1 00:00:00,240 --> 00:00:00,800 This is the 2 00:00:00,800 --> 00:00:03,640 Art Beauty podcast, where we are always reaching for truth in beauty. 3 00:00:03,640 --> 00:00:04,680 Remember 4 00:00:04,680 --> 00:00:06,440 the guests on the show are not paying to be here, 5 00:00:06,440 --> 00:00:08,480 so we get to have honest conversations with them 6 00:00:08,480 --> 00:00:10,240 because you deserve to be informed 7 00:00:10,240 --> 00:00:13,240 so you can make the best choices for yourself. 8 00:00:13,360 --> 00:00:14,720 With that said, I'm Amber. 9 00:00:14,720 --> 00:00:17,280 And today my fabulous co-host is Dr. 10 00:00:17,280 --> 00:00:18,240 Konstantin. 11 00:00:18,240 --> 00:00:21,240 He is a board certified facial plastic surgeon. 12 00:00:21,360 --> 00:00:24,120 He is going to be here today talking to us all 13 00:00:24,120 --> 00:00:28,600 about fillers, more importantly, removing fillers. 14 00:00:28,600 --> 00:00:30,560 But before we get into that, welcome to the show, Dr. 15 00:00:30,560 --> 00:00:32,520 Konstantin. Great to have you here. 16 00:00:32,520 --> 00:00:34,720 Thank you, Amber It's a pleasure. 17 00:00:34,720 --> 00:00:37,760 Now, you are a practicing in New York, correct? 18 00:00:38,120 --> 00:00:39,120 Yes, that's correct. 19 00:00:39,120 --> 00:00:42,480 I practice in New York and I am specializing 20 00:00:42,480 --> 00:00:47,520 in facial rejuvenation, facelifts and all the cosmetic procedures around the face. 21 00:00:48,080 --> 00:00:50,640 Now, it's funny, you know, so I have to be honest. 22 00:00:50,640 --> 00:00:51,720 My audience knows this. 23 00:00:51,720 --> 00:00:57,480 I don't have a ton of experience myself with fillers, Botox, you know, forever. 24 00:00:57,480 --> 00:01:01,880 But when when it comes to fillers, I think these days it's like, 25 00:01:01,880 --> 00:01:05,640 you know, people go to med spas people go to their dermatologist, 26 00:01:06,840 --> 00:01:09,840 you know, Do you feel like 27 00:01:10,640 --> 00:01:10,840 that? 28 00:01:10,840 --> 00:01:13,840 Probably going to a facial plastic surgeon, somebody who's 29 00:01:13,960 --> 00:01:17,080 civically specializes in the face is 30 00:01:17,080 --> 00:01:20,080 maybe the way to go when you go in your first time? 31 00:01:20,240 --> 00:01:24,880 Well, it's definitely all those specialties are well qualified. 32 00:01:24,880 --> 00:01:30,000 Cosmetic dermatology colleagues are fantastic at doing Botox and fillers. 33 00:01:30,480 --> 00:01:33,040 And the reason for somebody would be 34 00:01:33,040 --> 00:01:36,800 to go to a surgeon for fillers, for example, is 35 00:01:37,360 --> 00:01:42,320 you might want somebody who is an expert in many different procedures 36 00:01:42,320 --> 00:01:45,360 so they select the right procedure for you. 37 00:01:45,800 --> 00:01:50,360 You are not necessarily you want somebody 38 00:01:50,360 --> 00:01:54,480 who does something very well but doesn't really do anything else. 39 00:01:54,720 --> 00:01:57,600 It's like a hammer and everything looks like a nail. 40 00:01:57,600 --> 00:02:01,880 So they might take certain treatments a little too far. 41 00:02:02,160 --> 00:02:06,960 Now, somebody of my specialty, when people come, we typically start them was Botox. 42 00:02:06,960 --> 00:02:08,480 Then we add a little filler. 43 00:02:08,480 --> 00:02:10,760 Then we might had a small surgical procedure. 44 00:02:10,760 --> 00:02:13,400 Then we might recommend the bigger surgical procedure. 45 00:02:13,400 --> 00:02:17,160 So it's pretty much a comprehensive care, comprehensive treatment for somebody 46 00:02:17,360 --> 00:02:20,960 with who's concerned about the aging process in their face. 47 00:02:21,360 --> 00:02:22,080 Amazing. 48 00:02:22,080 --> 00:02:23,520 And I'm glad you brought that up, because I don't want 49 00:02:23,520 --> 00:02:24,880 my audience thinking here like, well, 50 00:02:24,880 --> 00:02:28,320 we going to have facial plastic surgeon that seems like overkill. 51 00:02:28,520 --> 00:02:29,120 You know what? 52 00:02:29,120 --> 00:02:30,760 The reason I wanted to bring you on today 53 00:02:30,760 --> 00:02:33,440 is because we know it's the holiday season. 54 00:02:33,440 --> 00:02:34,360 You know, I have to 55 00:02:34,360 --> 00:02:38,920 imagine there's an uptick in people looking for that non-surgical 56 00:02:39,960 --> 00:02:41,960 refreshment, let's say. 57 00:02:41,960 --> 00:02:45,240 But I think that it is equally as important. 