul cross-country or international flights where we strongly emphasis waiting at least a week before jetting off.

Question 14

Dissolving Fillers

Accepted Answer

-Hyaluronidase: If you need immediate dissolution, the enzyme hyaluronidase can be used to dissolve the filler quickly.  
-After dissolving the filler, if it is a genuine filler, the dissolution will occur almost immediately, with noticeable results visible within 1-2 days.

-For Fake Fillers: If the filler used was fake or of substandard quality, such as fillers that have been in place for over 2 years without naturally dissolving, hyaluronidase may not completely dissolve the filler, regardless of the number of injections.

-Guarantee of Results: At Bodifly Clinic, we cannot guarantee that filler dissolution will be complete if the filler was administered elsewhere.

-Effect on Collagen: The enzyme used for dissolving fillers does not only dissolve the filler material but can also break down the patient’s collagen. Therefore, during the first treatment, the doctor will administer a small amount to observe the response and may schedule a follow-up session in 1-2 weeks.

-Skin Changes: After dissolving, the skin in the treated area may become loose or saggy due to the stretching from the filler. Normally, the skin will eventually tighten up on its own. The recovery time varies depending on factors such as the patient’s age, the duration the filler was in place, the amount of filler dissolved, and the injection site. It can take several weeks to months. Additional treatments like laser therapy can help accelerate skin tightening.   Many people also need to get new filler after dissolving the old one.

Question 15

Surgical Removal of Fillers

Accepted Answer

If there is swelling, redness, or inflammation due to the injection of counterfeit (fake) fillers, and the filler material cannot dissolve on its own, it may eventually form hard lumps or sag. The solution involves surgery or scraping out the filler. If the filler has been in place for a long time and has formed scar tissue, it may not be possible to remove all of the counterfeit filler even with surgery.

Question 16

How to Choose the Right Clinic for Filler Injections

Accepted Answer

With many clinics offering filler injections today, it’s important to choose wisely. Poor choices, such as getting fake fillers or improper placement, can lead to difficult and sometimes irreversible problems. If you're unsure where to get fillers, consider the following:

Choose a Reputable Clinic: Select a clinic that meets standard quality and safety requirements. 
Experienced and Trustworthy Doctors: Ensure the doctor has experience and credibility.      In Thailand, only qualified doctors are legally allowed to administer filler injections. 
Avoid clinics with inexperienced or unreliable people who offer low prices just to attract customers. 
Use Genuine Fillers: Ensure that only genuine fillers are used. The price should be reasonable but not excessively cheap. 
Check Customer Reviews: Look for reviews from previous clients on trustworthy and impartial sources. 
Post-Treatment Follow-Up: The clinic should provide follow-up care after the injection. 
Convenient Location: The clinic should be easily accessible, with convenient transportation and parking, and should allow you to schedule appointments in advance.

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