Wrinkle Treatment / Dermal Filler Treatment in Berlin

What Dermal Filler / Wrinkle Treatment Procedures Are Available?

Wrinkles can be treated in different ways depending on their location and depth. Dynamic wrinkles can be excellently treated with a well-known muscle relaxant. Static wrinkles can be wonderfully softened with both hyaluronic acid and autologous fat (see glossary).

Modern dermal filler treatment no longer aims to inject individual wrinkles; rather, we observe and interpret the face and show you, based on your aging processes, why certain wrinkles appear or have already appeared.

How do the individual dermal filler procedures differ? Advantages?

The various treatment procedures differ in technique, material, and, of course, the location of the desired dermal filler injection. After an analysis of your entire face, we will explain exactly which areas of your face injections will lead to which results.

Treatment with the muscle-relaxing agent leads to temporary paralysis of the facial muscles and is usually applied to the upper third of the face. This allows for the treatment of frown lines, the forehead region, and crow's feet. In some cases, it is also indicated to work with very little active ingredient in the area of the mouth or nose. We will explain exactly what effects can be achieved with this, based on your face. The result lasts approximately 4-6 months.

Hyaluronic acids can be used to compensate for both wrinkles and volume deficits in your face. The consistency varies depending on the region to be treated and how deeply the hyaluronic acid is to be injected. We distinguish between very fluid hyaluronic acids (e.g., for skin refreshment, eye treatment, or lip treatment) and firm hyaluronic acids, which are primarily used for volume enhancement in the cheekbone area. Hyaluronic acids also differ in their water-binding capacity depending on their firmness; thus, a fluid hyaluronic acid has less water-binding capacity than a firm one.

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Another option is the use of autologous fat. Here, in an operation (under general or local anesthesia), your fat is harvested from corresponding depots, specially and elaborately processed, and then injected into your face, etc. Autologous fat not only has volume-giving properties but also has a skin-refreshing and rejuvenating effect due to the stem cells and growth factors it contains. Unfortunately, on average, about 20-30% of the transplanted stem cells do not take, so the procedure may need to be repeated. The engrafted and transplanted autologous fat lasts permanently and is subject to your weight fluctuations as well as your skin aging.

Can all procedures be performed without restriction on all treatment areas?

Different procedures can be used depending on the treatment zone. It usually depends on the individual volume loss and skin condition which injection procedure is performed.

For whom are which wrinkle treatment methods suitable? At what age are which procedures / methods most effective?

Since there are different wrinkle treatment procedures, the best combination for the patient must be found during a consultation. Younger patients often benefit from dermal filler injections using a well-known muscle relaxant and/or hyaluronic acid. If patients desire a long-lasting result and additionally need skin refreshment, an injection in Berlin with autologous fat may be advisable.

Which method is chosen varies greatly individually and will be discussed with you during a detailed consultation in our practice clinic in Berlin.

How does wrinkle treatment / dermal filler injection differ from a facelift? Can methods be combined?

Modern wrinkle therapy is understood as a refreshing treatment for the patient. Changes in the face due to aging are taken into account and compensated for. Excess skin can thus be discreetly balanced with a dermal filler injection. However, if there is too much excess skin in the cheek and neck area, this can usually only be corrected with a facelift operation. We usually combine a facelift with the injection of previously harvested autologous fat to balance volume and refresh the skin with appropriate growth factors.

What are the advantages of dermal filler treatment?

The injection of wrinkles or facial areas with hyaluronic acid is a quick, non-invasive treatment after which you are usually immediately able to resume daily activities. The wrinkle can be lifted immediately, and you can notice an effect directly after the injection. The advantage of hyaluronic acid over all other methods is that it can be dissolved again with a special enzyme. The effect of the muscle-relaxing agent must be awaited for 4-6 months after the injection; there is no antidote. In the case of autologous fat injection, about 20-30% of it usually recedes after the injection, and then it remains permanently.

Dermal filler injections in the face offer you the advantage of feeling permanently fresh and rested through only minor corrections, without it being obvious that you have had injections.

What do I need to consider before wrinkle treatment?

Before treatment with hyaluronic acid, there is nothing to consider on your part. If you are in public life or have important appointments after the injection, it is recommended to perform the injections before a weekend. This way, any small bruises can be reduced over the weekend. After an injection, you should not use a sauna, exercise excessively, etc., for 24-48 hours.

After an autologous fat injection, the tendency for hematomas is usually more pronounced, so you should take 1-2 weeks off after this procedure.

Will my natural appearance / facial expressions be preserved after dermal filler treatment?

We ensure that your natural appearance and desired facial expressions are preserved during the treatment. Certainly, the effect of the muscle relaxant, especially in the forehead area, will influence your facial expressions, but this will reduce your wrinkle formation. As part of the treatment planning before each injection, we will explain to you which product we will inject into which facial area and what effect it is intended to achieve there.