58 00:02:45,240 --> 00:02:49,200 You know, fillers are a wonderful option, but it's equally as important to know 59 00:02:49,880 --> 00:02:53,720 about dissolving fillers, about what you can do if and when they go wrong. 60 00:02:53,720 --> 00:02:54,800 Am I correct? 61 00:02:54,800 --> 00:02:56,880 Yes, absolutely. That's that's correct. 62 00:02:56,880 --> 00:03:01,680 So dissolving and not many people actually know that we can dissolve the filler. 63 00:03:02,040 --> 00:03:06,560 Dissolving the filler became very important part of the process 64 00:03:06,560 --> 00:03:10,000 and of course, people use fillers when they lose volume 65 00:03:10,040 --> 00:03:14,720 and they have wrinkles when they want to improve the texture 66 00:03:14,720 --> 00:03:18,160 and the contour of the face and the skin, 67 00:03:18,560 --> 00:03:21,520 but not necessarily 68 00:03:21,520 --> 00:03:25,440 somebody would like their appearance after they'd done the filler. 69 00:03:25,760 --> 00:03:30,920 So many times people feel, Well, I think my cheeks need to be a little fuller. 70 00:03:30,920 --> 00:03:32,640 Let me try to put the filler there. 71 00:03:32,640 --> 00:03:37,520 And they go home and in a couple of days they realize how quite like it. 72 00:03:37,520 --> 00:03:40,000 This is not me. This is not my cheek. 73 00:03:40,000 --> 00:03:44,080 Now, fillers, of course, would last for about a year or two after they inject it. 74 00:03:44,320 --> 00:03:48,720 So somebody would just get stuck with that look that they don't like. 75 00:03:48,720 --> 00:03:51,560 But fortunately, fortunately, we can dissolve. 76 00:03:51,560 --> 00:03:56,000 If not all, then most of those fillers and the medication that we use 77 00:03:56,000 --> 00:03:59,040 to dissolve this is called HYALINE, that's no relation to that company. 78 00:03:59,040 --> 00:04:01,240 It's one of them. The other one is called by Trace 79 00:04:02,440 --> 00:04:03,880 and it 80 00:04:03,880 --> 00:04:07,120 became a part of this whole 81 00:04:08,000 --> 00:04:13,120 remodeling of the face or filler use of fillers to rejuvenate the face 82 00:04:13,120 --> 00:04:18,000 because we can adjust, we can get rid of the filler entirely. 83 00:04:18,000 --> 00:04:20,280 Somebody did their lips and they realize, 84 00:04:20,280 --> 00:04:23,800 I can't stand how I look on the pictures with lips like that. 85 00:04:23,800 --> 00:04:24,320 Right? 86 00:04:24,320 --> 00:04:29,160 We can just get rid of the filler entirely or we can gently remodel it. 87 00:04:29,320 --> 00:04:32,480 We inject that certain amount of filler and the patient feels like, No, 88 00:04:32,480 --> 00:04:35,160 it may be a little too much, or I want my lips to be 89 00:04:35,160 --> 00:04:38,480 a little thinner on the sides and maybe slightly fuller in the middle. 90 00:04:38,920 --> 00:04:41,920 We can go ahead and we can adjust those fillers by reading 91 00:04:41,920 --> 00:04:44,920 the strategically removing them in some areas. 92 00:04:45,200 --> 00:04:46,880 So, you know, you bring up a good point. 93 00:04:46,880 --> 00:04:48,120 I want to be very clear here today. 94 00:04:48,120 --> 00:04:52,440 When are the you know, when do fillers need to be dissolved? 95 00:04:52,440 --> 00:04:55,440 So one of them is if perhaps it was overdone 96 00:04:55,440 --> 00:04:58,480 or may be that the patient doesn't like it as much. 97 00:04:58,480 --> 00:05:01,480 Are there other options that people are coming to using 98 00:05:01,640 --> 00:05:04,640 when dissolving filler is the best course of action? 99 00:05:05,320 --> 00:05:07,280 Well, the other situation would be medical, 100 00:05:07,280 --> 00:05:10,360 of course, because fillers, just like any medication, it can have 101 00:05:10,360 --> 00:05:14,280 a side effects and specifically hyaluronic acid fillers. 102 00:05:14,640 --> 00:05:16,800 They attract water. Right. 103 00:05:16,800 --> 00:05:18,720 And this is why they are so great, 104 00:05:18,720 --> 00:05:22,400 because water gives us the plumpness and the elasticity in the skin. 105 00:05:22,640 --> 00:05:26,360 But at the same time, at the same time, they can just attract too much water 106 00:05:26,360 --> 00:05:27,400 to a certain area. 107 00:05:27,400 --> 00:05:31,240 So people end up with maybe bags under the eyes or some swelling 108 00:05:31,240 --> 00:05:35,320 in certain areas and that swelling can last as long as the filler lasts. 