You may be going in to get ultrasound, radiofrequency, dermal filler or neuromodulator injection treatments, but in what sequence should these treatments be done?
Figuring out the best strategy for facial rejuvenation treatments can be tricky, but a recent study has revealed that the truth is, it doesn’t matter what order you get your treatments – the effect is still as good one way or the other without an increase in adverse events.
The debate has raged for years about when to use energy devices (lasers, radiofrequency), when to inject dermal filler or neuromodulators, and when you shouldn’t use these treatments in quick succession, or which procedures should be avoided after what.
There have been some theoretical concerns regarding heating up neuromodulators or dermal fillers using energy-based devices that use thermal energy as their main mode of action, with changes of the protein structure thought possible. This would possibly change the way the injected substance behaves in the body. Another theoretical concern was injecting the skin with dermal filler or neuromodulators right after energy-based treatments, and what effect that might have on slightly damaged skin.
There isn’t a lot of research into these questions, so it’s been very useful for dermatologists to have more information and feel comfortable using either injections or energy-based technology without fear of adverse effects, in any order they see fit.
The researchers looked at whether a cosmetic dermatologist could use ultrasound devices within six months of dermal filler and/or neuromodulator injections without issue. A record was made of any adverse effects of those treated with both the dermal filler/neuromodulator injections and the ultrasound within six months of each other in the same area.
Many of these patients had both treatments in the same day or within three months of each other, in the same area, with seven out of 101 patients having adverse effects in total, but none relating directly to the combination of treatments.
Four of the adverse events resolved on their own, and there was no follow-up visit on the other three, so the effects were unknown. These adverse events were mild bruising, swelling, a cold sore outbreak, and a small rash.
What was not seen, which could prove these theories that at the very least ultrasound combined with dermal fillers was safe, was any sign of granuloma formation (lumps) and there was no melting of dermal fillers. This was a very small study, but an important one – it starts off the discussion about when dermal fillers/neuromodulators are safe to be used with energy-based devices.
How dermal fillers are made
Because dermal filler is (for the most part) made up of a molecule naturally found in the skin, it may have less likelihood of any damage occurring when combined with other treatments. This substance holds a thousand times its own weight in water, so has a neutral or positive effect in skin, acting as the go-between of skin and blood vessels.
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