We recently held the 2nd episode (watch full video) of our webinar series where expert plastic surgeons, Dr. Matt Stefanelli, Dr. Sofia Carvalho and Dr. Piero Crabai talked extensively about hip dips, the anatomy and their modification with HA body fillers. At BioScience, we are consistently driven to empower professionals through education and training on our products and their use. This is why our team has compiled the answers to all your questions raised during the webinar.
Q1. Which HYAcorp Body Filler is used for Hip Dips Correction?
A1. HYAcorp MLF2 is being used for hip dips correction. Due to its particle size being bigger, it’s more adapted to indications like buttocks and hips. HYAcorp MLF1 can be used in hips but only in the superficial layer of the skin.
Q2. What is the density and viscosity of HYAcorp Body Fillers?
A2. Density is the measure of mass/volume (gr/mL) and is not so relevant for fillers. Meanwhile, the viscosity (defined as its capacity to remain at the injection site or to spread into the tissues) of MLF1 or MLF2, is 14.000 – 20.000 mPas.
Q3. What is the difference between HYAcorp MLF1 and HYAcorp MLF2?
A3. While the concentration of hyaluronic acid in HYAcorp body fillers is 20mg/mL, the particle size is different in both gels, namely 200-350um for MLF1 and 300-500um for MLF2. Moreover, they have different rheological characteristics. For instance, MLF2 is the firmer compared to MLF1 which is why it is indicated for the bigger indications.
Q4. Where should the tumescent be injected?
A4. It should be injected at the entry point and in the injection area.
Q5. Do you use any injectable lidocaine before the filler injection?
A5. Yes, it is recommended to use Zylocaine+epinephrine with 30G needle at the entry points in small amounts and 10cc with 22G cannula in the injection areas.
Q6. What kind of cannula do you use for injection and what diameter?
A6. Blunt Tip cannula of 18G x 100mm is ideal for injection of HYAcorp MLF2.
Q7. How many mLs of body filler is ideal?
A7. It depends on the patient but we advise between 20 and 50 mL on each side per session. A trained injector can go up to administering 70 cc per side which is the maximum advisable amount.
Q8. Can you please show the directions and entry point for buttocks?
A8. This depends on the area to inject. A general recommendation is never enter from the bottom and avoid downward angulation of cannula.
Q9. Which layer of the skin should we inject the body filler in and are there in notes or caution to be mindful of?
A9. The injection of body fillers should be done in the subcutaneous plane. The neurovascular structures (superior and inferior gluteal arteries) are in the muscular planes.
From the technical point of view, the angle of incidence states the level of the infiltration. The angle of 60° reaches the deep layer of subcutaneous tissue / fat under the camper’s fascia, the 30° angle is over the camper’s fascia. This can have a different behaviour in the tissue. The more superficial we are injecting the higher is the vascularity which can create further inflammatory responses.
On the contrary, the deeper the infiltration, lesser is the inflammation. From the result point of view, superficial infiltration gives more volume, and less volume when we inject deeper. So, the possibility to have two products one softer than the other (such as MLF1 and MLF2) gives us the possibility to infiltrate the two layers for optimal results.
Q10. Is filler migration possible to the lower part of the hips? How to prevent it and what factors can affect this migration?
A10. If we use a product specially designed and indicated for this kind of procedure such as HYAcorp MLF1 or MLF2, and the right technique, we’ll have a very low risk of migration. However, migration could occur if the patient presents skin laxity. In this case, it is better to start with a low amount of product and give more superficial injections.
Q11. Is anterior injection in the trochanteric area more susceptible to migration?
A11. The trochanteric region is safe for enhancement using the proper technique and products.
The absence of gluteal muscles in this lateral area makes the probability of migration very low, as well as intravascular injection.
The zone of greatest risk of migration is the inferior zone of the gluteus in the ischial tuberosity region, associated with sitting. That’s why the right technique involves performing it above this plane.
Q12. How long does the body filler last before a patient requires touchup?
A12. The duration depends on the patient’s lifestyle. In general MLF1 and MLF2 lasts up to 24 months. During this period the product gradually reabsorbs, so based on the patient’s request the doctor will decide when it’s time for a touch-up. However, to avoid a large amount of product to be injected in the first session, the doctor may decide to inject a safe amount of product initially (50ml/side) and with the amount needed in the second session (after 3-4 weeks) to complete the procedure.
Q13. What is the average topup volume after the results fade?
A13. A touch-up volume could be approximately 20/30 ml per side or more depending on the patient’s need.
Q14. Which is the antibiotic of choice for this treatment?
A14. A broad-spectrum antibiotic such as Augmentin 1g twice per day is ideal.
Q15. Can exercise have an impact on the result?
A15. Strenuous exercises should be avoided for at least for 2 weeks after the product is totally integrated in the tissue to extend the results with HYAcorp body fillers.
Q16. Is there any BMI range for the ideal candidate?
A16. In general, HYAcorp body fillers are ideal for patients with low BMI.
Q17. What is the risk of intravascular injection? Is there a risk of palpable nodules and thromboembolism as in BBL?
A17. With a trained injector the risk of intravascular injection is very low, almost none. Also because, unlike for the buttocks, there are no muscular fascias under the fat where the neurovascular structures reside. Palpable Nodules are also very rare and mainly depend on the injection technique. For this reason it is advisable to give a cycle of antibiotics after the procedure.
Q18. What are the contraindications of body fillers?
A18. HYAcorp MLF1 and MLF2 use is contraindicated for breast and genital augmentation as well as for the face.
Q19. Can HA Body fillers be combined with PRP (Platelet-rich plasma)?
A19. Yes, HA and PRP can be combined.
Fake or Unsafe fillers are a huge public-health problem in our industry. How can we make sure to purchase authentic products?
There can be many counterfeit or fake products found in the market at a cost cheaper than the market value.To avoid them, it is crucial to be sure of the following:
- Special Trademarks
The filler should be certified by a governing authority such as BioScience fillers which are all CE Mark certified. This mark guarantees the product’s conformity to EU regulations. After which you need to ensure that the product bears the correct symbol on the boxes.
They also come bearing the holographic seal which in case broken is a sign that the product may be unsafe. It is also better to check the images of the product online at the official website and compare to detect any misspellings or design elements that match.
- Product identification
Products such as medical devices are required to have some sort of identification such as a batch code/lot number which is required in order to be able to trace and recall the products. These should always be on the package, and if you are ever in doubt, you can ask the parent company for the identifications prior to making a purchase.
While the above tips can help detect the counterfeit from the original, it is always best to purchase products from trusted sources – you can contact the parent company to get the details of their local verified distributor.
How can I buy HYAcorp for my practice?
Contact [email protected] and our team will put you in contact with our local distributor.
How to contact the specialists from this webinar?
Dr. Matt Stefanelli
Dr. Sofia Carvalho
Dr. Piero Crabai