What Are Dermal Fillers?

You have probably heard fo dermal fillers before. A common place to get them is in the lips, but they are useful for restoring volume that is lost in our faces as we age. They can be utilized in essentially all areas of the face and even in hands when used by an properly trained professional for an appropriate client.

There are three main types of filler which are FDA approved and available from a licensed medical professional. The first are hyaluronic acid (HA) fillers. HA is naturally occurring in our skin and helps attract water, maintain hydration, and help our skin stay resilient. There are many types of HA filler that are approved for different areas and your injector will help you pick the appropriate one for your treatment area.

Second are Resilient Hyaluronic Acid (RHA) fillers. These are very similar to HA fillers, except that true to the “resiliant” in their name, they have more flexibility and dynamic movement with your skin. This means they not only fill the space, but move more with you and tend to last longer.

Last are fillers in the bio-stimulation category. These are Radiesse and Sculptra. These “fillers" help to stimulate your body's own collagen production. They take time to “develop” and the best results will be seen up 6-9 months later. Radiesse has a short-acting agent that acts as a filler to bridge the time while your body makes more collagen. It is NOT dissolveable and should only be administered by a highly confident injecton. It can not be dissolved if thereis a vascular occlusion or if it is misplaced. Sculptra is a bio-stim that does not have the original short-term filler. You must wait for the results, but they are your body's own growth.

What is the Difference Between the Different Types of Dermal Fillers?

There are many different fillers on the market, so how do you know what is right for you? Ultimately, your injector is your knowledge base for the best filler for you. There are many different brands, but the main differences in filler besides those listed above are the G' (say “G prime"), stretch or dynamic movement, and the hydrophilic (how much it attracts water) properties.

Different areas require different G’ filler based on where on the face they are and the desired effect. The G' is the thickness or viscosity of the product. For instance a very soft, malleable filler is said to have a low G' and is more appropriate for places such as the tear troughs, peri-oral lines, or lips. On the other extreme, you have fillers with a high G', these are firm fillers designed for cheeks and jawline. It is important to follow your injectors recommendations, it is not worth your time or money to get inappropriate product for the area you want to treat.

Different fillers have more flexibility and movement. RHA fillers tend to be more dynamic,

The hydrophilic property of the filler is very important to consider. You might get filler placed and leave feeling great, but then realize you have more swelling than you thought that doesn't go away. If you have a filler that has a high hydrophilic tendency, it will attract fluid that will be in there as long as the filler is there. It is important to consider this when choosing a filler.

What Is Important When Choosing an Injector?

Ultimately, it is important to have someone you feel comfortable and confident with inject your filler. It is important that your injector understands where the muscles, deep and superficial fat pads, nerve bundles, arteries, and foramens are in the face and neck and how they interact with each other. An educated injector is less likely to have side effects such as an overfilled area, an area filled with an inappropriate product, unpleasant aesthetic results, nerve damage, bruising, vascular occlusion, blindness, etc, but sometimes these things can happen, even with the best in the world! Your injector should have hyaluronidase such as Hylenex ready as well as other emergency and first aid supplies in the event of an extreme complication.

Be patient while your injector learns your face and musculature, don't rush things. A medically beautiful face relies on knowledge of appropriate ratios and how a face is balanced. It is important not to overwhelm the face with product or create a heavy jowl/face by not treating the midface.

Your injector should be open and honest and also aware of the limitations of fillers, they can do amazing things, but they can't fix everything and can even make things worse if done inappropriately.

Have an injector who is not afraid to say “no!” to a treatment. This person has your best interest at heart!

You should always feel comfortable to ask questions!