DR. SNEZHANA ATANASOVA
AT WHAT AGE CAN FILLERS BE INJECTED?
There are no specific age restrictions. As dermatologists, we always make decisions based on the indications and the individual characteristics of the patient’s face. Of course, we do not perform procedures on minors without the presence and consent of a parent or legal guardian.
IN WHICH CASES DO YOU REFUSE TO INJECT A FILLER FOR A PATIENT?
Usually, these are either very young patients who have no real indications for the procedure, or older patients who have not previously maintained their facial appearance and come to me with pronounced tissue ptosis and significant age-related skin changes. In such cases, I refuse the procedure and refer them to a plastic surgeon instead.
A proper assessment is extremely important for these patients. They should not be promised results that simply cannot be achieved. To avoid unnecessary disappointment, such procedures should be performed only by qualified dermatologists or plastic surgeons.
WHO IS QUALIFIED TO PERFORM SUCH PROCEDURES?
This should be a dermatologist who specializes in aesthetic dermatology or a plastic surgeon. Under no circumstances should such procedures be performed by a dentist or a physician from another specialty. Likewise, it is not acceptable for them to be carried out by a nurse or a cosmetologist.
These are highly specialized procedures that require specific knowledge of dermatology and considerable practical expertise. When a patient comes to us, as dermatologists, we conduct a comprehensive facial assessment — evaluating the condition of the skin and underlying structures, taking a detailed medical history, and selecting an individualized treatment approach.
Naturally, this cannot be done properly and competently by physicians from unrelated specialties, let alone by individuals without medical qualifications.
WHAT ARE THE RISKS OF IMPROPER FILLER INJECTION?
The risks are numerous. Any procedure that involves breaking the skin barrier — such as filler injections, Botox, thread lifts, mesotherapy, or ablative laser treatments — can lead to various complications, ranging from a simple infection or allergic reaction to tissue necrosis.
Unfortunately, cases of necrosis have become increasingly common in Bulgaria in recent years because such procedures are often performed by unqualified practitioners. The consequences of necrosis can be very serious, ranging from permanent scarring to irreversible blindness.
IS IT POSSIBLE TO CORRECT THE MISTAKE?
Yes, it is possible. However, only dermatologists who specialize in aesthetic dermatology and plastic surgeons know how to manage such situations properly. We undergo specialized training on complications on a regular basis and are taught how to recognize and treat them promptly.
The most important thing is not to lose time, because irreversible processes may occur, especially in cases of tissue necrosis. When a doctor does not know how to act or refuses to help a patient in such a situation, it is effectively an admission of a lack of professional competence.
WHICH FILLERS DO YOU WORK WITH, AND WHY?
I have been practicing aesthetic dermatology for 12 years, and I have always been very meticulous and demanding when selecting the products I use — products to which I can entrust my patients, as well as my own name and professional reputation.
These are fillers from long-established and well-proven manufacturers: Galderma and Allergan.
YOUR ADVICE TO OUR READERS.
I would like to address patients directly: entrust your beauty and health only to qualified specialists. In Bulgaria, there is now the Bulgarian Association of Aesthetic Dermatologists, and its website, BAAD , where you can find an aesthetic dermatologist in various cities. You can also leave your feedback and opinions anonymously.
The goal is to help patients receive comprehensive, qualified care in the field of aesthetic dermatology and to protect them from low-quality products on the market and the complications they may cause.
And one final piece of advice: winter is approaching, and the skin requires special care during this season. It is advisable to switch to nourishing creams with a richer texture and avoid using lightweight moisturizing creams.