Fillers
Fillers
Dermal (skin) Fillers
Many methods and substances have been used to treat facial wrinkles and to conceal the effects of aging on the face. In addition to formal surgical procedures, laser treatment and botulinum toxin, there are a large number of fillers available which can be injected as an outpatient. These can often be used in conjuction with a facelift to correct any deeper wrinkles or scar depressions.
Types:
A: Restylane These have a good safety record and are resorbable. The choice of filler is often determined by the wishes of the patient. Fillers with hyaluronic acid (Restylane) as the main component may last initially only 6 months, however with increasing periods of use this may be extended into years. Hyaluronic acid preparations (eg Restylane) are obtained by bacterial synthesis. This is the preferred method for lip augmentation and can be done as a outpatient procedure. The gel comes in three types aimed at correcting very fine wrinkles, larger furrows or deep depressions requiring volume enhancement. The injections last between 6 and 9 months and although well tolerated there is a 1% incidence of adverse reactions including granulomatous inflammation and sterile abscesses.
B: Synthetic fillers are permanent but may be associated with rejection, migration and granuloma formation and are unable to change with the ageing face. In the case of an adverse reaction removal may be difficult to achieve. There are few indications in current practice for the injection of synthetic fillers to correct lines and effects of ageing. They are included for reference rather than recommendation.
Bio-Alcamid - this is a permanent injectable implant, and useful for large defects and depressions and facial contour irregularities. An advantage of this implant is the ability to remove any excess through a small incision if necessary, as it extrudes with ease.
Calcium hydroxyapatite in a gel carrier (Radiesse) - this is the principle mineral component of bone and teeth. The effects are more permanent, and therefore more suitable for isolated scar depressions or for correcting deep naso-labial furrows
Fillers no longer recommended
Collagen - Collagen implants are prepared from three sources: bovine, human or autologous. Collagen synthesis may also be increased by fibroblast stimulation or injection of cultured cells.These are no longer in common use and have been superceded by the fillers mentioned above.
Silicone Injections are banned in most countries but are still used in France and Italy. Although giving apparently excellent initial results, migration and inflammation are almost inevitable and the surgery then required is likely to result in much greater aesthetic deformity than that leading to the initial treatment.
Back To Top |