Dermal Fillers
In recent years, hyaluronic acid dermal fillers have become the gold standard for filling facial wrinkles. Reasons for the rise in popularity of fillers are their biocompatibility and biodegradation in the skin, simplicity and safety of application, and minor pain during injection. Hyaluronic acid is a natural substance of connective tissue that gives the skin firmness, elasticity, and maintains its hydration. Over time, the content of hyaluronic acid in the skin decreases, leading to weaker hydration, and as a result, due to gravity and constant muscle use, the face loses volume, the skin becomes tired and dull, and wrinkles form.
Treatment
After applying anesthetic cream to a clean face, the anesthetic is left on the skin for 15 to 30 minutes to make the treatment comfortable, and then it is removed. Then, in accordance with your wishes and indications, the chosen dermal filler is injected into the desired area using small, thin needles. We use dermal fillers to correct wrinkles, fine and deep lines, and skin folds: nasolabial folds (lines from the nose to the mouth), marionette lines (lines from the mouth to the chin), laugh lines, dark circles, frown lines, smoker’s lines (wrinkles around the lips). We also use them for shaping facial contours and increasing volume: lip augmentation, lifting lip corners, and cheek contouring. By injecting them into the skin, in addition to filling wrinkles and restoring lost volume, we stimulate skin rehydration, new collagen formation, and maintaining a natural look. By treating specific parts of the face with special techniques, a face-lifting effect is actually achieved. The treatment is painless as the new generation of dermal fillers contains anesthetic. The treatment duration ranges from 15 to 60 minutes, depending on the areas being treated and the amount of filler applied.
The fillers we use in our practice are the new generation of hyaluronic fillers Juvéderm® Volbella, Volift, Voluma, and Volux, depending on the indication and the area treated. Juvéderm® Voluma and Volux dermal fillers are designed to restore volume and can be used on the chin, cheeks, and lower jaw. Juvéderm® Volbella dermal fillers are best suited for sensitive areas such as the lips, around the lips, and around the eyes. Juvéderm® Volift dermal fillers are intended for filling deep to medium-deep wrinkles such as nasolabial folds, smoker’s wrinkles, and wrinkles from the edges of the lips to the chin, and are excellent for lip augmentation. Produced using Vycross technology, Juvéderm® achieves a gentle gel structure that remains stable over time. That’s why Juvéderm® is the first smooth consistent gel of hyaluronic acid, FDA approved, which lasts up to a year with just one treatment. The latest generation of dermal fillers already contains a local anesthetic. Local anesthesia isolates pain, allowing for a painless and relaxed treatment.
Restylane hyaluronic fillers are stabilized forms of hyaluronic acid obtained by unique NASHA technology, of non-animal origin with a wide range of products. Due to good cohesiveness, they act to give a fresher and softer appearance immediately after application, revitalizing and smoothing facial contours. In practice, we most often use Restylane Lyft, which smooths facial wrinkles and folds and lifts the volume of the cheeks with a lifting effect, and Restylane Kysse, which gives a very natural, soft, and hydrated lip appearance. Restylane Vital is specially designed skin boosters that intensively hydrate the skin from the inside, improve its texture, strengthen thin skin, and smooth wrinkles. They are injected into the middle layer of the skin of the face, neck, décolleté, or hands with a series of pointy punctures or linear retrograde technique. Up to 2 ml is placed in one treatment per region, and the treatment is repeated after 2-4 weeks. Subsequent treatments or correction are possible depending on the needs of the treated region and the desired effect.
Belotero fillers produced by the well-known Merz Aesthetics adapt well in tissue due to lower density and are ideal for filling shallow wrinkles and folds when we don’t need excessive volume. In this regard, we use Belotero Soft to fill under-eyes and “tear through” deformities, soften fine lines between eyebrows and around the eyes, and Belotero Balance for filling smoker’s wrinkles, lip filling, and acne and atrophic scar filling.
Evanthia fillers are Italian hyaluronic fillers produced by Bioformula. The Evanthia product range is created with one of the best cross-linking technologies, resulting in a high-quality, safe dermal filler that adapts very well to tissue without forming unwanted lumps. It uses 2 different concentrations of cross-linked hyaluronic acid to ensure application in many indications in facial volumization – lip filling, emphasizing facial contours, filling perioral wrinkles, and other mild to deep wrinkles.
Candidates
As we age, the skin gradually loses collagen and fatty tissue, resulting in the formation of skin folds and wrinkles. Dermal fillers are suitable for those who wish to restore the youthful volume of the skin and fill in wrinkles. Candidates for hyaluronic filler treatment are individuals with pronounced wrinkles, which in some may appear in their late twenties, while in others it may appear later, influenced by genetics and lifestyle (smoking, lack of sleep, stress). To maintain a refreshed, youthful appearance and good facial contour for longer, hyaluronic fillers can be replenished approximately every year. The main contraindications for using dermal fillers include: active infection near the filler application site, known allergy or hypersensitivity to any of the filler components, and coagulation disorders.
Results
Initial results are visible immediately after the treatment, while the full effect is achieved in a month. This is because hyaluronic acid binds water to itself and increases the volume of the applied hyaluronic acid. The longevity of the results depends on the type of applied dermal filler. Unlike older generations of dermal fillers, which had short-term effects (lasting a few months), the effect of new generation fillers lasts longer (from a year to a year and a half). Since results can vary from person to person, you can repeat the treatment once the desired effect begins to diminish.
Recovery
After the treatment, sensitivity at the application site and skin redness may occur, which usually disappears within a few hours. However, swelling and bruising typically subside within a few days. For the next two weeks, it’s recommended to avoid sun exposure, saunas, tanning beds, and facial massages. Most patients return to their regular activities immediately after the treatment. Serious side effects with dermal fillers are extremely rare. Temporary fillers, such as hyaluronic acid, are very safe and rarely cause serious side effects. More common side effects include redness, swelling, bruising, and sensitivity at the injection site. Rarely, an infection may occur at the injection site. However, you can successfully avoid this by carefully following post-treatment instructions. Occasionally, lumps or bumps that show through the skin may form, related to superficial injection of the filler. If they occur, they can be successfully removed with hyaluronidase, an enzyme that breaks down hyaluronic acid. If you often have H. simplex infection (herpes), a recurrence is possible after treatment, so inform the doctor during the consultation, and they can prescribe a medication to reduce the risk of recurrence.