These are substances injected under the skin to smooth out folds and even out wrinkles. These folds are due to the loss of subcutaneous fat or the combined effects of loss of skin elasticity and gravity.
There are numerous filler substances in the market but the ones that are more familiar include collagen, hyaluronic acid derivatives etc. Calcium Hydroxyapatite and fat.
Collagen was one of the first substances injected but is gradually falling out of favour because of its shorter duration of action (about 6 months) compared to the newer hyaluronic acid-based products. And, unlike these synthetic compounds, collagen requires skin testing prior to injection.
Filler substances are useful for individuals who are not quite ready for plastic surgery but want some correction of certain lines/folds in the meantime. The effect usually lasts from between 8 months to a year.
The more common areas that fillers are being injected include the nasolabial fold (the fold that runs from nose to corner of the mouth), the lips (for better definition and a fuller appearance) as well as other lines and depressed scars on the face.
Complications include pain during injection, swelling and redness of the injected areas that lasts for one to two days and very rarely a hypersensitivity action to the injected substance.
BEAUTY SOS FILLERS
Turn back the hands of time and look younger, more refreshed, and less tired looking with this non-surgical technique-Fillers; some have even called this technique, the liquid facelift.
With ageing, the skin is thinned and sags, bone gets resorbed and fat is lost, creating wrinkles and loss of volume in the face. This loss of volume below the eyes and mid-face creates what we have come to recognize as ageing changes the hollowing around the eyes, sagging of the cheeks and deepening of the folds from the nose to the mouth (nasolabial folds). In the lower face jowls (skin that sags below the jawline), thinning of the lips and squaring of the lower jawline also appear, all of which may also reflect this volume loss.
Previously when only surgical facelifts were performed to attempt to correct these ageing changes, the result was the creation of many skeletal gaunt faces with taut skin. Now we recognize the importance of the restoration of volume to an ageing face to give it a more youthful plumped up appearance; much like that, we see in babies and younger individuals. This realization has fueled the recent explosion of filler injections as a cosmetic procedure to treat ageing faces.
In parallel with the growth of this procedure is the increase in the number of brands of fillers for the skin. Permanent fillers are not popular among many doctors here because of the potential for the formation of lumps and reactions to the filler material.
So how do we use fillers to correct volume loss and these folds?
Following the lessons we have learnt from just performing surgery to treat ageing skin, we now recognise that a variety of treatments/procedures are required to restore the ageing skin to youth and health
We need creams and lasers/chemical peels/IPL etc to treat the external surface of the skin to make it smoother, less blemished and more radiant
We use a combination of Neuromodulator and fillers to restore volume and smooth out wrinkles for the upper, mid and lower face as described below:
- For the forehead and frown, lines-Neuromodulator is required to diminish the appearance of forehead and frown lines. Neuromodulator works by blocking the transmission signal from nerve to muscle, causing the muscle to relax and thereby smoothening out those wrinkles that are caused by the raising of the eyebrows or the act of frowning.
- Fillers further help to fill up the residual frown lines that remained after relaxation by Neuromodulator, because the lines are too deep after years of frowning. In the upper face, fillers are also injected into the temples that become hollowed out with ageing as well as along the outer aspect of the eyebrows to raise the eyebrows
- For the nasolabial folds, fillers are ideal to decrease the depth of these folds. The filler material is injected just below the skin causing an instant correction and it can be injected directly into these folds or into the mid-cheek to achieve some lifting and therefore a softening of the nasolabial folds
- With mid-cheek ageing, fillers help to fill out the sagging cheeks as well as cause a lift-this softens the nasolabial folds, restores the highlight back to the cheekbones and also helps to fill out the hollowing below the eyes (also called the tear trough area)
- In the lower face, fillers can be used to restore the angular contour of the jaw, lengthening and broadening of the chin area and filling out the marionette lines (the folds that are present between corners of the mouth and the chin).
- Neuromodulator has a limited role in the lower face but it can be used to soften the marionette lines, vertical lip lines and reduce a too prominent overactive chin
- The lips and nose are special areas that are also readily treated by fillers. It has been said that fillers are now able to replace many surgical “nose jobs” that were done in the past. Fillers can fill out any irregularities in nose contours and be used to build up the nasal bridge, so desired by many Asians, to create a higher sharper nose
- In the lip area, fillers can be used to restore volume and projection to the lips as well as fill out some of the vertical wrinkles. These wrinkles can be further softened by the use of Neuromodulator. Although many desire luscious pouty lips as a sign of youth and feminine appeal it is important not to overfill else one can end up with unnaturally big lips that are not normally looking
Nevertheless, fillers as a procedure are not without potential complications. It is expected that for the first or second day after the filler injection, there will be some redness and swelling. There is also the bruising that may occur in certain areas like the midface and below the eyes and rarely the development of lumps with certain filler materials in the initial few weeks. So it is best to discuss with the doctor the potential benefits and risks before embarking on this procedure. But used rightly and if the minimal side effects are accepted, the good cosmetic results of fillers are seen instantly when one walks out of the clinic(*).
*Individual results may vary.