What are Wrinkle Fillers?
The dermis is the layer between the skin surface and the underlying fat and muscle. With age creases or wrinkles appear and the use of fillers may be used in the dermis to improve the contour. They can also improve volume in both the dermis and in other deeper layers. They are also often used in conjunction with other skin rejuvenation treatments.
What do they contain?
Fillers may be be autologous (belong to you) or non autologous. Autologous fat transfer is an example of an autologous filler. There are many non autologous fillers on the market but it is recommended that only fillers with FDA approval be used. These fillers consist of hyaluronic acid, collagen, poly-L-Lactic Acid, Hydroxylapatite and polymethlmethacrylate.
Hyaluronic acid is a natural substance in the body and is not derived from anaimal sources. High concentrations are found in soft connective tissue and skin tissue. Collagen is a natural substance known as a protein and is found in cartilage, teeth and bones and is derived from human skin or cows. Hyroxylapatite consists of calcium based microspheres suspended in a water based gel and is found in human bones. Polylactic acid is a synthetic material that stimulates collagen production.
Polymethlmethacrylate(PMMA) fillers contain PMMA microspheres suspended in 80% purified collagen gel.
Are they permanent?
Although not all autologous fat transfer used as a filler will be permanent it is thought that between 25% and 75% will be permanent depending on the surgical technique used.
Of the non autologous fillers Hyaluronic acid, collagen, poly-L-Lactic Acid, and Hydroxylapatite fillers are classified as temporary fillers and polymethlmethacrylate as a semi permanent filler. One should not consider any of these fillers as permanent and the commonest fillers hyaluronic acid and collagen will last for anywhere between 12 and 24 months.
How is the treatment given?
For non autologous fillers the area to be volumised is determined following discussion with you. Some fillers are mixed with local anaesthetic and do not require separate anaesthetic injections. These are my preference and I tend not to use separate local anaesthetic injections. Once the area in question is highlighted the chosen substance is injected which can take up to 15 mins depening on the site and the amount of substance being injected.
What are the risks?
Immediately following the injection one can experience bleeding at the injection points and swelling. Usually these settle. Infection, haematoma and direct damage to nerves and blood vessels are uncommon but have been reported. Reactions to fillers have also been reported but are exceedingly rare and least likely in substances that are not derived from animal sources. Swelling is often apparent for 24-48 hours and this is particularly noticeable in lip augmentation. Irregularities may occur and the time for the substance to wear off is variable but usually occurs between 12-24 months.