1. Understand the Challenge.
An estimated 12,000 Americans turn 50 each day, according to Susan H.
Weinkle, MD, speaking at the Winter Clinical Dermatology Conference in Kaui in January. Most
cosmetic procedures (83 percent) are non-surgical. When it comes to using fillers, recognize the contributors
to loss of volume: bony architecture, loss and distribution of fat, thinning of the dermis,
and atrophic volume distribution due to gravity, motion, and sleeping, Dr. Weinkle says.
2. Minimize Infection Risk.
Biofilms present risk of infection. To minimize risks, cleanse the skin prior to
treatment with an antibacterial, Dr. Weinkle says. One option she recommends is TechniCare Scrub
(Care-Tech Laboratories).
3. Reduce Bruising.
Pre-treatment with vitamin K supplements can help to reduce the risk of bruising, Dr.
Weinkle notes. Two options include Auriderm Gel (Biopelle) or Arnica Forte (Boiron). If bruising
develops, treatment with the V-Beam laser (Candela; 10mm spot, 6-10J/cm2, 10-29msec) will help
reduce it, she says.
4. Keep Hyaluronidase On-hand.
Hyaluronidase can be used to correct a poor injection result, including overcorrection,
Dr. Weinkle says. The agent (Amphadase 1mL, Custom Scripts Pharmacy) is
also useful if a patient experiences a reaction to hyaluronic acid, she says, because it disintegrates
the product.
5. Give Patients a Hand.
Reverse the appearance of aged hands by adding volume with hyaluronic acid, Poly-
L-lactic acid, or calcium hydroxylapatite, Dr. Weinkle suggests. Results when these fillers are used
in the hands may last up to two years.
