Soft Tissue Fillers
Soft tissue fillers – which fill out the skin or the tissue under the skin – are used to smooth out wrinkles, which begin to appear as collagen and elastin fibers in the skin break down. This breakdown can be attributed to aging, excessive squinting, frowning, smiling, and especially smoking. Fillers are also used to restore volume that may be lost through aging and weight loss.
Types of fillers
Permanent- various materials are available to produce long lasting results however these products are more difficult to use, and carry some increased risks when compared to temporary fillers
Temporary- The most common type of dermal filler. These are either collagen based or hyaluronic acid based and come in various formulations.
Fat grafting or lipofilling – transfer of fat from one part of your body to another
These fillers are commonly used in aesthetic medicine and can be made from various materials, including:
Hyaluronic Acid (HA): A naturally occurring substance in the skin, HA fillers are popular for their ability to provide immediate results and their reversibility. Common brands include Juvederm, Restylane, and Belotero.
Calcium Hydroxylapatite: Found naturally in bones, this mineral compound is used in fillers like Radiesse. It provides both immediate volume and stimulates collagen production for longer-lasting effects.
Poly-L-lactic Acid: This biodegradable synthetic substance stimulates collagen production over time. Sculptra is a well-known brand that provides gradual and long-lasting results.
Polymethylmethacrylate (PMMA): This semi-permanent filler contains microspheres that remain under the skin to provide lasting support. Bellafill is an example of a PMMA filler.
Fat Injections (Autologous Fat Transfer): Fat is harvested from the patient's body, usually via liposuction, and then purified and re-injected into the desired areas. This method is natural and offers long-lasting results.
Applications:
Facial Wrinkles and Lines: Fillers can smooth out nasolabial folds, marionette lines, and other facial wrinkles.
Volume Restoration: Used to restore volume in areas like the cheeks, temples, and under the eyes.
Lip Enhancement: Fillers can add volume and shape to the lips.
Jawline and Chin Contouring: Fillers can enhance the jawline and chin for a more defined look.
Hand Rejuvenation: Fillers can be used to add volume to the hands, reducing the appearance of veins and tendons.
Fat grafting – procedure
Fat transfer is widely used because it is tolerated well and you cannot be allergic to substances taken from your own body. In addition to filling out wrinkles, lipofilling can be used to recontour the face and provide fullness to cheeks, chin, lips and lower eyes. The fat used for fat transfer is liposuctioned from another part of your body like the abdomen or thighs and injected into an area of the face that requires more volume.
Injected fat lasts longer in larger areas of non-movement, so while it is successful for the correction of grooves under the eyes and sunken cheeks, it is not as successful for creating fuller lips.
Fat grafting can also improve atrophic aging of the hands. Fat grafting is usually performed on an outpatient basis. Both the area from which the fat is taken and the treatment site are anesthetized with a local anesthetic. Using a small needle attached to a syringe, fat is removed from a donor site where you have spare fat, such as your abdomen. Once removed, your fat is processed to remove excess fluids and then reinjected using another needle, which is placed just under your skin beneath the wrinkle, or deeper if contour change is desired. The procedure may need to be repeated until the desired correction has been achieved.
Swelling and bruising is expected after fat injection. Discomfort following the procedure can be easily controlled with medication. Although your body may resorb some of the fat a significant portion will survive and produce long lasting results
Your plastic surgeon will discuss with you the risks and benefits of all of the available tissue fillers.
