Filling
What is Dermal Filler?
With advancing age, some loss of subcutaneous fat tissue occurs. Depending on genetic structure and lifestyle, varying amounts of lines and wrinkles appear on the skin. At this point, dermal fillers come into play and provide a good option in the treatment of collapsed fat loss areas, wrinkles and deep facial lines. However, it is very important to select suitable candidates. Fillers; It cannot replace surgical solutions such as face lift, forehead lift and blepharoplasty. In other words, hoping for benefit only from fillers on an extremely sagging and wrinkled face will result in disappointment. People who are middle-aged, have a healthy physical structure, are non-smokers, have a constant effort in skin care, and have just started to notice age lines on their face are good candidates for fillers. Depending on their basic chemical structure, synthetic fillers dissolve and disappear in the body after a certain period of time.
Dermal Fillers Are Examined in Various Categories:
1. Autologous materials:
They are prepared from the person's own tissue. Fat, cartilage, fascia, dermis and fibroblasts (Fibrocell) produced from tissue culture can be injected. Allergic, immunologic and carcinogenic effects are not observed.
2.Biological materials:
These are of foreign human and animal origin. These include products based on collagen and hyaluronic acid. They may have disadvantages such as hypersensitivity and disease transmission. Their duration of stay in the body is limited.
3.Synthetic materials:
They potentially stay in the body longer. They do not have the risk of protein reactions and disease transmission. On the other hand, the main disadvantages are garnuloma formation, causing infections, wound scars and collapses due to displacement and removal.
a) Calcium hydroxyapatite (semi-permanent: Radiesse)
b) PTFE and PMMA (permanent products: Artefill)
4.Unlabeled products:
These are products that are not approved for use in the United States but are widely used in Europe and other countries. They are sold under hundreds of brands. Let's examine the most commonly used ones:
Radiesse:
They are fillers with calcium hydroxylapatite structure and can remain in the body for an average of 9-18 months. They are injected into the deep dermis. They are successfully used in cheek, chin and chin edge elevations, deep lines between the eyebrows and on the forehead, treatment of acne scars, facial fat melting, deep nasolabial lines, treatment of depression areas due to trauma or steroid injection. It is not used in lips. Maximum volume is reached at 4-6 weeks after injection. 8-10% tendency to clump. Massage after injection is important to eliminate irregularities.
Juvederm, Restylane, Hylaform, Perlane, Prevelle, Captique, Puragen, Esthelis:
These are filling products in hyaluronic acid structure. They do not show immunologic reaction, therefore no skin test is required before application. The application may be a little painful, so some products contain lidocaine for comfort of use. Their permanence in the body is 6-9 months on average. Swelling may last 3-5 days after application. In some cases, intermittent swelling periods of 2-6 weeks may be observed. If bruising occurs, these heal within 1-1.5 weeks. To minimize these side effects, intermittent ice application will be useful for the first 24 hours after application. The most frequently used areas; acne scars, laugh lines, cigarette lines on the lips, cheeks, lines between the eyebrows, wrinkles called crow's feet at the corners of the eyes, marionette lines extending down from the corners of the mouth, scars on the face, etc.
Sculptra:
It is a filler in polylactic acid structure. It acts as a stimulant that enables the body to produce its own collagen. Therefore, it shows its effect increasingly within a few months. It is injected into the deep plan. It is applied on cheekbones, cheeks, laugh lines and temporal region to increase volume. In order to achieve the desired result, 2-3 sessions repeated every 3 months may be required. It has the potential to form papules in subcutaneous tissue.
Zyderm I-II, Zyplast,osmoderm I-II, Cosmoplast, Artecoll, Artefill, Isologen, Dermalogen
These fillers in collagen structure are products of human and animal origin or obtained from them through bioengineering. Depending on their compound structure, they are used throughout the face, deep or superficial, for wrinkle removal or volume provision. Products called Isologen and Autologen are based on the principle of injecting fibroblasts cultured from a piece of skin taken from the person. Fibroblasts also produce collagen where applied. The permanence of collagen-based filling materials varies between 3-12 months depending on their chemical structure.