109 00:05:35,320 --> 00:05:39,440 So for a year or two, obviously nobody wants to walk around swollen. 110 00:05:39,720 --> 00:05:42,760 So then for medical reasons, we dissolve that filler 111 00:05:42,760 --> 00:05:45,920 to get rid of the swelling that sometimes might come along with it. 112 00:05:46,680 --> 00:05:49,200 So, you know, we're talking about fillers. 113 00:05:49,200 --> 00:05:52,600 And I do know I'm glad you mentioned before, the hyaluronic acid base fillers 114 00:05:53,160 --> 00:05:54,160 is that important? 115 00:05:54,160 --> 00:05:55,080 Are there certain fillers 116 00:05:55,080 --> 00:05:58,120 that can be dissolved and certain that cannot be dissolved? 117 00:05:58,840 --> 00:05:59,800 Yes, absolutely. 118 00:05:59,800 --> 00:06:02,160 So there's the whole range of fillers. 119 00:06:02,160 --> 00:06:06,920 And fortunately, hyaluronic acid is the most common filler that we use. 120 00:06:07,080 --> 00:06:10,720 But other ones, things like silicone permanent fillers, 121 00:06:10,720 --> 00:06:14,040 which typically I don't recommend using, but in some situations, 122 00:06:14,040 --> 00:06:15,360 of course, it could be appropriate. 123 00:06:16,320 --> 00:06:17,400 Those fillers don't get 124 00:06:17,400 --> 00:06:20,600 dissolved at all and they don't go away after they inject it. 125 00:06:20,880 --> 00:06:22,560 Now, there are other fillers like a drugs 126 00:06:22,560 --> 00:06:26,360 appetite that works beautifully well, but it can not be dissolved. 127 00:06:26,360 --> 00:06:27,440 So before you do it, 128 00:06:27,440 --> 00:06:31,480 you got to make sure that you this is the right filler for you. 129 00:06:31,480 --> 00:06:34,200 And, you know exactly what you're doing. 130 00:06:34,200 --> 00:06:37,120 Because if you are happy, you just cannot get rid of it. 131 00:06:37,120 --> 00:06:39,920 And if you don't mind, I don't mean to put you on the spot here, but 132 00:06:39,920 --> 00:06:42,520 can you mention some of the brand names of these fillers? 133 00:06:42,520 --> 00:06:43,040 That may be 134 00:06:43,040 --> 00:06:46,520 because I think that most people might be familiar with them a little bit better. 135 00:06:47,000 --> 00:06:49,200 They can be dissolved, of course. Yes. 136 00:06:49,200 --> 00:06:53,320 So Radius would be one of the fillers that cannot be dissolve. 137 00:06:53,360 --> 00:06:56,960 Bellafill is another filler that's that's either 138 00:06:56,960 --> 00:07:00,000 permanent or near harm or at least very long lasting. 139 00:07:00,760 --> 00:07:03,120 That could not be dissolved. 140 00:07:03,120 --> 00:07:05,800 Okay. And Sculptra is that another one? 141 00:07:05,800 --> 00:07:10,320 Sculptra is the filler that can not be dissolved, but it's a temporary filler. 142 00:07:10,320 --> 00:07:12,000 It goes away on its own. 143 00:07:12,000 --> 00:07:13,160 Okay, great. Okay. 144 00:07:13,160 --> 00:07:16,040 So, you know, with some of these permanent fillers, 145 00:07:16,040 --> 00:07:18,760 you know, before we get on to sort of the process of dissolving, 146 00:07:20,080 --> 00:07:21,000 which were the ones that you 147 00:07:21,000 --> 00:07:24,800 said you don't recommend, the silicone based ones are there? Yes. 148 00:07:24,840 --> 00:07:29,400 So silicone, it's could be appropriate in certain situations. 149 00:07:29,400 --> 00:07:29,760 Right. 150 00:07:29,760 --> 00:07:34,400 But for most people, most cosmetic patients, for people 151 00:07:34,400 --> 00:07:39,600 that are interested in facial rejuvenation or slowing down the aging process, 152 00:07:39,600 --> 00:07:44,360 that may not be the right filler because the face constantly changes. 153 00:07:44,360 --> 00:07:47,360 And the filler that was done ten years ago 154 00:07:47,560 --> 00:07:50,440 now could be completely out of place. 155 00:07:50,440 --> 00:07:53,080 Doesn't serve the purpose. It doesn't belong there. 156 00:07:53,080 --> 00:07:56,720 But since it's a permanent filler, you really cannot do anything with it. 157 00:07:56,720 --> 00:07:57,880 You cannot get rid of it. 158 00:07:57,880 --> 00:08:02,120 So that's why in those situations, silicone would not be, in 159 00:08:02,120 --> 00:08:05,120 my opinion, would not be appropriate way to treat face. 160 00:08:05,560 --> 00:08:08,920 And, you know, we're talking about these kind of quote unquote, permanent ones. 161 00:08:08,920 --> 00:08:12,840 But for most of the hyaluronic acid fillers, they've got a lifespan 162 00:08:12,840 --> 00:08:15,840 of of what, about 12 to 24 months. 