Fillers (Dermal Fillers)
Overview
Fillers (Dermal Fillers)
When we are young, our skin is smooth and tight, but as we age, our bodies lose collagen, hyaluronic acid and elastin, building blocks that support the meshwork that holds our skin in place. As a result, we develop wrinkles and hollows on our faces, and fillers can reduce these and make your skin tight and smooth again, restoring your youthful appearance.
Each year, more than 1 million people discover that cosmetic fillers can create natural-looking enhancements by reducing wrinkles and plumping their skin.
Fillers can:
- Plump lips
- Plump hollow cheeks
- Correct contour deformities
- Decrease or remove undereye bags
- Improve the appearance of some scars
- Soften or eliminate wrinkles and creases
- Plump the appearance of hollow hands
Filler Types
There are several different types of fillers from which to choose, and your doctor will help you determine which type to use based on the lines and hollows you want to target. Your doctor can choose from the following options:
Calcium Hydroxylapatite (Radiesse or CaHA) Fillers
CaHA comes from the same minerals that give your bones strength and texture. It works by helping stimulate your body to make natural collagen and is ideal for deeper lines and wrinkles. CaHA worked better in trials and lasted longer in reducing severe wrinkles than collagen, lasting about 12 months.
Collagen (human)
This product comes from cultures of human cells, so there are fewer allergic reactions. You will need to get injections two to four times per year to maintain your results.
Fat Injection Fillers
Also known as autologous fat injections or facial fat grafting, this procedure involves injecting fat from another part of the body into the face. Because it is your fat, there should be no allergic reactions. Results can last for several years before you need to get another injection.
Hyaluronic Acid Fillers
Hyaluronic acid (H.A.) is a natural part of your skin that keeps it plump and hydrated, but you have less of it as you age. Both natural and synthetic types of H.A. are available, and allergic reactions are few. H.A. breaks down more slowly than collagen fillers, so you only need to get injections around every six to nine months. Hyaluronic acid is the most commonly used filler.
Poly-L lactic Acid (Sculptra) Fillers
This filler is a synthetic product that causes your body to produce collagen. This product is excellent for deeper wrinkles and can last for two years or more.
Why Fillers?
Dermal or wrinkle fillers are far less costly or invasive than plastic surgery. Fillers can restore a more youthful appearance to your face by reducing wrinkles and filling out hollow cheeks. The use of fillers may improve your self-confidence. Wrinkle fillers can:
- Improve facial symmetry
- Smooth out a chin crease
- Smooth lines around the nose and mouth
- Plump the lips and diminish vertical lip lines
- Restore volume to sunken cheeks or temples
Risks
Fillers Potential Risks and Complications
Dermal fillers are a standard procedure and are relatively safe when using a highly-trained, board-certified doctor. However, as with any medical procedure, there is always a risk of complications, including:
Inflammatory Lesions
Though less common, these are more severe than non-inflammatory and are more common in patients with systemic illness or immunosuppressed systems.
Non-Inflammatory Lesions
These lumps or bumps of fluid under the skin are less severe than inflammatory lesions.
Hematoma (ecchymosis, petechiae and purpura)
Hematomas, the number one side effect of using dermal fillers, occur most frequently around the eyes. Hematomas may appear as bruising resulting from a traumatic injury to the tissue under your skin. The bruising usually goes away within a few weeks.
Bacterial Infection
Infections are rare occurrences caused by external bacteria entering the skin. There are different levels of severity, and severe bacterial infections can cause biofilm, abscess formation or septicemia, which can be life-threatening. Bacterial infections are most common with injections around the lips.
Nerve Injury
Nerve injuries are rare complications.
Salivary Gland Injury
Salivatory gland injuries can occur when the surgeon injects fillers around the chin and jawline.
Blindness
Though rare, temporary or permanent blindness can be caused by injecting a dermal filler product into a facial artery or vein.
Impending Necrosis
Vascular occlusions (V.O.) can cause impending necrosis. Necrosis can occur if an artery is blocked by the product, thus preventing oxygenated blood from reaching tissue.
Stroke
Strokes occur infrequently but can happen if the product enters the intracranial (the space inside the skull) circulation and comes to rest in an artery.
Prep
Preparing for Fillers
Discuss the treatment plan with your doctor before the procedure to know what to expect. Your doctor will give you instructions on how to prepare for your treatment, but generally speaking, you should:
- Dress comfortably
- Not wear jewelry
- Avoid alcohol because it increases the chances of bleeding
- Discuss recovery time with your doctor
- Let your doctor know if you bruise easily
- Discuss your medications with your doctor before surgery
- Tell your doctor if you are, or think you are, pregnant or are breastfeeding
Additionally, prep your skin to achieve the best results:
- Wash your face thoroughly on the morning of the surgery, and do not apply makeup
- Eat pineapples because they have an ingredient (bromelain) that helps prevent clots and reduce scarring
What to Expect
What to Expect
Dermal filler injections are non-surgical, typically completed during an office visit. Your first appointment will be a consultation with your surgeon to discuss what you want to achieve, review your medical history and any medications you are currently taking, talk about risks and review your options. The nurse or surgeon will give you instructions on preparing and what to expect.
During the Procedure
Your nurse or surgeon will explain what to expect during your procedure based upon which treatment method you and your surgeon decide. Regardless of the treatment you choose, your nurse or surgeon will probably apply an anesthetic gel to your skin, rub it with ice for a few minutes to numb the area and inject a local anesthetic so you don’t feel any pain during treatment.
After the Procedure
Your nurse or surgeon will explain what to expect after the procedure. However, generally speaking:
- Apply sunscreen and moisturizer after the treatment to protect the skin as much as possible.
- Apply a cold compress to the injected area to minimize redness, bruising and inflammation.
- Avoid alcohol before because it increases the chances of bleeding.
- Do not exercise immediately after your treatment because the injected material needs to settle down.
Follow-Up
Your surgeon will schedule follow-up appointments as needed.
Specialists
