Injectable fillers are gel-like substances that plastic surgeons inject (beneath the skin) into an aging, wrinkled face to replace volume loss and give the face a youthful appearance. With aging, the tissues on the face thin out, leaving behind etched lines on the nose, mouth, and cheek regions, causing them to look sunken. Injectable fillers help to smoothen wrinkles, soften creases, fill the lips, enhance facial contours, and rejuvenate a patient’s appearance.
The duration it takes for the product to wear off depends on the product itself, area of treatment, and patient factors. The denser the product and the more deeply it is injected, the longer it will last. The patient can opt to have a repeat procedure to maintain the results. First-time users may use Hyaluronic (HA) acid fillers as they have temporary effects.
Injectable fillers to the lips wear out faster than those to the nasolabial folds. Fillers made from synthetic material last longer, but the patient must be certain of this, as they will have to commit to the results for many years.
Also Known As
- Facial Fillers
- Dermal Fillers
- Wrinkle Fillers
- Soft-Tissue Fillers
- Injectable Implants
Preparation & Expectation Before Procedure
In a consultation process with the cosmetic surgeon, the patient is taken through all the possible treatment options. The cosmetic surgeon evaluates the patient's areas of concern and reviews medical history. Medical history is important because of the risk of an allergic reaction, reaction from certain medications and skin and neurological conditions, that can jeopardize the patient's safety or results.
For example, blood thinners such as aspirin increase the possibility of bruising. The patient must sign a consent form to ensure the s/he fully comprehends the procedure, risks, and likely complications.
Types, Purpose & Procedure
Common injectable fillers include non-surgical and surgical.
Non-surgical options are achieved in a doctor's office. They include:
- Hyaluronic acid (HA) such as Juvederm XC, Restylane, and Belotero Balance, is infused with lidocaine for minimal discomfort during and after treatment. HA is naturally occurring since it's already found in the skin’s fluid and tissue. It helps to keep the skin hydrated and adds plumpness to the skin. HA effects typically last six to 12 months.
- Calcium Hydroxylapatite (CaHA)e.g., Radiesse, is a mineral-like compound that occurs naturally and mainly found in the bones. It has a thicker consistency whose effect lasts longer than HA's (about one year). CaHA works on deeper wrinkles and lines since it assists in stimulating natural collagen production.
- Poly-L-lactic Acid, like Sculptra Aesthetic, is a collagen stimulator that helps the skin rebuild natural collagen. It is safe to use in the body (biocompatible) and can dissolve with the filler gel dissipating in a few days following treatment (biodegradable). Deeper facial wrinkles can be treated with long-lasting results (2 years and over).
- Polyalkylimide (brand name, Aquamid) treats deeper wrinkles in depressed scars and nasolabial folds. It makes thin lips appear plump and enhances cheekbones and the jawline. It is also used to treat facial wasting caused by HIV medications. The filler is both biocompatible and radio transparent (doesn’t interfere with X-ray). One procedure is enough to inject large volumes into the skin and last a long time. It can also be removed if necessary.
- Polymethylmethacrylate (PMMA), such as Bellafill, is a biocompatible and synthetic semi-permanent filler. It comes in the form of a tiny ball which is injected beneath the skin indefinitely, for continued support. PMMA fillers also provide collagen for firmness and structure in the skin.
In this minimally invasive procedure, the cosmetic surgeon:
- Evaluates facial appearance and skin tone. S/he marks the appropriate injection site(s) and takes photographs of the site if necessary.
- Cleans the area and gives the patient a topical anesthetic to numb the area and minimize discomfort during and after the treatment. S/he may opt to offer pain relief at the injection site by using a very cold instrument to chill the skin.
- Injects a precise filler amount strategically under the skin. S/he will massage and evaluate the result, and if need be, add more fillers.
- Cleans off the markings once the results are deemed satisfactory.
The only surgical procedure includes the autologous fat injection which is known as facial fat grafting. It is a minor invasive procedure requiring surgery. The method may make use of local or general anesthesia along with sedation. The surgeon:
- Harvests the patient’s own fat from a different part of the body using liposuction (a suction technique)
- S/he then purifies and injects the fat into the face. The effects last for many years.
Risks, Side Effects & Complications
The patient who has undergone the minimally invasive procedure may experience temporary bruising and swelling, which should resolve over the days following treatment. Other common side effects which should take 7-14 days to clear may include:
- Redness of the skin
- Itches and skin rash
- Pimple-like eruptions
- Asymmetry, lumps, or wrinkle overcorrection
- The sensation that there is something under the skin
Rare side effects may include:
- Blood vessel injury
- Filler leakage via the injection site
- The filler moving from one area to another
- Skin damage that leads to wounds or scarring
- An inflammatory reaction to the filler (granulomas)
- Nodular growths on the site which may need surgical intervention
- Skin cells may die since blood flow may be limited in the affected area
- Blindness or loss of vision caused by an injection into an artery, blocking blood flow to the eyes
The risk involved in patients who have undergone a surgical procedure with fat injections is the surgeon overfilling the treatment area. The result is the patient’s face appearing overly full, but it should gradually settle into a more natural appearance. Another risk is that some of the injected fat may not survive.
Patients are also advised to select well-trained and licensed practitioners to perform these procedures to minimize the risk of failure. The procedure should be done in a medical setting, and patients are advised to avoid online purchases.
After Care, Recovery & Outcome
The patient may be offered an ice pack to reduce swelling and alleviate discomfort. The injection site may feel a little bit tender for one or two days, but this should resolve without medication.
Recovery time varies from patient-to-patient. For non-surgical procedures, the results are apparent immediately, and normal activities can be resumed right away. However, it's advisable to avoid intense physical activity in the first 24-48 hours after the procedure.
Since fat injectable fillers involve surgery, recovery may take a few weeks, depending on the extent of the liposuction. Often, about 50% of the grafted fat survives, lasting forever. Because the results can be unpredictable, the surgeon may need to perform multiple transfer procedures to achieve desirable results.