Fillers

As we age, our face begins to show the effects of gravity, exposure to the sun and of facial muscle movement (smiling, chewing, etc.). When the deeper tissue begins to relax, it creates wrinkles and small creases such as "crow's feet" in the areas where these movements occur.
These wrinkles can be treated with fillers. Fillers are injectable substances, such as collagen,  hyaluronic acid, fat or implantable substances such as PTFE (gore-tex), that help to temporarily fill or provide support to the soft tissues (gore-tex), improving the aesthetic aspect and giving the face a younger look.  The fillers can also be used to give more fullness to the lips or as a filler for the cheekbone area. They can be used alone or together with laser treatment, face lifting, etc..

Possible uses

The main use of fillers is for the treatment of subtle facial expression wrinkles,  depression wrinkles or for small scars, or renewal around the lips to increase their outline and their fullness making them more sensual.
Fillers are not, however, sufficient for deeper facial wrinkles, such as, for example, the vertical ones above the upper lip, where dermabrasion, chemical peeling or resurfacing with laser can be more effective.
It should not be forgotten that the experienced specialist in Plastic Surgery can offer the best treatments with the most advanced techniques and that each patient has completely individual problems and, therefore, for each case the treatments that can guarantee the best aesthetic results will have to be decided upon.

What are fillers?

Fillers are divided into injectable and implantable substances. Among the former there are collagen, hyaluronic acid and autologous fat. Among the latter, PTFE.
There are also other filler substances, however, as I do not use them in my practice I will not mention them here.

What can be expected from the treatment?

The most important thing to remember about injectable material is that the results are not permanent. The substances are metabolized and absorbed by the organism, therefore, no permanent results should be expected as compared to those of cosmetic surgery.
The time taken for reabsorption is individual and can take from a few weeks to many months. Biological studies on this, though not having being able to provide a precise and conclusive response, lead us to believe that various factors, such as age, skin quality, genetic background, lifestyle and the position of the implant may condition the metabolization time.

Treatment risks

If the treatment is carried out by an experienced and qualified Plastic Surgeon, complications are rare and usually of a minor nature.
Collagen - Allergic reactions are the main risk. To avoid the emergence of undesired reactions a test is carried out a month before the implant. The test location is checked over the period of the 4 weeks and if there are no reactions of any type the implant goes ahead.  
Fat - There is no risk of an allergic reaction as the fat originates from the patient herself, however, a minor risk can emerge from an implant infection.
PTFE - Risks involve implant dislocation and its visibility or poking out under the skin.

The treatment

Collagen and  hyaluronic acid are generally injected without using any kind of anesthetic. However, in more sensitive patients an anesthetic cream can be used to desensitize the area to be treated.  
The procedure is carried out by means of infiltration with a very fine needle along the line of the wrinkle to be filled. Immediately following the treatment a slight reddening occurs which lasts for some hours. No type of specific medication is required.
Fat is injected using a local anesthetic for both the donor and receiving areas.
The fat is drawn from an area where there is an excess of fat with a procedure similar to liposuction,  then prepared and injected into the receiving area with specific needles. A medication is applied on both areas involved.
Usually, a higher amount of filling than is actually required is used as a part of the fat implanted is reabsorbed.
In the immediate post-treatment period, the tissue appears reddish, swollen and slight bruising can appear. However, the situation tends to become stabilized in a few days.