163 00:08:15,840 --> 00:08:17,040 Depending on the filler. 164 00:08:17,040 --> 00:08:19,600 And fortunately, we have the whole range here. 165 00:08:19,600 --> 00:08:23,560 So it can last from six months to two years. 166 00:08:23,560 --> 00:08:23,840 Right. 167 00:08:23,840 --> 00:08:27,160 And of course, those are averages because every every patient is different 168 00:08:27,600 --> 00:08:31,480 and every filler may behave differently depending on the patient, 169 00:08:31,480 --> 00:08:35,520 depending on the facial structure and on the purpose 170 00:08:35,520 --> 00:08:39,880 and the location where we inject make it complicated enough. 171 00:08:40,520 --> 00:08:41,160 Yeah. 172 00:08:41,160 --> 00:08:43,600 No, I mean, well, listen, and this is why you want to go to 173 00:08:43,600 --> 00:08:47,760 a qualified professional who one has a range of options available. 174 00:08:48,040 --> 00:08:48,800 I always say this. 175 00:08:48,800 --> 00:08:49,360 Be careful. 176 00:08:49,360 --> 00:08:51,280 You know, don't go to the person who only has one laser 177 00:08:51,280 --> 00:08:53,000 because they're going to push you for that laser. 178 00:08:53,000 --> 00:08:56,000 You want to make sure that you're getting the right laser filler, 179 00:08:56,760 --> 00:08:59,760 whatever it might be for your particular needs. 180 00:09:00,360 --> 00:09:04,760 You know, when it when it comes to this idea of fillers and dissolving them now. 181 00:09:04,760 --> 00:09:07,440 Right. So so what does that process look like? 182 00:09:07,440 --> 00:09:12,000 And also, when should you when should you come in? 183 00:09:12,000 --> 00:09:12,240 Right. 184 00:09:12,240 --> 00:09:15,120 Because I know if you're a filler with most fillers, 185 00:09:15,120 --> 00:09:18,160 you're going to look over swollen at first, right. 186 00:09:18,160 --> 00:09:22,080 So you shouldn't go home like the next day if you wake up swollen and say, my God, 187 00:09:22,080 --> 00:09:24,160 this is too much, I've got to go dissolve it. Right. 188 00:09:24,160 --> 00:09:26,360 What is the guidelines for that? Yes. 189 00:09:26,360 --> 00:09:27,640 So you absolutely right. 190 00:09:27,640 --> 00:09:31,600 Must people and this is where I get those those calls from patients, 191 00:09:31,800 --> 00:09:33,360 especially the ones that do the lip. 192 00:09:33,360 --> 00:09:36,240 They called me the next morning. They say, my God, it's too much. 193 00:09:36,240 --> 00:09:40,320 Can I can I come in and we get rid of it and I have to tell them, look, no, 194 00:09:40,320 --> 00:09:41,360 this is just normal. 195 00:09:41,360 --> 00:09:43,520 This is the swelling. It's going to be going away. 196 00:09:43,520 --> 00:09:47,040 So I would definitely recommend waiting for at least a week, 197 00:09:47,040 --> 00:09:50,160 preferably two weeks after you had the filler injected. 198 00:09:51,200 --> 00:09:54,840 And if swelling persist beyond that time, 199 00:09:54,840 --> 00:09:59,040 then you might consider dissolving the filler or not dissolving. 200 00:09:59,040 --> 00:10:02,400 You have to have a discussion with the your plastic surgeon 201 00:10:02,400 --> 00:10:05,400 or the dermatologist or the person who is injecting it. 202 00:10:06,360 --> 00:10:08,720 And based on the experience, is a trend. 203 00:10:08,720 --> 00:10:11,400 The area or give it a little bit more time. 204 00:10:11,400 --> 00:10:13,440 Now, do you find that people you know, we talked about the lips 205 00:10:13,440 --> 00:10:15,480 and I've heard this before, that if they call the next 206 00:10:15,480 --> 00:10:17,920 if they don't call the next day and they like the way they look, 207 00:10:17,920 --> 00:10:19,520 they generally they're back for more. 208 00:10:19,520 --> 00:10:22,520 And in two or three weeks, once that swelling goes down. 209 00:10:22,640 --> 00:10:24,360 That is absolutely true. 210 00:10:24,360 --> 00:10:25,440 And I tell everybody, 211 00:10:25,440 --> 00:10:28,960 if you like your lips the next day, then you have to get more of 212 00:10:29,640 --> 00:10:32,640 that fullness is just going to go away over time. 213 00:10:32,920 --> 00:10:33,280 Okay. 214 00:10:33,280 --> 00:10:36,040 So when you're getting filler, you've done it for the first time. 215 00:10:36,040 --> 00:10:37,480 There is some normal swelling. 