Dermal fillers injections are used for volume replacement. Aesthetic indications include:
- Naso-labial folds, marionette lines
- Hollow Tear Troughs
- Nose augmentation
- Lip augmentation
- Cheek augmentation
- Chin augmentation
- Reduce glabella fold
- Breast augmentation
Injections are deep into the dermis or subcutaneous layer of the skin, and an immediate filling effect is seen. With most fillers, a 100% correction is the goal, but erring on the side of caution and slightly under-filling may be ideal. It is always easier to add more than to remove.
Fillers are generally very safe, particularly those in the hyaluronic acid family. Some degree of bruising (usually pin point) or swelling is not uncommon. Allergic reactions are rare. Should these occur, it’s generally in the form of painful, inflamed nodules, called granuloma. For hyaluronic acid fillers, granulomas are easily treated with an enzyme that dissolves the filler.
As dermal fillers are gel-like substances, it is easy to mould these after injection. It is normal to feel the products in the skin after injection, although any obvious lumps can be massaged to smoothen them out.
There are many dermal filler options available now. We favour the hyaluronic acid family in view of their margin of safety. Hyaluronic acid is a product that is naturally occurring in our skin. The molecules are cross-linked so they last longer, but are naturally degraded over a period of 6 months to a year.
Hyaluronic acid can be cross-linked to different degrees. The less cross-linked products are softer and more suitable for areas like the tear trough and lips. The thicker ones better for nose and naso-labial folds.
For this group of fillers, we are currently offering Visagel, a popular product in Europe. It is made of pure hyaluronic acid, unlike the other products which require protein for cross-linking. It is the protein which can cause allergic reactions, so we have chosen this for its safety profile.
We are not using Aquamid or other semi-permanent fillers as complications in this group are not easy to manage. Please not that Sculptra has not been classified as a dermal filler per se, as the volume correction is from the stimulation of new tissue production rather than the product volume itself.