After a detailed consultation, we will jointly decide which products are suitable for you to best fulfill your wishes.

Are preliminary examinations / skin analyses necessary?

No preliminary examinations or skin analyses are necessary as part of a wrinkle treatment. However, skin texture and quality certainly play an important role in the selection of the various substances.

What role do regularly taken medications play? Are there medications that should be avoided during treatment?

If possible, you should avoid blood-thinning medications before an injection. This could lead to unwanted bruises (hematomas). If you regularly take blood-thinning medications, we would ask you to inform us before an injection.

Which cosmetics should be avoided beforehand?

You can use your daily cosmetics as usual. If you have any specific questions, please feel free to contact us during the consultation.

How are wrinkles tightened / treated in Berlin? What is the process of a dermal filler treatment?

First, during a detailed consultation in Berlin, we will jointly decide which products we will use in which areas of your face. By using an established muscle-relaxing agent, the corresponding facial muscles are paralyzed, and wrinkle formation is thus eliminated. This means you will have no wrinkle-producing movement in these areas for approximately 4-6 months. As a result of reduced movement, the existing wrinkle depth also decreases, so that existing wrinkles can significantly improve with regular application.

An injection with hyaluronic acids lifts the wrinkle from within. We work with different hyaluronic acid concentrations and thus different water-binding capacities, so that various wrinkle depths and volume deficits can be treated.

Under certain circumstances, a combination of muscle relaxants and hyaluronic acids can also lead to your desired result. At the beginning of each treatment, we should create an individual plan detailing which preparation we will use at what time.

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How long does the dermal filler procedure take in Berlin for each method?

A dermal filler injection takes 10-60 minutes, depending on the scope. Usually, a detailed consultation precedes the injection, in which we explain which preparations we will use in which areas.

How are the treated areas anesthetized?

In sensitive regions, e.g., around the mouth or lips, a numbing cream can be applied before the injection. This takes effect in about 15 minutes and provides surface anesthesia, so the injection causes little pain. Most hyaluronic acid preparations contain a local anesthetic, so the injected areas become slightly numb. The numbness subsides after 2-3 hours.

During injections with muscle relaxants, anesthesia is not typically used, as the minor pain during the treatment cannot be minimized by a numbing cream. However, upon request, we can also apply a numbing cream before this treatment.

To what extent is dermal filler treatment in Berlin noticeable or painful?

You will experience very little pain during wrinkle treatment, as we numb the skin in certain areas before the treatment, and some needles are so thin that you will barely feel them. Punctures are certainly unavoidable, but they are not comparable to normal injections. Before the first injection, people are often anxious about this, but are usually surprised at how painless the treatment is afterward.

Is a clinic stay necessary for dermal filler treatment in Berlin?

No clinic stay is necessary for injections. Some patients also opt for combined procedures, such as a liposuction or a facelift / facelifting, so in these cases an overnight stay may be necessary.

When is a result visible after wrinkle treatment in Berlin?

The result is usually immediately visible after an injection with hyaluronic acid. After treatment with a well-known muscle relaxant, the onset of effect takes approximately 2-4 days; only then can you notice a reduction in your wrinkle activity.

After an autologous fat injection, the skin is usually still swollen, and bruises may also be visible. The final result can be observed after approximately 6 weeks.

How long does a wrinkle treatment with muscle relaxant last?

After the onset of effect in about 4 days, the maximum effect is visible after 2 weeks. Subsequently, the effect diminishes individually. Thus, the effect cannot be precisely predicted; rather, the duration of effect depends on you and the preparation used.

Do the wrinkles return?

After the effect of the well-known muscle relaxant has worn off and the hyaluronic acid has also been broken down, the wrinkles return in approximately the same form. However, due to the effect of the muscle-relaxing agent and hyaluronic acids, regularly treated wrinkles become significantly shallower and less noticeable over time.

How often must a wrinkle treatment with hyaluronic acid or autologous fat injection be performed?

How often a treatment with the respective materials must be performed depends heavily on the patient's initial findings. For example, a young woman of 35 may only need one hyaluronic acid treatment per year, while a woman of the same age or older may require multiple applications. Certainly, the number of treatments also depends on the patient's financial possibilities. It is also possible to distribute the planned treatments over a desired period to extend the effect.

Can the effect of wrinkle treatment be supported or extended by other methods?

No, the effect and duration of action of a treatment with the muscle relaxant depend solely on the dose of the active ingredient and the individual breakdown of the preparation in the muscle.

How long after the treatment are injection sites or skin redness, swelling, etc., visible?

In rare cases, minor hematomas, swelling, or skin redness may occur after an injection. These are usually barely visible or can be easily covered with makeup.

