Dermal Filler Injections (injectable cosmetic filler, injectable facial filler) are soft tissue fillers injected into the skin to help fill in facial wrinkles, restoring a smoother appearance. Most of these wrinkle fillers are temporary because they are eventually absorbed by the body. Some people may need more than one injection to achieve the wrinkle-smoothing effect. The effect lasts for about six months or longer. Successful results depend on health of the skin, skill of the health care provider, type of filler used.
Dermal filler injections, also known as “soft-tissue fillers,” do just what their name suggests: they fill in the area under the skin. Some dermal filler injections are natural and some are synthetic. They all work to improve the appearance of aging skin in the following ways:
While properly administered dermal filler injections are very safe procedures, there remains a risk of complications related to them. Most common, although still infrequent, complications of dermal filler injections are infection and filler irregularity/ migration. The infection usually resolves with antibiotic treatment, if indicated. Small grannulomas (nodules) may resolve on there own, be treated with steroid injections, or , if noticeable and large, may be excised via small skin incision. One of the more serious complications associated with dermal filler injections is tissue necrosis, which results from occlusion of the small blood vessels feeding the area by the filler. This is extremely rare, however, if occurs, it usually leaves a patient with permanent scarring/ deformity.
Various dermal filler injections are better used for various areas. One example of specific dermal filler products for a specific area is the use of Juvederm/ Restylane for lip augmentation. Another specific product for a particular use is the use of Radiesse for midface, nasolabial folds, temples, jaw line, etc. Choosing the right doctor is more important than choosing a filler. An appropriately experienced and well trained doctor will make the most appropriate determination in terms of which dermal filler to satisfy your personal needs.
Dermal filler injections are used all over the face; cheeks, lips, under the eyes (tear troughs), nasolabial folds (nose to mouth lines) and marionette lines (mouth to chin lines). This is important when discussing pain. Areas such as under the eyes, lips and cheeks are less painful than nasolabial folds and marionette lines. The areas associated with higher pain caused by dermal filler injections have a higher number of nerves that innervate the skin and deeper layers.
Most clinicians offer topical anesthetics (a numbing cream) before filler treatments to reduce pain sensations. Most topical anesthetics take between 15 – 60 minutes to take effect. It is a common belief that topical anesthetics make dermal filler injections less comfortable and therefore, more comfortable. In addition to topical anesthetics, many dermal fillers contain a local anaesthetic within the filler itself. This means after the first injection there will be further numbing to the treatment area.
Another factor to consider is the viscosity of the filler. Fillers that are injected deeper (for example cheeks) require a thicker filler in order to provide structural support for the tissue and skin layers above. This can be associated with a sensation of fullness or tightness in the treatment area.
The most common product brands of dermal fillers are:
Restylane®, Perlane®, Juvederm Ultra®, Emervel®, Stylage®, Restylane Vital®, SubQ®, Voluma®, Belotero®, Teosyal®.