216 00:10:37,480 --> 00:10:41,680 So the recommendation is, don't freak out, this is normal. 217 00:10:41,840 --> 00:10:47,040 Make sure that you wait a week or two, preferably before you consider dissolving. 218 00:10:47,280 --> 00:10:49,280 That said, let's say that you're in a situation. 219 00:10:49,280 --> 00:10:51,120 You're like, This doesn't look like my cheek. 220 00:10:51,120 --> 00:10:52,360 This doesn't look like my lip. 221 00:10:52,360 --> 00:10:54,200 I don't like the placement of this. 222 00:10:54,200 --> 00:10:56,040 What is that process for? 223 00:10:56,040 --> 00:10:57,720 Dissolving filler? 224 00:10:57,720 --> 00:11:00,280 So when it starts was discussion, right? 225 00:11:00,280 --> 00:11:05,480 So we have to sit down and talk and look at the face using the mirror, 226 00:11:05,520 --> 00:11:08,520 maybe take some pictures, go over everything, 227 00:11:08,520 --> 00:11:12,000 make sure we're doing the right thing, because we are not going to end up in 228 00:11:12,160 --> 00:11:16,280 we don't want to end up in a situation when we put the filler 229 00:11:16,320 --> 00:11:19,320 and then dissolve it and put the nasal fillers somewhere else 230 00:11:19,320 --> 00:11:20,280 and then dissolve it again. 231 00:11:20,280 --> 00:11:24,520 So it's not the best way to treat the face, because obviously 232 00:11:24,520 --> 00:11:28,240 every time we do the injections there is a potential side effects. 233 00:11:28,240 --> 00:11:30,720 So we have to make sure that we do the right thing 234 00:11:30,720 --> 00:11:34,080 every time we use some kind of injection on the face. 235 00:11:34,480 --> 00:11:37,240 Now, if we both certain 236 00:11:37,240 --> 00:11:40,560 the doctor and the patient, we're both certain that while 237 00:11:40,560 --> 00:11:44,280 esthetically it's not the best look and we do have to get through it 238 00:11:44,320 --> 00:11:47,560 and then of course we go into a process of dissolving. 239 00:11:47,840 --> 00:11:50,520 Typically in my office, it starts with using the numbing cream 240 00:11:50,520 --> 00:11:52,920 because nobody wants to fill those benches. 241 00:11:52,920 --> 00:11:55,800 And then we use a special device 242 00:11:55,800 --> 00:11:58,800 that creates migration and that really helps with that pain. 243 00:11:59,080 --> 00:12:00,680 I take the medication 244 00:12:01,680 --> 00:12:02,400 typically a 245 00:12:02,400 --> 00:12:06,400 diluted because it's I found it just works a little better 246 00:12:06,400 --> 00:12:10,600 when it's not very concentrated and we inject it to the area 247 00:12:10,920 --> 00:12:13,920 where I know there is filler 248 00:12:13,960 --> 00:12:17,000 and this way it starts dissolving it. 249 00:12:17,160 --> 00:12:20,240 Now, this medication, this enzyme, it just chops the filler 250 00:12:20,240 --> 00:12:23,240 into smaller pieces and the filler gets reabsorbed. 251 00:12:23,320 --> 00:12:26,520 Typically, it happens fairly quickly was in a couple of days. 252 00:12:26,520 --> 00:12:27,360 That patient 253 00:12:27,360 --> 00:12:30,960 should see the reduction of the swelling, and the filler is going away. 254 00:12:31,320 --> 00:12:32,200 On occasion. 255 00:12:32,200 --> 00:12:34,680 It gets worse before getting better, right? 256 00:12:34,680 --> 00:12:38,120 So for the possibility when we it doesn't happen very often, 257 00:12:38,120 --> 00:12:42,640 but sometimes when we dissolving the filler, the swelling can actually increase 258 00:12:42,640 --> 00:12:45,640 for a day or two and then it starts going, okay. 259 00:12:46,200 --> 00:12:49,120 I mean, I'm just thinking about all the people if you're going through this 260 00:12:49,120 --> 00:12:51,840 and then it gets worse before it gets better, I'm here for you. 261 00:12:51,840 --> 00:12:54,480 I feel that that must be an awful feeling. 262 00:12:54,480 --> 00:12:56,120 Again, another PSA. 263 00:12:56,120 --> 00:13:00,000 Why you want to go to a reputable doctor or a surgeon that you trust? 264 00:13:01,040 --> 00:13:01,960 You know, 265 00:13:01,960 --> 00:13:05,160 with this you mentioned before that there are some side effects. 