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Injectable aesthetic medicine/material used to add volume ,and favourably alter the contours of the face, and fill in wrinkles.

What are injectable fillers?

Hydroxyapetite (HA) is a natural material occurring in the body. This can also be produced in the laboratory. HA fillers are artificial materials that are injected in the specific areas to restore the youthfulness. Fillers can also enhance the lips and shallow contours or soften the facial creases and wrinkles. Although they can't help with excess sagging skin, these soft tissue fillers add more volume and provide immediate results. These treatments aren't permanent, however, and they must be repeated and maintained after 9-15 months, and this depends on the type of the filler.

Aging of the face is inevitable. As the years go by, the skin begins to loosen on the face and neck. Crow's feet appear at the corners of the eyes. Fine forehead lines become creases and then, gradually, deeper folds. The jaw line softens into jowls, and beneath the chin, another chin or vertical folds appear at the front of the neck. Heredity, personal habits, the pull of gravity, and sun exposure contribute to the aging of the face. Surface irregularities such as pigment discolorations and large pores also develop. Facial rejuvenation involves removing years from your appearance by non-surgical or surgical modalities employed in combination or alone. Fillers are an important component of facial rejuvenation.

What are the areas that can be treated?

Treatment areas include lips, wrinkles running from the nose to the corner of mouth (nasolabial folds), folds beneath the corners of the mouth (marionette lines), lines between the eyes, grooves under the eyes, fine lines on the cheeks or around the mouth, and central cheek depressions. Fillers may also be used to treat larger areas of facial volume loss seen with conditions such as extreme weight loss and AIDS.

Fillers are used for

  • Plumping up folds that run from the bottom of the nose to the corners of the mouth
  • Filling in the prominent vertical wrinkles, (the "11s") between the eyebrows
  • Augmenting the hollows under the eyes
  • Reducing the "Marionette lines," the downturned creases at the corner of the mouth
  • Scar correction
  • Augmenting thin or aging lips
  • Restoring facial volume
  • Jaw contouring
  • Shaping the lips

What types of injectable fillers are available?

Fillers can be temporary or semi-permanent and permanent. Temporary and semi-permanent fillers are safe and are generally used. Own body fat can also be used as a filler material and is generally permanent.

Temporary fillers include:

  • Collagen injections which are made of highly purified bovine or human collagen.
  • Hyaluronic acid gel (Restylane, Juvederm) is a protective, lubricating gel that is produced naturally by the body and binds with water to plump the skin.
  • Calcium Hydroxyl apatite is a mineral that is a major component of bone. It is reserved to fill the deepest creases like the naso-labial folds, marionette lines, frown lines. It can also be used to enhance fullness of the cheeks and other facial contours
  • Poly-L-lactic acid (PLLA) is occasionally used as filler material.

Permanent – non-absorbable fillers are

  • Polymethylmethacrylate beads (PMMA microspheres) are tiny round, smooth plastic particles which when injected, stimulate the body’s own production of collagen.

How long do injectable fillers last?

Corrections achieved with collagen fillers last about 6-15 months. Corrections achieved with poly-L-lactic acid and calcium hydroxyl apatite may persist for 1-2 years or longer. Fat fillers are lifelong and show changes as the patient ages. Contact your doctor for more details on this.

What to expect during and after the treatment?

The area is cleansed and a topical anesthetic cream or injectable anesthesia is utilized prior to the filler injection. There may be slight to moderate discomfort upon injection of the filler, but most patients find the treatment very tolerable. After the treatment, mild redness, swelling and tenderness may develop and persist for a few hours to 1-2 days. Occasional bruising may develop, which usually resolves after a few days. Details of fat filling shall be explained by the Doctor.

What are the possible complications?

Rarely, bruising, persistent lumpiness or redness around the injection site may develop and persist for weeks after a procedure. Occasionally a superficial infection requiring antibiotics may occur. With the newer forms of fillers, allergic reactions are very rare. Rarely injection of fillers may compromise blood flow to the skin, causing scab formation and possible development of a scar. This may need an urgent treatment to neutralize these fillers. There are rare reported cases in literature which have lead to permanent blindness due to inappropriate use of the filler.

Can fillers be used safely with Botulinum toxin and Lasers?

Yes, these modalities often complement one another and it is safe and complimentary to have a combined approach to facial rejuvenation.

Dermal fillers are wonderful to rejuvenate your appearance, but they can't stop the aging process. If you want a permanent solution, talk to your doctor about a facelift, brow lift or eye lift. It's a great way to see some impressive changes and improvements in your appearance, such as the reduction of forehead wrinkles, until you're ready for a permanent surgical option.

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