Dermal fillers are injectable substances used to add volume, enhance facial contours, smooth out wrinkles, and improve skin texture. They are commonly used in aesthetic medicine to provide a more youthful appearance. The most commonly used types of dermal fillers and their associated uses and side effects include:
- Examples: Juvéderm, Restylane, Belotero, Voluma
- Uses: HA fillers are the most popular type and are used to treat a wide range of concerns, such as smoothing nasolabial folds (smile lines), enhancing lips, correcting under-eye hollows (tear troughs), and restoring cheek volume. They are also used for fine lines, facial contouring, and hydration since hyaluronic acid attracts and retains water in the skin.
- Side Effects: Common side effects include swelling, redness, bruising, and tenderness at the injection site. Rarely, patients may experience allergic reactions, lumps or nodules, and vascular occlusion (if injected into a blood vessel), which can lead to tissue damage if not treated promptly.
- Examples: Radiesse
- Uses: CaHA fillers provide volume and are often used to treat deeper lines and folds, such as nasolabial folds, marionette lines (lines running from the mouth to the chin), and to enhance cheekbones. CaHA fillers are also used for contouring the jawline and improving the appearance of aged hands.
- Side Effects: Similar to HA fillers, CaHA fillers can cause bruising, redness, swelling, and tenderness. Other possible side effects include nodules, granulomas (small lumps under the skin), and the risk of vascular occlusion.
- Example: Sculptra
- Uses: Poly-L-lactic acid is a biodegradable synthetic substance that stimulates collagen production. Unlike other fillers, which provide instant results, Sculptra works gradually over several months to add volume and improve skin quality. It is used for volume restoration in areas like the cheeks, temples, and chin, as well as for deeper wrinkles and folds.
- Side Effects: Immediate side effects may include swelling, redness, and tenderness at the injection site. Due to its collagen-stimulating nature, there is a risk of developing small lumps under the skin (known as papules or nodules), which may resolve on their own or require treatment. Proper technique is crucial to avoid such side effects.
- Example: Bellafill
- Uses: PMMA fillers are considered semi-permanent because they contain tiny, biocompatible beads suspended in a gel matrix, providing long-lasting volume. These fillers are primarily used to treat deep wrinkles like nasolabial folds, acne scars, and to restore volume in areas like the cheeks.
- Side Effects: Due to the more permanent nature of PMMA fillers, side effects can include prolonged swelling, redness, bruising, and the formation of nodules or granulomas. These fillers require a skilled injector as they are not easily reversible like HA fillers.
- Uses: In this procedure, a patient’s own fat is harvested (often from areas like the abdomen or thighs) and injected into areas needing volume restoration, such as the cheeks, temples, lips, and around the eyes. Because it uses the body’s own tissue, it is considered a natural filler.
- Side Effects: Swelling, bruising, and tenderness are common at both the donor and injection sites. Since some of the injected fat may be reabsorbed by the body over time, multiple sessions may be needed. There is also a risk of lumps or uneven contours.
- Example: Ellansé
- Uses: Polycaprolactone is a biostimulatory filler that not only provides volume but also stimulates collagen production. It is used for deep facial wrinkles, volume loss, and facial contouring. PCL fillers tend to have long-lasting results.
- Side Effects: Common side effects include swelling, redness, and bruising. There is also a risk of nodules or granulomas forming, as with other collagen-stimulating fillers.
While dermal fillers are generally safe when administered by trained professionals, there are potential risks. Vascular occlusion (accidental injection into a blood vessel) is a serious complication that can lead to tissue necrosis or vision loss if not treated promptly. It is essential to choose an experienced injector who can identify and manage such complications if they arise.
Temporary Side Effects: Most side effects like swelling, redness, bruising, and tenderness are mild and resolve within a few days. Long-Term Considerations: Long-lasting or semi-permanent fillers require careful planning, as improper placement or lumps can be difficult to correct.
Dermal fillers offer a wide range of cosmetic benefits, and their use has grown significantly in recent years. However, they require professional expertise for safe and satisfactory results.