266 00:13:05,640 --> 00:13:08,440 So So what are some of the side effects 267 00:13:08,440 --> 00:13:12,240 of not only getting filler but then having to dissolve it 268 00:13:13,320 --> 00:13:15,720 right. So getting filler, of course, 269 00:13:15,720 --> 00:13:18,720 there could be a possibility of allergic reaction, 270 00:13:19,960 --> 00:13:22,160 be in any kind of, 271 00:13:22,160 --> 00:13:26,040 you know, just anything that goes along with injection, things like infection. 272 00:13:26,040 --> 00:13:28,960 We have to make sure that everything is sterile. 273 00:13:28,960 --> 00:13:32,600 We have to make sure we inject it right, to inject it to the right place, 274 00:13:32,600 --> 00:13:35,880 and then vascular occlusion is one of those dreaded complications 275 00:13:35,880 --> 00:13:38,480 that happens maybe once in a million, but it's real. 276 00:13:38,480 --> 00:13:40,880 So we have to be very mindful of that. 277 00:13:40,880 --> 00:13:45,840 Now, dissolving the filler typically is a fairly safe process. 278 00:13:45,840 --> 00:13:49,200 It's it's considered to be much safer than actually 279 00:13:49,200 --> 00:13:52,200 injecting the filler, and that's pretty safe on its own. 280 00:13:52,240 --> 00:13:55,760 So dissolving the filler, most we have to warn the patients 281 00:13:55,760 --> 00:13:58,760 that they might get some bruising, they might get increased swelling, 282 00:13:58,960 --> 00:14:00,960 they might feel a little bit of pain 283 00:14:00,960 --> 00:14:03,960 for a short period of time, but then it's just going to go away. 284 00:14:04,320 --> 00:14:07,440 Now, are there areas that, you know, 285 00:14:07,680 --> 00:14:11,720 we mentioned that you can dissolve the hyaluronic acid based fillers 286 00:14:12,040 --> 00:14:16,000 Are there areas, though, that you can't dissolve as well? 287 00:14:17,840 --> 00:14:21,600 It becomes hard to dissolve old filler. 288 00:14:21,840 --> 00:14:22,400 Okay. 289 00:14:22,400 --> 00:14:27,240 Not necessarily specific to the area, but when the filler was placed 290 00:14:27,240 --> 00:14:30,960 some time ago, maybe a year ago, and this is the reason why 291 00:14:31,360 --> 00:14:34,040 I recommend people once you see the swelling 292 00:14:34,040 --> 00:14:37,040 that doesn't go away, then go to the doctor and take care of it. 293 00:14:37,200 --> 00:14:38,160 Because the longer 294 00:14:38,160 --> 00:14:42,080 the filler sits there, the further it's going to spread throughout the tissue. 295 00:14:42,080 --> 00:14:45,600 Just with normal facial movement was smiling, was talking. 296 00:14:46,200 --> 00:14:49,800 The filler is just going to be moving all around all those muscles. 297 00:14:49,800 --> 00:14:54,360 So finding that filler and injecting it exactly to the area 298 00:14:54,360 --> 00:14:58,040 where the filler is becomes harder and harder as the time goes on. 299 00:14:58,320 --> 00:15:00,600 So that can create a problem. 300 00:15:00,600 --> 00:15:02,000 And sometimes people 301 00:15:02,000 --> 00:15:05,160 who had the filler done two years ago and they still have swelling, 302 00:15:05,400 --> 00:15:10,040 we go through rounds and rounds of those injections trying to find that 303 00:15:10,040 --> 00:15:14,400 specific area where the filler sits now and where it's causing the problem. 304 00:15:14,880 --> 00:15:18,160 You know, you brought up a good point because you keep mentioning 305 00:15:18,160 --> 00:15:22,000 that, you know, this filler that you have to inject where the filler was. 306 00:15:22,000 --> 00:15:23,280 You need to figure that out. 307 00:15:23,280 --> 00:15:27,240 In general, if you are going to a doctor who you trust, 308 00:15:28,040 --> 00:15:30,120 you know, not a Groupon where you got the filler 309 00:15:30,120 --> 00:15:31,680 and then you go to another doctor to fix it. 310 00:15:31,680 --> 00:15:35,400 But do you recommend sticking with the same doctor if you trust them, 311 00:15:35,720 --> 00:15:37,880 who did the filler to also do the dissolving 312 00:15:37,880 --> 00:15:39,800 because they'll at least know where it was placed? 313 00:15:39,800 --> 00:15:43,200 Or can a regular can another qualified 314 00:15:43,200 --> 00:15:46,800 medical professional generally be able to tell where that filler is sitting? 315 00:15:48,360 --> 00:15:49,560 Yes, you are absolutely right. 316 00:15:49,560 --> 00:15:51,080 So the first thing in 317 00:15:51,080 --> 00:15:54,840 when somebody calls my office and say they want to dissolve filler, my 318 00:15:54,840 --> 00:15:59,040 receptionist would tell them we recommend actually going to the same doctor. 