• Dr. Naureen Akhtar General Practitioner MBBS,MRCGP,DRCOG

Cosmetic procedures involving dermal fillers are quickly growing in popularity. Whether to address loose or sagging skin, cheeks that appear hollow, or an overall loss in the volume of the face, women and men of all ages are flocking to schedule appointments with cosmetic surgeons. While people choose to have these procedures done in an effort to turn back the hands of time, it is important that you understand exactly what causes the aging effects and what your options are before you make your decision.

The Effects of Aging

Before you can make the proper choice in dermal fillers, you need to understand how the effects of aging transform your appearance. As you age, your skin is exposed to harsh weather, the damaging rays of the sun, and any bad habits such as drinking, a poor diet and smoking that you pick up over the years. These types of exposure wreak havoc with skin, causing it to become rougher, drier and losing elastin, which is the tissue responsible for maintaining elasticity. Add in the fact that your skin also becomes thinner due to lost layers of the epidermis, and you can see why the effects of aging can become quite severe.

Another contributing factor to your skin losing its youthful appearance is free radicals, which are oxygen molecules that become unstable and overactive. These are the same cells that are believed to be responsible for contributing to the growth of cancerous cells and benign lesions. Other factors, including the effects of gravity, stress, the ways in which you move your facial muscles and even not getting enough sleep also lead to aging of the skin. Together, all of these factors result in skin that appears rough, slack and becomes more fragile.

Changes to the Facial Structure

In addition to the effects of aging on the skin, as you age, the structures beneath your skin also change. Factors such as bone loss, which occurs around the mouth and chin, results in the mouth and lips having a puckered appearance. You also begin to lose fat beneath the skin in the nose, cheeks, chin and eye area, which can greatly alter your appearance as well.

As a result of all these effects and changes, the wrinkles, hollows and fine lines all become slightly more prominent each year. These results are the reason that many women turn to dermal fillers in an effort to regain their youthful glow and appearance.

What Are Dermal Fillers?

Dermal fillers are substances that are injected beneath the skin. While there are a number of options available, each one is designed to restore a youthful appearance by filling in the fine lines and wrinkles that appear due to aging. Dermal fillers, which are often referred to as “volumizers” or “plumpers” work by filling in the areas in which they are injected, which is typically in those places that are most likely to show wrinkles and lines.

Opting for dermal fillers are popular due to their ability to greatly reduce lines and wrinkles, without requiring the considerably more costly facelifts and other cosmetic surgery procedures. Additionally, the effects of these substances are very quick, with many showing results in as little as 30 minutes that last for several months up to over a year. However, it is also important to understand that specific dermal fillers work best for certain areas of treatment. Generally, these substances work by smoothing out wrinkles and fine lines, restoring volume and plumping specific areas of the face.

You also need to understand the dermal fillers available, and what makes them the best option for your individual needs. The following are the most common types available to help you in choosing dermal fillers that are right for you.

Hyaluronic Acid

The most common and popular dermal fillers are known as hyaluronic acid (HA). HA is a gel-like substance that occurs naturally in your skin, as well as in some fluids and other connective tissues in the body. As a result, it is one of the most popular options for those choosing dermal fillers.

Once injected, hyaluronic acid works by providing support for the facial tissues and structures that have lost volume due to aging. HA also works to restore a more soft and supple appearance by drawing water within the body towards the surface of the skin.

The effects of HA can last between six and 12 months before the substance is absorbed back into the body.

Calcium Hydroxylapatite

Calcium hydroxylapatite (CaHA) dermal fillers are also naturally occurring in the body, though it is a mineral-like compound that is found in the bones and is thicker than HA. As with HA dermal fillers, calcium hydroxylapatite is produced biosynthetically, which means that no animal products are used for it. For you, this minimizes the risks of allergic reactions.

CaHa injections are typically used for deeper lines, such as those that appear around the nose, marionette lines, which appear around the mouth, and for deep frown lines. This is a popular dermal filler as it has very few side effects and it doesn’t migrate as other options may do. The effects of CaHA generally last for around 12 months.

Poly-L-Lactic Acid

Poly-L-lactic acid is a biocompatible substance, which means that even though it is synthetic, it is also safe for use in the body. This type of dermal filler, which is made of the same substances as those used in dissolvable stitches and other medical devices, is a thick substance that is used for areas with very deep wrinkles. Poly-L-lactic acid dermal fillers are often considered semi-permanent options, as the results of an injection can last up to two years or longer in some cases. Additionally, the material can also stimulate and improve collagen production in the body, which is an important component of plump, youthful skin.

