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Body fillers

Sun, 2012-02-05 01:16 -- csb


Want better curves without implants? Bervin Cheong fills you in on the use of body fillers for breast and buttock augmentation.

Such is life that some areas of the body can be sculpted and trimmed through good diet and exercise, but other areas need to be filled out for us to feel that we are perfect. The breasts and buttocks for example, are almost impossible to add volume to in this way, even with focused exercises.

Malaysian plastic surgeon Dr. Eileen Fong says that surgery is still the number one choice if one is looking for a significant increase in size.
Malaysian plastic surgeon Dr. Eileen Fong says that surgery is still the number one choice if one is looking for a significant increase in size.

The breasts and buttocks are areas on a woman that men deem to be points of attraction. Terms like ‘butt man’ or ‘breast man’ refer to men with a partiality for those parts of the female anatomy. This perhaps reflects the importance of these body parts from an aesthetic point of view.

Until recently, the only option for increasing volume in these areas was with surgical implants. However, not everyone is comfortable with the idea of going under the knife. Understandably, surgical procedures do come with their own set of risks and if given the choice, many would prefer a minimally invasive procedure with less complications, downtime, and scars!

Fill Me Up!

The answer can now be found in dermal fillers, which have been around for quite some time and have become one of the more popular facial rejuvenation options. From filling up lips to plumping out hollow cheeks and even reshaping the chin or nose tip, doctors are using dermal fillers more and more these days to add or restore volume in certain areas – they are safe, cheap and convenient.

"I find that the use of body fillers like Macrolane injections is an exciting option for patients who are having liposuction to the hips, flanks and saddle areas. By augmenting the buttocks, it gives a more shapely contour to the lumbo-sacral region and makes the curvature of the buttocks more attractive and sensual!" – Malaysian plastic surgeon, Dr. Charles Lee.

Pictures courtesy of Dr. Charless Lee

Dr. Lee injecting Macrolane VRF30 into the right buttock of a woman.

Dr. Lee injecting Macrolane VRF30 into the right buttock of a woman.

However, dermal fillers are not indicated for use in body shaping. Although fillers like Aquamid® and ArteColl® have been used by some to shape the breasts and buttocks, plastic surgeons on the whole are cautioning against it.

Malaysian plastic surgeon, Dr. Eileen Fong comments, "Dermal fillers have been developed for use in the face and injecting it in other parts of the body like the breasts or buttocks is not advisable. One may not get the results desired and dermal fillers are not cost effective enough for shaping the body."

But fillers for the body have now come onto the market. One such example is Macrolane™ VRF (Volume Restoration Factor) from Q-Med, which offers volume restoration and shaping of body surfaces.

Dr. Charles Lee, a Malaysian plastic surgeon says, "Macrolane is the first hyaluronic acid product to be launched for volume restoration and contouring of body surfaces that is based on Q-Med’s proven and patented NASHA™ (non-animal, stabilised hyaluronic acid) technology."

Hyaluronic acid is a naturally occurring polysaccharide (sugar derivative) found in the structure between cells in all tissues of the body. It is, therefore, a biodegradable and biocompatible material, making its use in body shaping predictable and sustainable.

The efficacy and safety of Restylane®, a hyaluronic acid dermal filler for the face which was introduced by the same company more than a decade ago, has been widely documented and published. Macrolane, however, was specially created for body shaping. "Unlike dermal fillers, Macrolane has a thicker gel which allows it to provide enough lifting capacity to be injected in large volumes safely, and yet, be economically feasible," adds Dr. Fong.

While currently indicated for volume restoration and shaping of the body (the breasts, buttocks and calves), Macrolane can also even out discrepancies on the skin surface of the body, such as those caused by liposuction. Macrolane can also be used to improve the appearance of deep, disfiguring surgical scars.

Of Busts and Butts

The fact that fillers can be used for augmenting the breasts and buttocks has gotten everyone excited. You can now choose a minimally invasive method for larger breasts or firmer, fuller buttocks. Results can be achieved with a simple injection as opposed to careful placement of implants via surgery.

Buttocks before augmentation and with pre-op markings

Buttocks before augmentation and with pre-op markings

Buttock augmentation using macrolane was performed on the areas marked in red, while liposuction was  performed on areas marked in blue.

Buttock augmentation using macrolane was performed on the areas marked in red, while liposuction was performed on areas marked in blue.

