Dermal filler injections can restore lost facial volume, fill out wrinkles and lines, and improve facial contours.

The ‘youthful glow’ associated with being young and healthy is often put down to the fullness and smooth, plump contours evident in the upper, lower and mid-face regions. In seeking to restore this glow, practitioners often call on one or more of a variety of dermal fillers that can be injected under the skin to smooth and fill deep folds and lines.

Dermal fillers are gel-like substances injected into these areas to plump out wrinkles and smooth the face. They are also used to restore volume to the face where tissue has degenerated with age, or where lipoatrophy (fat loss caused by disease) has caused the cheeks to collapse.

Fillers can also be used to fill in pockmarks and acne scars, contour or reshape facial features, add volume to lips and cheeks and as an adjunct to botulinum toxin injections for a cumulative and complementary result. More permanent fillers can even be used to reshape the nose and jaw line to create a more balanced and harmonious face shape.

There is a multitude of different fillers on the market that range in longevity, composition and viscosity, which can be quite confusing for the average consumer. While a cosmetic doctor is the best person to advise on the most suitable filler for specific needs, prospective patients should educate themselves before the consultation. This will ensure they feel more comfortable and confident when it comes to discussing their options.

HA Fillers

These are injected under the skin to plump out wrinkles and smooth the face. They are also used to restore volume to the face where tissue has degenerated with age, or where lipoatrophy (fat loss caused by disease) has caused the cheeks to collapse.

Fillers can also be used to fill in pockmarks and acne scars, contour or reshape facial features, add volume to lips and cheeks and as an adjunct to wrinkle-relaxant injections for a cumulative and complementary result. More permanent fillers can even be used to reshape the nose and jaw line to create a more balanced and harmonious face shape.

Man-made hyaluronic acid (HA) gel, which is bio-compatible and bio-degradable, comprises the vast majority of contemporary dermal fillers, which range in longevity, composition and viscosity.

Hyaluronic acid occurs naturally in the body throughout connective, epithelial and neural tissues and
is particularly abundant in the dermis. It can attract up to 1,000 times its weight in water and is one of the main agents in maintaining hydration and a fresh, youthful appearance, as well a major component of tissue repair.

Filling superficial fine lines and moderate facial wrinkles, and for treating those with fine skin, calls for products with lighter textures and come under brand names such as Restylane Touch, Juvéderm Ultra and Esthélis.

Greater volumes of these finer fillers may also be injected into the mid or deep dermis for subtle contouring of larger areas of the face such as the lips, cheeks and chin. Treatments can last around nine months, depending on
the patient.

Where a stronger and longer-lasting result is required, practitioners may opt for medium volume HA fillers like Restylane, Juvéderm or Perlane. These are intended for deeper injection to restore lost volume in areas like cheeks, under-eye hollows, nasolabial (nose to lip) folds and marionette lines (drooping mouth corners). They are also used to correct deeper facial wrinkles and folds and augment the lips. Results last for at around six months to a year, again depending on the patient.

More robust and longer lasting fillers are used to revolumise larger areas such as the cheeks and mid-face, or fill out facial depressions, deep contours and hollows. HA products like Restylane Sub Q, Juvéderm Ultra Plus, Fortélis Extra and Modelis Shape can last around 12 months or more in some patients, and do not tend to migrate from the injection site.

A ‘permanent’ option is Aquamid, which many practitioners are using as a means of enhancing facial features, creating a similar effect to using facial implants. It can be used to fill nasolabial folds, enhance cheekbones, lips or the nose, and to smooth wrinkles or folds in the skin. It is composed of 97.5 percent water and 2.5 percent polyacrylamide and, once injected, it integrates with the body’s tissue.

Aquamid does not migrate from the injection site, is biocompatible, non-toxic and non-absorbable, which means results last for a number of years – as many as 10. Therefore, practitioners usually advise patients take a ‘practise run’ with a different filler first to ensure they are happy with their new look.