Naso-labial fold furrows in a very 38-year-old
female just before collagen injection What are soft tissue fillers?
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Soft tissue fillers are versatile substances that may be injected to the skin to enhance the look of fine lines and wrinkles, plump lips, fill hollow cheeks, repair a number of facial imperfections, boost scars, and elevate deep folds. The outcome may be a smoother, far more youthful appearance with minimal "downtime" and maximum safety.
Dermatologists use a variety of soft tissue fillers, including human and bovine (cattle) collagen, hyaluronic acid, autologous fat (one's own fat),
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What can soft tissue fillers do?
The aging process generally causes a loss of volume as the underlying collagen, hyaluronic acid, and elastin fibers begin to deteriorate and fat stores in the face decrease. This most commonly occurs around the eyes, mouth,
Microsoft Office Pro Plus 2007 Serial Key, cheeks, jaw line, brow, and bridge of the nose, producing crow's feet, laugh lines, folds and furrows on the forehead, and "hills and valleys" on the lower third of the face. Soft tissue fillers have the unique ability to fill and contour these changes.
Fillers is placed in to the lips to create a fuller, more youthful look, or in the hollows of the cheeks to reduce a gaunt look. Facial scarring from acne or injury also responds well to soft tissue filler techniques.
How do soft tissue fillers work?
A filler substance is injected beneath the surface of the skin where it corrects the line or wrinkle by temporarily plumping and smoothing out the skin depression. Most fillers replace the host components of the skin: collagen, hyaluronic acid, and elastin. Some fillers also can stimulate production of collagen.
24-year-old with an early naso-labial fold and
some soft tissue loss lateral to the chin
Seen at six months with excellent response to fat transfer
What exactly are the ABC's of fillers?
Dermatologists have developed a variety of filler substances to address a wide range of cosmetic flaws and other needs of the individual patient. Each filler brings subtle, distinctive benefits. Sometimes extra than one filler may be used to achieve the best results. Some fillers provide longer-lasting results; others allow for significantly more precision with good lines, and still others can gradually bring the face into better balance, creating an overall rejuvenated look.
Soft tissue fillers are often considered the first line in the treatment of aging skin and are frequently used in combinations or with other techniques for facial rejuvenation. Filling substances commonly used by dermatologists are:
Collagen Collagen products give structure to the skin and are used to add volume to lips, raise the corners of the mouth, and redefine the shape of the nose. Collagen fillers may be layered with hyaluronic acid fillers to diminish deep wrinkles. Introduced nearly 20 years ago, bovine collagen has proven effective. Some patients may be allergic to bovine collagen; therefore, test doses are given to determine if a patient has a sensitivity. Human-derived collagen offers an alternative and does not require a skin test. Hyaluronic acid Hyaluronic acid can be a natural component of human skin and is the framework in which skin cells live. There are several hyaluronic acid products available. Each has diverse characteristics that the dermatologist will take into account when choosing a filler. All hyaluronic acid products bind water and give the skin volume. These fillers is often used to fill hollow areas of the face, including the cheeks, and to plump lips. Autologous fat Removed by a mini liposuction procedure from other parts of the body such as the thighs, buttocks, or stomach, one's own fat has been used to reduce deeper wrinkles and contour the "hills and valleys" associated with the aging face. Poly-L-lactic acid This filler is used to replace lost facial fat, giving the face a a lot more youthful look.
Calcium hydroxyapatite Suspended in an aqueous gel is often a semipermanent filler which holds promise for long-term soft tissue augmentation. Implants Polymers and collagen-related implants offer a longer-lasting option for diminishing deep facial grooves and folds, particularly around the mouth, nose, and lips. The material is inserted under the skin as strips, threads, or hollow tubes that serve as a permanent filler. These substances also can form the foundation into which other injectable fillers may be added.
Botulinum toxin While technically not a filler, very tiny amounts of botulinum toxin are injected into specific facial muscles to immobilize or relax the underlying cause of lines and wrinkles. It is commonly used to enhance forehead creases, furrows between the eyebrows, and crow's feet. Using botulinum toxin and fillers in the same area may achieve longer-lasting results. Other Products
New and improved fillers are constantly being researched, tested, and evaluated. Other types of hyaluronic acid products which may last longer may be offered. Hybrid fillers, which contain small spheres and bovine collagen, are another form of partially permanent filler. The vehicle does not last, leaving small beads behind as long-term permanent beads. Micro-droplet silicone may be a a great deal more permanent filler.
Dermal stimulators stimulate the skin cells to produce collagen. Since collagen production takes time, dermal stimulators do not offer the instant gratification provided by soft tissue fillers. Dermal stimulators are injected on a monthly basis, and the wrinkles gradually diminish over time. The treatment cycle typically spans 3 to 5 months, with the results lasting up to two years. Dermal stimulators will be combined with soft tissue fillers to achieve both immediate short-term correction and delayed long-term correction.
What happens during and after treatment?
Injections are usually given within a dermatologist's office. Before beginning treatment, a skin test may be administered to determine if you are likely to have an allergic reaction to the filling substance; however, most of the new fillers on the market do not require skin testing. The dermatologist may ask about the use of aspirin, warfarin (coumadin), alcohol,
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Prior to the procedure, the face is cleaned and a topical or local anesthetic may be used. The filler is injected directly into the area to be treated using a very small needle. There may be a stinging or burning sensation as the filler is inserted. A series of treatment sessions may be necessary to fill and smooth the lines and wrinkles, or raise a depressed scar to the level of the surrounding skin.
After the procedure, there may be some temporary swelling, redness, or minor bruising at the injection sites. This usually subsides quickly. Makeup is often applied immediately after the treatment.
42-year-old woman with deep naso-labial furrows
Excellent response is seen immediately with injection of filling substance
Are there any possible risks?
All medical procedures carry some risk. However, soft tissue fillers are generally considered safe and effective. Apart from an allergic reaction to the injected substance, side effects are few and typically due to the local injection.
How long does the improvement last?
This depends on the type of filler used, the areas treated, and the ability of the patient's skin to absorb the materials. Results are generally long-lasting with maintenance treatments performed after 3 to 6 months. Occasionally, touch-up treatments may be needed sooner. Correction of acne scarring, as well as the use of combination techniques, tends to last longer.
What are other treatment options?
As experts on skin aging,
Windows 7 Pro 64bit, dermatologists are uniquely qualified to employ a variety of corrective and preventive techniques to keep skin looking its best. In fact, dermatologists pioneered many of the dermatologic surgical treatments used today to preserve and maintain healthy,
Office 2007 Professional Serial, youthful-looking skin, particularly, soft tissue fillers. The dermatologist will discuss alternative and complementary treatments to enhance the outcome of filler procedures.
To learn extra about soft tissue fillers, call toll-free (888) 462-DERM (3376) to find a dermatologist in your area.
AAD website: www.aad.org
Toll-free (888) 462-DERM (3376)
Images used with permission of the American Academy of Dermatology
National L ibrary of Dermatologic Teaching Slides
© 2006 American Academy of Dermatology
Revised 2002, 2006
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