Soft tissue augmentation is important in aesthetic improvement and rejuvenation of facial features. Given the considerable expense in both time and money of surgical approaches, new less-invasive techniques have been developed. Careful, intelligent use of Botox has largely satisfied the requirements for the upper regions of the face and desirable improvements such as wrinkle reduction can now be done. But there has been a necessity to create agents that could be used to address deficiencies in the lower regions of the face.
In addition, there was a realization in the field of esthetics of the desirability of making the face look more 3 dimensional. The youthful face appears much fuller; not a pulled, flat, 2 dimensional look. This understanding has become one of the central tenets in the field of soft tissue augmentation.
Over the years many substances have been promoted to cosmetically improve soft tissue deficit and restore volume. One very useful category of substances is the Fillers. Fillers can enhance, and even at times replace, “pulling” to remove wrinkles. In addition, as mentioned, filling creates a more pleasing roundedness than pulling. And filler for subtle lip augmentation is something that is here to stay. Initially Fillers were used for wrinkle and line filling. Newer applications such as facial shaping are being developed by advanced practitioners.
As these new techniques have been developing, new products are continually appearing at an even increasing rate. The list of available filling agents a decade ago consisted of 5 substances. Now there is a cornucopia of agents available for the practitioner to use. This places considerable responsibility on the medical aesthetician to understand the applications, advantages and disadvantages of a constantly growing family of products. Today, the more common products would include: Facia, Fat, Perlane, Collagen, Restylane, and the newer agents like Juvederm, Bellafil, Belotero, Restylene, Radiesse and Sculptra.
Many older fillers are now disappearing from the market as newer, better substances are developed. For example, Silicon should be used with caution and is not approved in the U.S. But some less informed practitioners are still using out-dated materials and techniques. As always, buyer beware!
The results that can be achieved depend on the agent used, its durability, the amount used and the technique. Frequently, fillers can be used in combination with Botox to improve fine lines and fill in deficits. The initial indication for Fillers was to improve nasolabial folds, contour lips, enhance cheekbones, correct defects in the nose and suppress scars. Newer indications include volume restoration of the temporal area, jaw line, marionette lines and the area under eyes. Fillers can also be used to rejuvenate hands, giving a more youthful look.
The reason why these new semi-permanent filler agents work well is because the face is a dynamic process and changes over time. Permanent fillers will not adapt to these natural changes. In addition, these new fillers stimulate the collagen and improve the skin texture. The aging face is a dynamic process and as time goes on one can always add and refill again. Remember, a combination of aesthetic procedures can yield enhanced results when used simultaneously, for example, Fillers used in combination with Botox, Laser or Chemical Peels.
The dermal Filler restores volume and contours facial anatomy. Compared to surgical procedures it is less invasive, has lower risk, little or no down-time and is cost effective. It is important to schedule an appointment with a professional to discuss the best possible treatment options. Together you can assess, plan and perform volume enhancement to replace your biometric volume loss. Patient satisfaction with the results achieved using Fillers is high, with some studies reporting a 90% satisfaction level after 3 years. Some newer Fillers are semi-permanent and last even longer.