Aging as well as certain diseases make us loose facial tissues (fat, collagen, muscle and bone). The skin also changes due to reduction in collagen and elastic fibers. This makes the skin thinner, lax, more transparent, making the blood vessels under the skin more visible (this is in part due to the loss of fat under the skin).
Fillers can correct the effect of aging by adding volume (correcting fat, muscle and bone loss that normally occurs with aging) and “plumping” the area. Gravity also plays a role in aging, lowering the cheeks, changing the lower jaw line.
With “fillers” we are capable of changing some facial features avoiding surgey. Small chins can be augmented, cheeks and cheek bones can be augmented, facial imperfections can be improved. Also naso-labial folds, marionette lines, lip lines and other facial wrinkles can be softened, dorsal aspect of the hands can look fooler (veins less visible). Lip enhancement can also be achieved with fillers.
Biodegradable vs Nonbiodegradable Fillers
Fillers classified as biodegradable are absorbed by the body and tend to have a shorter duration of effect. Fillers classified as nonbiodegradable have components that do not degrade. These fillers may yield excellent longer-lasting results, but they tend to be less forgiving and are associated with an increased incidence of granuloma formation and/or extrusion.
Mode Of Action
Some dermal fillers operate in a more passive manner, occupying space until the injected material biodegrades. These products are known as tissue replacement fillers or “volumizers”; they have limited action and must be repeatedly injected to yield continuing results. Other dermal fillers, known as “stimulators,” induce an inflammatory reaction with the goal of stimulating collagen production. Neocollagenesis is believed to yield both longer-lasting treatment results and possibly other benefits to the dermis.
Types Of Fillers
Hyaluronic Acid (HA)
HA is a naturally occurring polysaccharide found in the extracellular matrix in many human tissues; approximately 50% of the total HA in the human body is found in the skin. These fillers do not produce allergic reaction. The following fillers belong to this group:
These fillers are based on calcium hydroxylapatite, a naturally occurring mineral component of human bone and teeth. The dermal filler is composed of CaHA microspheres (30%) suspended in an aqueous carboxymethylcellulose gel carrier (70%). This dermal filler injection provides immediate correction, but it is believed to generate longer-lasting results by providing scaffolding for collagen growth. Following injection, the gel carrier is absorbed and new collagen occurs around the slowly biodegrading CaHA microspheres. The patient’s own collagen production thus contributes to the prolonged effects.