Dermal Fillers

This term covers all the available substances to fill in superficial or deep wrinkles, but it also allows for an increase in volume. The basic principle is the injection of a liquid product into the thickness of the skin or in the subcutaneous space that is designed to produce a volume of filler or increase.

Many products are available on the market benefitting from EC (European Community) Markings.

Biodegradable products: these are gradually reabsorbed by the body.

Hyaluronic acid: (Juvéderm™, Voluma™, Emervel™, Restilane™, Perlane™ etc..) this is the most frequently used product (synthetic origin, no prior test, lasts for between eight and 18 months). This is the product of choice. It generally contains local anaesthetic to improve the comfort of the injection.
Collagen: (Zyderm™, Zyplast™, Resoplast™ etc.) are of animal origin. Risks of allergy are the reason for two successive skin tests prior to injection, but the efficacy is very short so it is hardly used any longer.
Polylactic acid: (New-Fill™): of synthetic origin – no test – partially re-absorbable – hardly ever used nowadays.

Non-biodegradable products:: these remain in place for several years, or even indefinitely (abandoned by most plastic surgeons).

  • Silicone: banned in injectable form since 1997 due to the often disastrous side effects.
  • Acrylic hydrogel: (Dermalive™) and Methyl polymethacrylate (Artecoll™): non-biodegradable synthetic particles “transported” on either hyaluronic acid or on collagen – the risk of granuloma is reputed to be high.
  • Polyacrylamide: (Aquamid™, Bioalcamid™, Outline™).

Hyaluronic acid injection

  • Hyaluronic acid injections are performed in the doctor’s office after an information consultation. Contact anaesthesia using an anaesthetising ointment is possible. Sometimes full local anaesthetic is used by injecting a local anaesthetic (Xylocaine™). The injection is performed using a very fine needle. The session lasts for about 30 minutes. An additional session may be necessary after two to three weeks.
  • The average time a hyaluronic acid injection lasts is between eight and 18 months.
  • This may be shorter or longer depending on age, skin quality, a healthy lifestyle (smoking, being exposed to the sun or to UV rays will shorten the length of time), the choice of product and the area to be injected.
  • Sequels and any complications from hyaluronic acid injections will be explained to you by Dr COURBIER during the consultation and in the literature supplied to you.

My opinion

Injection with a filler product is a good addition to Botox injections; only re-absorbable products such as hyaluronic acid should be used. It works well in creases and localised wrinkles. If the skin sags badly, it should be combined with a face lift; if the wrinkles are too widespread, skin peeling is preferable. Hyaluronic acid is effective in correction hollows and moderate losses of volume, but in cases that require large quantities of the product, lipostructure is preferable.

SOCIÉTÉ FRANÇAISE DE CHIRURGIE PLASTIQUE, RECONSTRUCTRICE & ESTHÉTIQUE
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