With increasing age our soft tissue – fat, muscle and connective tissue – decreases. This loss is compensated with the injection of dermal fillers. Small scale injections can be applied in the surgeon’s office. A wide range of ready-to-use dermal fillers are available that are easily and painlessly applied. The effect of fillers can be temporary or permanent. Besides effectiveness, the most important criterion is safety; after all the dermal filler is a foreign material and the body may react to it.
Frequently asked questions about dermal fillers for the face:
What materials are used?
With respect to their effect, they are divided into temporary, long-term and permanent materials. The most frequently used temporary substance is hyaluronic acid (HA); its effect lasts between 6 months and 2 years.
Calcium hydroxyapatite, a substance that occurs in bones and teeth, and poly-L-lactic acid have a long-term effect. They last about 2 years.
Synthetic polymers-containing substances, like methyl methacrylate and liquid silicon, are permanent. They are not decomposed. Due to the associated high risk, they are not recommended.
What are the properties of hyaluronic acid-based fillers?
Hyaluronic acid (HA) is a glycosaminoglycan, essentially a polymeric sugar. HA is part of the connective tissue, comparable to the binder used for ceramic tiles. HA is marketed in various concentrations of different durability.
What are the main types of HA and where are they applied?
We distinguish the following 5 HA types:
- Pure HA products without filling properties. They improve skin elasticity and its moisture content. They are applied to the neck and décolleté, for example at the beginning of the summer.
- Light fillers against crow’s feet and small wrinkles such as lip wrinkles
- Medium-strengths fillers against nose and lip lines, marionette lines and frown lines
- Special contour fillers for the lips
- Deep and firm fillers to pronounce the cheek bones and to improve the jaw line. They are applied directly above the bone.
- All filler types are used for hand rejuvenation.
The more concentrated the dermal filler, the longer it lasts. For medium-strength fillers the limit is 9-12 months, high-strength fillers last for up to 2 years.
What are the advantages of HA fillers?
The main advantages are easy, controlled and quick application in an office environment. No excessive swelling; patients can immediately return to their normal activities. Compared with other substances, the risk is low. HA is absorbed naturally.
How is HA applied?
HA is applied in an office environment. Before the injection, the injection points are numbed with an anaesthetic crème. A local anaesthetic may be used for deeper filling and injections into the lips. Some new dermal fillers contain anaesthetics and cause only marginal pain. Bruising is rare. In general, patients can immediately return to their normal activities.
Where else is HA applied except in the face?
HA is used for breast and hip augmentation and leg contouring. Its application is limited, however, due to the high cost and its temporary effect. There is also the risk of infections; after all even the best substances are foreign materials to which the body may react.
What are the risks of HA fillers?
Allergic reactions are rare. The body may react to the foreign material or may get infected. These side effects can, however, be reduced to a minimum if tried and test products are used, if the application is carried out by an expert and if the injected quantity is not excessive.