Polymethylmethacrylate

Polymethylmethacrylate (PMMA) is another synthetic substance that is used as dermal fillers. Like Poly-L-lactic acid, PMMA is also safe for use in the body. As a filler, PMMA resembles a microsphere that provides support for the skin indefinitely once it is injected. This type of dermal filler also contains collagen, which provides the firmness and structure seen in younger skin.

Considering the Effects of Dermal Fillers

Whenever you are considering injecting something into your body, you need to make sure you understand what the substance is and how it can affect your body. Generally, there are varying levels of side effects based on which dermal filler you choose. The following information will help you gain a better understanding of these effects.

Hyaluronic fillers, as mentioned, are one of the most popular options due to it being a naturally occurring substance in the body. However, while side effects are considered quite rare, some people may suffer from swelling, bruising or redness. In some cases, the HA filler can result in very small bumps that appear beneath the skin. HA is also believed to stimulate the production of collagen in the body. Additionally, some research has also shown that HA fillers may require less with each subsequent injection to achieve the desired result.

Collagen Dermal Fillers

While collagen is a naturally occurring substance in the body, the material used for the injections is often extracted from cows and purified. The resulting filler produced natural results, but they typically begin fading much sooner than is seen when choosing dermal fillers from other categories. Additionally, as these substances are taken from cows or are synthetic options, the potential for allergic reactions is increased. Generally, these side effects include redness, bruising and an increased risk of allergic reactions to the substance.

Synthetic Dermal Fillers

There are also several synthetic dermal fillers available. These substances, which do not occur naturally in the body and are made in labs, can cause significant side effects in some patients. These can include bruising, swelling, redness, and in some cases, small bumps that require surgical removal. However, the results of choosing dermal fillers that are synthetic are that they often last longer than other options.

Autologous Wrinkle Fillers

Another category available when choosing dermal fillers are autologous. This type of filler is one of the most frequently used options as it is created from your own fat or plasma. Fat from other areas of the body, such as the stomach, buttocks or thighs, is removed and treated in a special process. Once the fat has been treated and purified, you will have to come back in for a second appointment to have it injected.

You can also choose to have your own blood drawn and treated to prepare it for injection as a wrinkle filler. With this option, the results can last up from 1 year up to 18 months. While somewhat costlier than other options, the results of both fat and plasma may be semi-permanent after you’ve completed a series of the injections. Even though these are more natural dermal filler options, autologous dermal fillers can also cause side effects, including swelling, redness and bruising. One special consideration, however, is that since the material being injected comes from your body, FDA approval is not required.

Considerations When Choosing Dermal Fillers

Now that you have a better understanding of the dermal fillers available and how they can affect you, you are well on your way to choosing the option that is best for your needs and comfort. However, you also need to consider a few more things to ensure your dermal filler outcome is the one for which you are hoping.

Price Isn’t Everything – If you are considering a dermal filler and it is being offered at a considerably lower price than other locations are charging, it may be due to either product quality or the ability of the person doing the procedure. While bargains may work well in some areas, taking that risk with your face is not advisable.

Medical Settings – No matter which dermal filler you choose, you need to ensure that it is administered in a medical setting. This will ensure the instruments used on you are sterile, which is of great importance when having substances injected into your body.

Know the Source – You should always check with your doctor and make sure that the options he or she is using as your dermal filler are sourced from the manufacturer. If you find out that it is not, or the doctor refuses to answer whether the substance is FDA approved, you should seriously consider finding another source for your dermal filler injections to ensure your safety. Unscrupulous persons have injected materials such as baby oil and industrial silicone in an effort to make money doing these procedures, and this can result in serious disfigurement if you aren’t careful.

Choosing Dermal Fillers – Quick Facts

When trying to decide whether dermal fillers are right for you, it helps to consider a few key facts related to the subject. These types of treatments are increasingly popular, among both women and men who are interested in maintaining a more youthful appearance. Generally, each of these dermal filler options provide instant results, allowing you to get back to your life without worrying about downtime for healing. There are also varying levels of longevity with these dermal filler options. Some can last as little as six months, while others can last up to two years or more depending on the treatment you choose.

It is also important that you understand that the different materials available in dermal fillers have varying formulations to reach a specific densities, textures and rates of injection to address specific types of wrinkles and fine lines. You should always discuss these choices with your physician to ensure you understand how each option works and will address your needs in the best way.

Now that you better understand the effects of aging on the skin, and how dermal fillers can help address those issues, you are ready to speak with your doctor to find out which options he or she believes is right for you.

Dr. Naureen Akhtar
Dr. Naureen Akhtar is a GP Practitioner providing Wrinkle reduction treatment in the Basingstoke, Hampshire area.