Filler

Common areas to inject fillers are in the face, neck, and décolleté, resulting in a fuller, smoother and more youthful appearance. Fillers are among the most popular aesthetic medicine procedures because they carry immediate results, very few risks and little recovery time. ⁽²⁾

Hyaluronic acid injectable fillers are the most widely used soft tissue fillers to treat facial volume deficits, providing long-term facial aesthetic enhancement outcomes for the signs of aging and/or facial contouring.(1) Soft tissue fillers are a minimally invasive aesthetic medicine procedures used to improve or create volume, to remodel the contours of the face, and fill in wrinkles and deep folds.

Their main indications are the filling of wrinkles and folds, and the correction of soft tissue loss due to disease or age. Increasingly, fillers are used for volume replacement and enhancement procedures, including cheek and chin augmentation, tear trough correction, nose reshaping, mid-facial volumisation, lip enhancement, neck and décolleté rejuvenation, and the correction of facial asymmetry.

CLASSIFICATION

ORIGIN AND COMPOSITION

Fillers may be classified depending on their source as:

Autologous (e.g., fat, cultured human fibroblasts);
Collagen (bovine-derived, human-derived from tissue culture);
Hyaluronic acid (HA) (non-animal stabilised or viscoelastic HA from bacterial fermentation);
Synthetic or pseudo-synthetic implants (silicone, polymethacrylate microspheres, poly-L-lactic acid, calcium hydroxylapatite microspheres suspended in aqueous polysaccharide gel, alkyl-imide gel polymer).(4)

DURATION

Depending on their permanence in the body, fillers can be classified as temporary, semi-permanent, and permanent. The first two classes have a different time of duration in the tissue due to the reabsorption, while the permanent fillers are not absorbable.

Temporary fillers stay in the tissue for less than a year; they have a temporary effect because they contain materials that are absorbed by the body over time.(3) Examples are: fillers based on collagen, hyaluronic acid and calcium hydroxylapatite.(2)
Semi-permanent fillers stay in the tissue for up to 1–2 years.(3) Longer-lasting fillers typically contain substances such as the absorbable synthetic filler known as poly-L-lactic acid.(2)
Permanent fillers are substances that remain in the tissue more than two years.(3) Permanent fillers include silicone oils, polymethylmethacrylate (PMMA) microspheres, polyacrylamide, and several other materials either alone or formulated in various combinations with absorbable components.(5)

(1) Pierre S, Liew S, Bernardin A. Basics of dermal filler rheology. Dermatol Surg. 2015;41 Suppl 1:S120-S126.

(2) The American Society for Aesthetic Plastic Surgery. Fillers. [online] Available at: http://www.smartbeautyguide.com/procedures/injectables/fillers/ [accessed March 2017].

(3) Vedamurthy M, Vedamurthy A. Dermal fillers: tips to achieve successful outcomes. J Cutan Aesthet Surg. 2008;1(2):64-67.

(4) Ganceviciene R, Liakou AI, Theodoridis A, Makrantonaki E, Zouboulis CC. Skin anti-aging strategies. Dermatoendocrinol. 2012;4(3):308-319.

(5) DeLorenzi C. Complications of injectable fillers, part I. Aesthet Surg J. 2013;33(4):561-57

ASK YOUR DOCTOR

Always seek the advice from your doctor or other qualified healthcare professional regarding any medical condition or before starting a treatment.

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