Dermal fillers or filling substances are products that are injected into the skin and the subcutaneous tissue in order to reduce visible lines and wrinkles and to restore the face’s lost volume. They are also known as “fillers”, as well as “temporary filling substances” or “dermal implants”. They can be used in the facial zone as well as on the neckline, neck and arms, and less often on other body parts. The most commonly treated areas are: lips, nasolabial lines, lines around the mouth, forehead wrinkles and between the eyebrows. During recent years the dermal implants have been used to sculpt the face while recovering the lost facial volume, i.e. forming cheek-bones, chin and facial oval.
There are two types of substances with a temporary filling effect on the skin:
- Hyaluronic acid – it has the ability to give significant volume when injected in the skin in order to fill visible lines and wrinkles.
- Collagen stimulators (collagen stimulating substances) – with injecting them in the skin the process of forming new collagen is activated. The results are new, fresh and more stable connective tissue in the subcutaneous layers, and the tissues are firmer which makes the skin tighter, fuller and healthier.
The most commonly injected substance with an aesthetic purpose is hyaluronic acid. On one hand it can fill in the skin’s missing volume, and on the other it could restore the skin’s hydration.
How is the procedure done?
On the day of the procedure, the skin that will be treated is numbed. After initially cleaning the skin with a gentle product, numbing cream is applied. Transparent foil is applied onto the cream which creates the so-called “occlusive dressing”. This makes the numbing cream start working faster and has a longer duration, making the procedure less painful.
The filler is put in after numbing. It is done either with a sharp needle, by a series of injections or by using a cannula (a longer needle with a dull tip), which reduced the trauma on the tissues. The choice depends on the area and the depth in which the product should be injected, as well as the doctor’s experience.
What are the advantages of the procedure?
- Quick application – it takes about 30 minutes to achieve a numbing effect.
- Immediate results – the moment you get off of the dermatologist’s chair your face will already be changed according to your expectations – with bigger lips or filled wrinkles and lines.
- An incredibly short recovery period – the redness which occurs after injecting hyaluronic acid is for only about a couple of hours even in people with sensitive skin. This means you could do the procedure even during your lunch break and then go back to your daily activities.
- The effect’s duration – the duration depends on the kind, quality and quantity of the used product, as well as the facial muscles’ mimic activity. It varies from 4-6 months to over a year.
- Natural and safe procedure with small risk of unwanted reactions
When is it suitable to apply the dermal fillers?
Putting temporary dermal filling substances is suitable for anyone who wants to have fuller lips, or to fill in hollow parts on the face – the nasolabial lines or the lines under the lips to the jawline, as well as the zone under the eyes, to enlarge their cheek-bones or to fill their cheeks. Hyaluronic fillers are one of the substances suitable for overall sculpting of the skin of the face – for making the cheek-bones bigger and filling up hollow cheeks, the temple area and the chin.
Are there counter-indications for putting in dermal fillers?
One of the absolute counter indications is a heightened sensitivity towards hyaluronic acid.
Among the relative counter indications for putting in fillers is a local infection – bacterial or viral. In case you have damages on the skin’s surface, you need to have it treated and recover fully before attempting the procedure. Having herpes on the face or near it is also a temporary counter indication for doing the procedure. In case you have active herpes it is desired to postpone the procedure until full recovery of the damaged area.
Are there different types of fillers?
Temporary dermal implants, based on hyaluronic acid application can have a different density and because of that are applied in different facial areas in order to correct different defects.
The finest dermal implants are used for correcting fine lines and wrinkles in the area of the eyes, neckline and forehead. They are put in superficially and the achieved effect has a shorter duration.
In correcting the nasolabial lines and lines in the area of the chin, as well as in improving the lip’s contour medium density dermal implants are used. It is usual to use more elastic products in these areas because of their more active movement.
The highest in density dermal fillers are used when filling very deep nasolabial lines, which could be applied in the area of the cheek-bones and the chin in order to make them fuller.
With some fillers, a pain numbing agent is added to the hyaluronic acid – most commonly lidocaine, which lessens the pain and discomfort from injecting the product into the skin. In case of an allergy to the pain numbing agent, this product cannot be injected due to a risk of having an allergic shock.
What are the possible risks from the procedure?
The most common complications from injecting fillers are local bruising. It happens most often if the areas are with better blood supply like the area around the mouth, but it could be observed everywhere, when the skin undergoes the treatment. Rarely the hematomas are combined with swelling in the surrounding tissue.
If the hygiene requirements are not followed, a bacterial contamination of the deeper layers of the skin occur and it can be infected, followed by redness and swelling. Another possible complication from the procedure could be forming a granuloma at the place where it has been injected.
It is possible for a clot to appear when injecting the filler directly into the blood vessel. This is considered the most serious complication from using temporary filling substances – it is rare, but it’s better to be aware of it and the risk should be discussed with the doctor before the procedure.
Is preparation beforehand required?
Injecting temporary dermal filling substances does not require any special preparation. In case the skin has a tendency to easily bruise from hits or prickling, a special cream, vitamin K or another product that reduces the bruising effect. It is better to consult a doctor first.
Should you take specific care of the skin after the procedure?
Injecting temporary dermal fillers in the skin requires specific care for the treated area. On the day of the manipulation you will receive instructions by your doctor on how to treat your skin during the recovery period. You will know whether you will need to massage the treated areas. During the first days of the procedure you should continue to apply cream for reducing the risk of bruising.
It is recommended to not have procedures that have a heating effect 14 days after having fillers done.
Injecting hyaluronic dermal implants can be combined with using botulinum toxin /botox/ in different laser procedures in order to achieve optimal aesthetic results, but the exact sequence of the procedures should be decided by your doctor.