319 00:15:59,040 --> 00:16:03,360 But if doctor is not available or the relationship with that 320 00:16:03,360 --> 00:16:07,080 doctor may be broken and people want to look for somebody else, 321 00:16:07,520 --> 00:16:10,560 definitely we will help to dissolve the filler. 322 00:16:10,560 --> 00:16:15,040 But the best person to dissolve it would be the doctor who injected it 323 00:16:15,240 --> 00:16:18,760 because they know exactly where to place the filler and where to find it. 324 00:16:19,640 --> 00:16:21,720 You know, another thing that's so interesting 325 00:16:21,720 --> 00:16:23,720 is that you talk about old filler, right? 326 00:16:23,720 --> 00:16:27,520 But for these hyaluronic based acids that last between you said six months 327 00:16:27,520 --> 00:16:29,160 to 24 months, about two years. 328 00:16:30,120 --> 00:16:31,160 Well, 329 00:16:31,160 --> 00:16:34,520 I mean, shouldn't it all be gone by that point two years later? 330 00:16:34,520 --> 00:16:36,720 Shouldn't there be no sort of semblance of that? 331 00:16:36,720 --> 00:16:38,560 Or are there, you know, do 332 00:16:38,560 --> 00:16:41,560 we need to make sure that we're keeping track of where we've had everything done? 333 00:16:42,520 --> 00:16:45,000 It's unfortunately, it's not. 334 00:16:45,000 --> 00:16:46,440 And here we entering 335 00:16:46,440 --> 00:16:50,160 there's some some pharmacology and the concept of shelf life. 336 00:16:50,160 --> 00:16:50,960 Right. 337 00:16:50,960 --> 00:16:54,760 So the filler may it might take years and years 338 00:16:54,760 --> 00:16:57,760 and years for the filler to go away completely. 339 00:16:57,840 --> 00:17:00,920 It's just becomes less and less and less of it. 340 00:17:01,320 --> 00:17:05,640 And even though the external manifestations of the filler 341 00:17:05,640 --> 00:17:09,480 are pretty much gone and might be gone for a year or two, 342 00:17:09,760 --> 00:17:12,560 there's still a very small amount of that filler 343 00:17:12,560 --> 00:17:14,680 that could be sitting there in a tissue, 344 00:17:14,680 --> 00:17:15,560 and that's going to be 345 00:17:15,560 --> 00:17:19,720 getting smaller and smaller, but it still can cause the side effects such as well. 346 00:17:20,760 --> 00:17:21,760 So one 347 00:17:21,760 --> 00:17:25,520 thing I have to ask before I let you go is do you find, you know, 348 00:17:25,640 --> 00:17:27,080 there was such a boom in fillers 349 00:17:27,080 --> 00:17:30,600 and I feel like now there are you know, technology is always changing. 350 00:17:31,120 --> 00:17:35,400 As a facial plastic surgeon, are there times when you would say people 351 00:17:35,400 --> 00:17:36,240 to people 352 00:17:36,240 --> 00:17:39,080 maybe don't get filler if you think you might need a facelift 353 00:17:39,080 --> 00:17:41,200 down the road because it might cause scar tissue? 354 00:17:41,200 --> 00:17:43,560 Or are there any concerns there? 355 00:17:43,560 --> 00:17:46,200 You know, for somebody who's thinking about filler, 356 00:17:46,200 --> 00:17:49,240 I know with threads, the reason I'm getting this, those facial threads, 357 00:17:49,480 --> 00:17:52,280 I spoke to a lot of plastic surgeons who say 358 00:17:52,280 --> 00:17:55,440 they won't operate and people would add threading because of the scar tissue. 359 00:17:56,400 --> 00:17:59,400 So when it comes to or presents a lot of problems, 360 00:18:00,000 --> 00:18:01,240 is that the same with fillers? 361 00:18:01,240 --> 00:18:03,080 Is there anything that we should be thinking about 362 00:18:03,080 --> 00:18:05,520 before we go for our first one. 363 00:18:05,520 --> 00:18:10,080 The ending on that type of filler and depending on the area that's injected. 364 00:18:10,080 --> 00:18:12,000 So certain fillers like sculpture 365 00:18:12,000 --> 00:18:15,920 that you mentioned, it's known to leave the scar tissue behind. 366 00:18:16,240 --> 00:18:20,400 So those fillers, definitely if somebody is considering a facelift, may not. 367 00:18:20,400 --> 00:18:24,840 The idea of getting sculpture a few years before the facelift 368 00:18:24,840 --> 00:18:28,640 because it could create sufficient scar tissue to cause not the problem, 369 00:18:28,640 --> 00:18:31,640 but maybe some additional difficulties during the surgery. 