Monday, July 28, 2014

Combining Dermal Fillers With Other Procedures

Once you add cosmetic injections to your practice you will soon find yourself in conversations with patients who are also going through other various anti-aging treatments including laser treatment, chemical peels, Botox, radiofrequency treatments and aesthetic plastic surgery.  Here is a look at how you might possibly find yourself treating each one should your dermal injections be part of combination of therapies.

Fillers and Chemical peels

It is likely that you will encounter a patient that is undergoing a chemical peel to smooth out the face. You might also be asked if you can a chemical peel after you have administrated dermal fillers. 

For the most part you should avoid administering injections to skin that is inflamed as this can cause degradation of the filler.  It is best to wait a few days to do even the mildest of chemical peels however a superficial chemical peel can be tolerated by a patient.  Very deep tricholoroacetic acid peels and collagen remodeling using a peel are procedures that should never go hand in hand with dermal fillers.  A wait of two weeks is recommended in these cases.

Fillers and Botox

Fillers and Botox are now being applied in tandem to rejuvenate the look of the space, however not during the same office visit. It is best to apply the Botox first, because it relaxes the muscles and then administers fillers two weeks or so after that.

The only exception to this rule is possibly in the case of the patient with a very deep nasolabial groove. In this case fillers are injected first followed by the Botox.

Fillers and Laser Treatments

As most lasers use water as a chrompohore there is the risk that the use of them can dissolve hyaluronic acid-based fillers.  This is not an area where a lot of studies are done and even though some doctors do administer both laser treatments and dermal fillers at the same time, it is usually not recommended.  This is because discoloured pigment in the skin can be the result, especially if your patient has darker skin.

Fillers and Radiofrequency

Popular home radiofrequency tool
This is not an area where there has been a great deal of clinical research but for the most part the two therapies are considered to be copasetic, but not necessarily synergistic. To be safe, do these treatments separately.

Fillers and Plastic Surgery

Fillers are indeed used on a patient a few weeks after plastic surgery. Once surgery fillers contour the face can help add volume to the face and achieve finer corrections.  Fillers are often considered to be like the final polish to a plastic surgeon’s work.

Perhaps the rule of thumb to remember is that it is best to separate treatments wherever possible to avoid any complications, no matter how tempting it might seem to you or your patient to do two procedures at once.

For more information about The Pinewood Institute for the Advancement of Natural Medicine courses including course outlines, detailed descriptions of courses and information about upcoming training sessions, please go  You can also send us an email using our email form at or call us at 416-656-8100. If you prefer to fax the number is 416-656-8107.

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