Dr. Lee comments, "Filler injections can be performed as an office-based treatment under a sterile environment during a convenient, ‘walk-in, walk-out’ session. Treatment is carried out under local anaesthesia, but if a larger volume is required to be injected, then it is carried out under monitored anaesthesia care (where the sedative dosage is low enough that patients remain responsive and breathe without assistance). This makes it a minimally invasive procedure that gives the patient added comfort and a quick recovery."

Pictures courtesy of Dr. Charless Lee
One Week After
One Week After
Three Weeks After: pictures below showing patient with fuller buttocks and better curvature after her cosmetic procedures.
Three Weeks After: pictures below showing patient with fuller buttocks and better curvature after her cosmetic procedures.

Dr. Fong adds on, "Following the infiltration of the anaesthetic, the filler is injected using a blunt cannula in several directions until the desired contour is achieved. As the procedure is rather quick, taking barely more than an hour, recovery is fast as well, and one can even go back to work the next day!"

Dr. Lee says that the augmented area will feel firm for one week and this becomes softer as time passes. Thereafter, the augmented area should feel natural and no one should be able to tell that any work has been done. The risks (inflammatory reactions) are minimal and side effects such as tenderness, discomfort and redness are temporary and should go away within a day or so.

Unlike dermal fillers, body filler injections are rather costly and the price can end up being higher than regular implant procedures. "I think cost may be an issue here in Malaysia as Macrolane can cost more than augmentation with implants. Breast augmentation with implants is reasonably affordable in Malaysia," comments Dr. Fong.

"The cost varies according to the site and volume of filler injected and of course, will vary slightly between different doctors," says Dr. Lee.
In general, the cost of Macrolane injections range from RM15,000 to RM25,000, while regular implants for the buttocks and breasts cost around RM8,000 to RM12,000 and RM12,000 to RM18,000 respectively.

"It is a fairly quick, minimally invasive procedure with minimal downtime. So, if one wants to be discreet about getting breast augmentation, then this may be the ideal solution." – Malaysian plastic surgeon, Dr. Eileen Fong.

Pictures courtesy of Q-MED

Before

Before

After

After

Before

Before

After: A patient after breast augmentation using Macrolane injectable body filler.

After: A patient after breast augmentation using Macrolane injectable body filler.

Another fact to note is that body fillers are temporary and only last between one to two years in the body. Unlike implants, which are permanent, repeat treatments with body fillers are needed to maintain the shape desired. This can push the cost for bigger breasts and shapelier buttocks even higher.

Filling The Difference

According to plastic surgeons, the technique for both breast and buttock augmentation using body fillers is essentially similar, except that they are carried out at different sites of the body.

Dr. Lee comments, "While being technically the same, a more refined estimate of how much body filler to inject is needed during pre-operative planning for breast augmentation. This is because the doctor has a smaller margin of error to work with to ensure the outcome is aesthetically pleasing and the breasts look natural."

Both men and women are suitable candidates for body shaping procedures using body fillers. It is perfect for those with small buttocks who want more projection and fullness. It can also be used for patients who have had fat injections in their buttocks that have resulted in fat resorption and asymmetry, to correct the unequal size.

Fillers can only achieve a modest increase in breast size, however. Dr. Fong stresses, "There is only so much that a filler can do. Here, we are looking at a modest increase in size, and if one is looking for a significant increase in size, then implants will still be the number one choice. This procedure is also unsuitable for those with extremely saggy breasts and stretched, thinned out tissues."

Dr. Fong adds, "Fillers can also be used for shaping the male chest. This gives the illusion of bigger and shapelier pectorals. Nevertheless, because there is not much tissue cover or ‘cushion effect’ in the male chest, one would tend to use a filler of lower viscosity."

Filling Safe

As hyaluronic acid body fillers are naturally degraded by the body, long-term adverse effects are unlikely. This is unlike permanent synthetic fillers such as polyacrylamide hydrogel and silicone oil, where serious adverse effects have been reported. In these cases, permanent hardening in the areas injected, calcification and malignant change has happened.

Will the body filler in the breasts affect mammograms? Dr. Fong answers, "There will be some reduction of visualisation with the mammogram and hence MRI screening would be a better option than mammograms following filler injections for breast augmentation."

While body fillers are said to be safe, there are still worries. Dr. Fong expresses her concern, "My concern is that there may be unscrupulous people out there who will claim to be using body fillers, but are in fact using something else likely silicone oil (which is cheap and easily obtainable) or polyacrylamide gel. I would advise every patient to ask to see the labels of the product used to ensure they are being given what is promised. For example, Macrolane is packaged in boxes of 10ml, and every 10ml should have a label with a serial number."

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