Minimally invasive plastic surgery is becoming a major trend in the aesthetic medicine market of Korea as well as around the world. Continued from the previous issue, we listened to the overseas experiences on filler and minimally invasive plastic surgery. Our guest for the second article is Peter Peng, a Taiwanese dermatologist. His practice, P-Skin Professional Clinic, is one of the most famous dermatology clinics in Taiwan. He shared his experiences on filler procedures.

 

 Peter Peng (P-Skin professional Clinic)

 

Q. Which filler products do you prefer and why?

The HA filler that I most frequently use is Juvederm Voluma by Allergan. Voluma is an excellent HA filler for volumizing. It is particularly good for lifting and volume enhancement. One drawback of this product that it cannot be used in the skin surface and lips.

My second most favorite is Sculptra by Sanofi-Aventis. Sculptra’s key advantage is that it promotes gradual collagenesis leading to a very natural outcome. The effect lasts for about 2 years, which is another benefit. However, it cannot be used in certain areas including lips and the periorbital membrane, etc. Also, accurate prediction of the outcome is sometimes difficult with this product.

Radiesse by Merz is another one of my favorites. This product has excellent lifting and supporting effects and can be diluted to fit the injection site. But it cannot be used in the lips and drooping eyelids.

 

[Advertisement] Ultra Skin/Pastelle – Manufacturer: WONTECH(www.wtlaser.com)

Q. Can you classify fillers according to the area of use?

Nose, under-eye areas (apple cheek), submalar, lateral cheeks, temple, forehead, chin, and nasolabial folds, etc. – Voluma

Tear trough – Restylane vital light or Vital

Sunken upper eyelids & Charming rolls of lower eyelids — Restylane Vital

Lips – Juvederm Ultra or Restylane

Chin — Voluma or Radiesse

Forehead — Radiesse, Sculptra, Voluma

Temporals — Deep injection: Voluma, perlane.

Superficial injection – Voluma with cannula or restylane with acannula

 

Q. What are conditions of a good dermal filler?

I believe the safety and durability are the most important properties of fillers. Fillers should bring natural outcome, be biocompatible and not cause problems with the tissues.

 

Q. What are the most common side effects and prevention measures?

The most common side effects are bruising and temporary edema. To prevent them, I use cannulas. Injection is carried out slowly and stably. Gradual injection of small amounts can also prevent side effects.

 

Q. What is your knowhow on enhancing the effect of filler procedures?

There are two ways to improve the effect of fillers.

First is to affect the areas adjacent to the injection site. The injection site is always in an interdependent relationship with surrounding tissues. For example, injection in the under-eye areas can also improve nasolabial folds and tear trough.

Second, the correct injection level is important. This can reduce side effects and help bring lasting and natural outcome. Injection level should be adjusted according to the filler type, hardness of the skin and soft tissues, and the support from underlying bone, etc.

 

Q. What are the most important aspects to filler treatment?

I believe that the accurate assessment of the overall face is very important. This step is one of key aspects that determine the success of the treatment. In fact, for every condition, diagnosis is the most important step toward treatment. Based on the accurate assessment, a successful treatment plan can be established and followed. Using appropriate location and injection dose can bring the desired outcome.

 

Summarized by/ Yoon-ae Shin