Fillers have become one of the most talked-about cosmetic treatments, and one of the most misunderstood. We asked Rachell Wong, Nurse Injector and Cosmetic Lead at Rejuvenation Dermatology Edmonton, to explain in plain terms what filler is, how it differs from Botox®, and how she talks to patients honestly about safety.
What a dermal filler is
Rachell explains that dermal filler is hyaluronic acid (HA). It can be made in different thicknesses, or viscosities, depending on what the injector wants to mimic. A firmer product can imitate a little bit of bone-like structure, another can mimic a fat pad, and a lighter one can simply bring hydration into the skin.
That is why one brand name rarely tells the whole story. At Rejuv Edmonton, HA filler options include Juvederm®, Restylane® and Revanesse®, and your injector chooses the product to match the job.
How filler is different from Botox®
Botox® works on muscles. It relaxes the muscles that cause lines in the skin, or muscles that pull certain features or areas downward. Filler does something very different: it hydrates, or adds volume and support. The two often address different concerns, and a plan may use one, the other, or both.
Why everyone is talking about filler
In Rachell's view, filler has made a really big difference in the cosmetic industry. Depending on how it is used, it has been a treatment that could replace surgery for some people. But some people got a little too excited with it, and results started to look overdone, so filler almost has a bad name that injectors now have to combat. That matters, she says, because nothing brings in volume and support the way filler does. (Read how she avoids that overdone look in The Art of Injectables.)
An honest look at filler safety
Rachell describes filler as pretty safe overall, and explains her reasoning. HA occurs naturally in our skin, and the body naturally produces hyaluronidase, an enzyme that breaks down HA filler. She told us the clinic also keeps hyaluronidase on hand at all times. It can be used cosmetically to adjust a result, or used to flood the whole area if there is any concern about a blocked blood vessel, known as a vascular occlusion.
She is equally clear that serious complications can happen. Rachell told us the clinic has been open for more than seven years without a case of occlusion, but she stresses that it is a numbers game: based on the studies, it can happen, and she puts the chance at less than 1 percent. No injectable is risk-free, and that is exactly why preparation and aftercare matter.
Normal side effects vs. warning signs
What is usually normal: a little swelling and possible bruising. Depending on the treatment, you may be asked to do some gentle massaging afterward. Rachell told us the clinic offers complimentary laser treatment if a patient does bruise.
What is not normal. For vascular occlusion, the most serious potential complication, Rachell says to watch for:
- an unusual net-like pattern of redness or bruising;
- blistering across the treated area;
- intense pain, the kind you can't sleep through, that feels like something is genuinely wrong.
Rachell says every patient is given the signs and symptoms to watch for and a 24-hour number to call, and her message is simple: even if it is 3:00 a.m., call. If you were treated somewhere else and notice these signs, contact your provider right away or seek urgent medical care.
Choosing a provider: what to ask
Rachell's first questions would be about the provider's experience and what training they have had. She feels Rejuv has an advantage because its injectors work alongside dermatologists who perform surgery on the face. They know the underlying structures and, if something goes wrong, exactly what to do to correct it. In her view, that dermatology backing is what sets the clinic apart from med spas, family doctor clinics or dental offices that also offer injectables.
Based on her answers, questions worth asking before any filler appointment include:
- How much experience do you have with filler, and what training have you had?
- Do you keep hyaluronidase on hand, and what is your plan if there is a complication?
- What warning signs should I watch for, and how do I reach you after hours?
- Is filler the right tool for my concern, or would something else work better?
Ready to talk through options? Book a consultation, explore injectables at Rejuv Edmonton, or call (587) 442-9121.
This article shares Rachell Wong's experience and approach, paraphrased from our interview with her. It is general information, not medical advice. Every face is different, every treatment carries some risk, and your plan is set with your provider at consultation. If you think you are having a complication after any injectable treatment, contact your provider right away or seek urgent medical care.