Are painkillers necessary?

No painkillers are necessary as part of a wrinkle treatment/dermal filler injection. Since most hyaluronic acids are mixed with a local anesthetic, the "pain" directly after the treatment is virtually non-existent and does not appear later either.

How high is the risk of infection?

The risk of infection is very low due to the tiny injection sites. Before each treatment, your face is thoroughly disinfected to avoid this risk.

To what extent are corrections possible after a treatment if I am not satisfied with the result?

Corrections are possible within the first 2 weeks after treatment with the muscle-relaxing agent. This is usually the case if unwanted facial expressions are still present or if there is an asymmetry in the wrinkle pattern. If the treatment with the relaxant was performed a long time ago, this can no longer be considered a correction, as the active ingredient in the muscle has already been broken down.

Which activities should I avoid after a wrinkle treatment with muscle relaxant or autologous fat tissue?

For 24 hours after an injection with both a well-known muscle relaxant and hyaluronic acid, you should not engage in excessive sports and refrain from sauna/steam bath visits. After an autologous fat injection, you should avoid such activities for 14 days, as tissue swelling can be more pronounced in that case.

Can I return to work immediately?

After a wrinkle treatment with muscle relaxants and also hyaluronic acid, you are usually immediately able to return to work. Minor swelling and hematomas can be easily concealed. In the case of autologous fat treatment, more pronounced bruising may occur, so we recommend taking about 1-2 weeks off from work. However, depending on the extent of the injection, we will inform you during the consultation about the downtime you can expect.

Are there certain cosmetics that should not be used after wrinkle treatment? Which care creams are recommended after the treatment?

After any type of wrinkle treatment, there are no restrictions regarding your daily cosmetics.

When can cosmetics be applied again?

Cosmetics can generally be applied again immediately, as the injection sites are very small. Only autologous fat is introduced with a slightly larger cannula, and the injection sites take about 2-3 days to heal.

Do scars remain at the injection sites?

In the context of all dermal filler injections, no scars remain at the injection sites.

What are the costs of the individual dermal filler methods?

The costs of a dermal filler treatment are individual. They depend on the method, the treated areas and the amount and type of product used. An autologous fat injection is usually more complex than a treatment with hyaluronic acid or a muscle relaxant because the fat has to be harvested and processed first. We will discuss the costs with you in detail during a personal consultation before the treatment.

Do health insurance companies or supplementary insurers cover parts of the wrinkle treatment?

Neither private nor statutory health insurance companies cover wrinkle treatment. Rarely, scar therapy with autologous fat may be covered by insurance.

What are the general risks of dermal filler treatment in Berlin?

Even if a dermal filler injection with muscle relaxants or hyaluronic acids performed by an experienced hand carries few risks, you should still be aware of some important ones.

Wrinkle treatment with the muscle-relaxing active ingredient can rarely cause headaches, slight nausea, and, of course, hematomas at the injection sites. Very rarely, the active ingredient can spread into the muscle of the upper eyelid and lead to a temporary "drooping eyelid." This is, of course, reversible, like the effect of the agent, and can be improved by using special eye drops. Nevertheless, the condition is very uncomfortable for affected patients during this time.

During injections with hyaluronic acids, hematomas, slight swelling, and a burning sensation at the injection sites can occur. The combination of hyaluronic acids with local anesthetics can temporarily lead to numb areas. Rare to very rare side effects include allergic and inflammatory reactions, hardening, and migration (dislocation) of the hyaluronic acid to adjacent facial areas.

How can complications arise?

Most complications can be discussed during a detailed explanation. Blood-thinning medication, existing allergies, and previous injections with corresponding materials play a major role. During an injection, we know exactly which areas of the face are so-called "zones of caution" and at what depth important structures are located.

Unfortunately, complications very rarely arise in difficult regions of the face (lower eyelid region) or when hyaluronic acid is applied to incorrect skin layers. Thanks to our many years of surgical experience as plastic surgeons, we know very precisely which preparations we can use for which patients.

Can facial nerves be damaged?

Facial nerves cannot be damaged, as the needles used are very thin. However, due to the injection with a mixture of hyaluronic acid (including local anesthetic), the treated areas can temporarily become numb. This usually lasts 2-3 hours.

Are facial expressions restricted during treatment with muscle relaxants?

Depending on the extent of treatment with muscle-relaxing agents in the forehead, crow's feet, nose, or mouth/chin region, a restriction of facial expressions may be desired. However, this can be modulated according to your wishes so that you feel comfortable with your expressions.

Are permanent damages possible?

Permanent damage is not possible. The effect wears off 100% after 3-6 months, and unwanted hyaluronic acid can be dissolved again with a special enzyme. Positive permanent effects include that regular injections build up connective tissue in the corresponding areas, and it remains there.