370 00:18:31,800 --> 00:18:34,000 Now, hyaluronic acid filler is considered 371 00:18:34,000 --> 00:18:38,600 to be fairly benign as far as creating the scar tissue. 372 00:18:38,880 --> 00:18:42,120 So the only reason not to get them is just 373 00:18:42,120 --> 00:18:46,200 why spend money on something that may not be necessary. 374 00:18:46,440 --> 00:18:48,240 So if you I tell my patients 375 00:18:48,240 --> 00:18:51,360 if you're planning to get a facelift within six months to a year, 376 00:18:51,600 --> 00:18:55,600 there is no point of doing the fillers in the cheek or around the jawline. 377 00:18:55,600 --> 00:18:56,080 Right. 378 00:18:56,080 --> 00:18:58,440 It's just it's just not necessary. 379 00:18:58,440 --> 00:18:59,400 Why spend the money? 380 00:18:59,400 --> 00:19:02,400 On the other hand, if somebody wants to get the fillers in the lid, 381 00:19:02,400 --> 00:19:06,200 that would be perfectly fine if they want to get a facelift fairly soon 382 00:19:06,200 --> 00:19:09,240 because one really would not affect the hazard. 383 00:19:10,080 --> 00:19:12,680 I want to thank you so much for your time today. 384 00:19:12,680 --> 00:19:18,000 Before I let you go, You know, are there any sort of do you have a favorite filler? 385 00:19:18,000 --> 00:19:19,480 Do you have a favorite area? 386 00:19:19,480 --> 00:19:21,840 Do you think that there's one thing I know, people are so different 387 00:19:21,840 --> 00:19:25,920 and every face is different, but is there one that you find really 388 00:19:25,920 --> 00:19:28,920 makes that wow difference? 389 00:19:29,080 --> 00:19:31,760 Well, it's either the cheeks or the lips, right? 390 00:19:31,760 --> 00:19:36,080 So those are the two areas that will create that Wow. 391 00:19:36,080 --> 00:19:37,320 Affect them on your friends. 392 00:19:37,320 --> 00:19:39,960 They will say, my God, you look good today. Right? 393 00:19:39,960 --> 00:19:43,520 So and of course, in the cheeks, I in my practice 394 00:19:43,520 --> 00:19:49,760 and I kind of no relation to the company I used juvederm volume up right. 395 00:19:49,800 --> 00:19:53,280 And then the lips we typically use Val Bela those are two different fillers. 396 00:19:53,480 --> 00:19:57,000 One is much thicker and longer lasting and then another one looks very natural. 397 00:19:57,000 --> 00:20:00,560 And that's the reason why we use them in those specific areas. 398 00:20:01,120 --> 00:20:03,120 Dr. Konstantin, I want to thank you so much. 399 00:20:03,120 --> 00:20:05,400 I really do appreciate because I think that 400 00:20:05,400 --> 00:20:08,400 some of these procedures that might not seem like a big step, 401 00:20:08,880 --> 00:20:11,840 you know, can can not always work for somebody. 402 00:20:11,840 --> 00:20:15,480 So it's, I think, equally as important to know, hey, can we undo this? 403 00:20:16,000 --> 00:20:19,560 For clarification, Botox is not undoable, correct? 404 00:20:20,000 --> 00:20:25,240 No, Botox is not undoable, but it unfortunately doesn't last quite as long. 405 00:20:25,240 --> 00:20:27,840 So even if you're unhappy with the results of Botox, 406 00:20:27,840 --> 00:20:30,560 all you have to do is just wait for a couple of months. 407 00:20:30,560 --> 00:20:31,560 Wait it out. 408 00:20:31,560 --> 00:20:33,600 Thank you so much for being with us today. 409 00:20:33,600 --> 00:20:36,240 If people want to come and find you, what's the best way for them to reach you? 410 00:20:37,280 --> 00:20:38,840 They can find me online. 411 00:20:38,840 --> 00:20:40,240 Of course they can. Google Dr. 412 00:20:40,240 --> 00:20:45,480 Konstantin, New York City, or they can call us 2123803634. 413 00:20:46,000 --> 00:20:48,240 Amazing. And I will make sure to have that information 414 00:20:48,240 --> 00:20:49,720 and those links in the show notes. 415 00:20:49,720 --> 00:20:51,760 I want to thank you so much for being with us today. 416 00:20:51,760 --> 00:20:54,120 And happy holidays to you. 417 00:20:54,120 --> 00:20:55,760 Thank you. The same to you. 418 00:20:55,760 --> 00:20:57,840 And if you have questions you want me to pass along to Dr. 419 00:20:57,840 --> 00:21:00,000 Konstantin or his team, I'm always happy to do so. 420 00:21:00,000 --> 00:21:02,400 You can email me at hello@artbeautypodcast.com. 421 00:21:02,400 --> 00:21:06,480 You can find us on Facebook, Instagram and YouTube @artbeautypodcast. 422 00:21:06,480 --> 00:21:09,280 And as always, we will see you next Tuesday. Bye!