Fillers are substances that are injected into the skin to correct surface irregularities such as wrinkles, folds and depressed acne scars. They are also used to enhance facial features by making them larger (e.g., lip augmentation) or more prominent (e.g., bridge of the nose, cheekbones). Filler injection produces an immediate result. For the initial correction a limited amount should be injected to avoid overfilling. Insufficient correction is followed by additional injection in about a month. Bruising, transient redness and swelling may last for a few days to over a week after the procedure. Make-up can be applied from the next day. Occasional complications are discoloration and bulging or unevenness.
At present we only use resorbable fillers in our clinic. With time resorbable fillers are completely eliminated from the body. Hyaluronic acid fillers are representative of this group.
Hyaluronic acid fillers are of non-animal origin and produced by bacterial fermentation. They can be used without a preceding skin test since allergies to hyaluronic acid are extremely rare.
Among various hyaluronic acid products now available, Teosyal® products from Switzerland are the main fillers we use in our clinic. They are so-called "monophasic" gels, i.e. they contain no hyaluronic acid beads, thus minimizing the foreign body reaction responsible for persistent redness and swelling.
Hyaluronic acid processed with the crosslinking technique cannot be easily absorbed due to its large molecules, and its effect lasts for 6 to 12 months, sometimes even longer depending on the site of injection and other factors.