Dermal Fillers

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Some wrinkles and undesired lines are formed on our face by the age, sunlights, and mimic movements. We use dermal fillers that got diversified in recent years to get rid of these lines.

Where are dermal fillers used?

As well as we can use the dermal fillers directly in hollowed, sunken areas, or the area we want to bring volume in; indirect applications can also be performed by the modern fillers in our day. To give an example to this, it can be provided the under eye hollows to seem less hollowed and better, by performing a filler application right under the under eye hollow without filling the hollow. In other words, with direct and indirect applications, changes can be provided on whole face.

• Lines coming down from each sides of the nose (Nasolabial Lines)
• Lines between the nose and the mouth (Philtral Lines)
• Lip augmentation
• Radial lines around lips
• Corner lip lift
• Wrinkles around eyes
• Camouflaging under eye bags
• Correcting under eye hollows
• Lines on forehead
• Brow lift
• Acne scars
• Deformities formed as result of accident or trauma
• Cheek and cheekbone augmentation
• Bring volume in tip of the chin
• Non-surgical nose job, nasal correction
• Making chin corners noticeable
• Correction of some asymmetries in the body

Classification Of The Dermal Fillers

Many classifications of dermal fillers can be made. These are according to where they are perfomed like cheek fillers, facial fillers, lip fillers,under eye fillers (light filling), around eye wrinkle fillers, deep and volume-creating fillers, uncross-linked fillers (IAL system youth vaccine, teosyal redensity), etc.

Moreover, dermal fillers are also classified according to their permanence time.

·         Non-permanent fillers

·         Semi-permanent fillers

·         Permanent fillers

Non-Permanent Fillers

Hyaluronic Acid-Based Fillers

Hyaluronic acid is actually a sugar chain in polysaccharide structure (NASHA). It is found naturally in human body, creatures. The function of the hyaluronic acid found naturally in tissues is to carry water to the skin and fix it. The synthetic or animal originated acid can easily be accepted by the body. This substance has duties such as cell division, providing the joint lubrication, and giving tightness to the skin.

Hyaluronic acid can keep a thousand times more water than its volume, and retain its shape where it is injected for a long time. It has been presented to the cosmetic applications by being produced in special laboratory conditions. It is removed by being metabolized by the body within 6-12 months in average.

Because allergic reaction is not observed in these fillers, there is no need for any allergic test. In this group, there are many different brands such as Restylane, Perlane, Puragen, Teosyal, Varioderm, Surgiderm, Juvederm, Teosyal Redensity (Light Filler), Amalian, Idea, Perfectha, and Juvederm Voluma.

Teosyal Fillers and Types

Teosyal filler is one of the non-animal origin fillers. It creates fewer side effects compared to other hyaluronic acid-based ones. There are types of Teosyal fillers according to the region to be performed application in.

Teosyal First Lines

Teosyal Touch Up

Teosyal Global Action

Teosyal Deep Lines

Teosyal Ultra Deep

Teosyal Ultimate

Lip Aesthetics Lip Augmentation With Teosyal Kiss

Its feature is the it is a filler specially produced for lip. The lips are an area that shows different features from the other areas. It has a moving structure and contains mucosa. Consequently, while an ordinary filler melts in the lip earlier than its time, this filler that has been specially prepared in the form of lip filler stays as plump in the lips for at least 6-8 months, and keeps itself even for a longer time. However, this procedure is not the permanent lip augmentationprocedure. There is also local anesthetic in the lip filler by itself. By this means, the patients do not feel pain in the course of application at all. And this eases the application of lip augmentation, and the swelling afterwards becomes at least.

Teosyal kiss does not create a situation like cyst, fibroma, or hardness that may be observed in other lip fillers. While performing the application of lip augmentation, I personally inject some part of the tube into the lower lip, not the whole tube into the upper lip. Thus, the upper lip does not become excessive big, and it appears natural, and also volume in also the lower lip becomes increased.

Under Eye Filler Application With Teosyal Redensity 2 Light Filling

The under eye filler applications was a relatively difficult application for the patients and doctor before. Being very thin and sensitive of the under eye skin were showing the filler too much. Due to Redensity 2 light filling and the semi cruciate ligaments it contains, the hollownesses, troughs, and lower part of the eye bags that are between the under eye and the cheek can be easily be treated.

At the same time, the under eye filling also lightens the under eye bruises in certain amount due to protein, vitamin, antioxidant, and minerals it contains. Due to local anesthetic found in its structure, it does not form pain. Also, due to application technique with cannula, it forms almost no bruise, swelling under the eye. Redensity 2 under eye filling is permanent for about 1 year.

Juvederm Fillers

Juvederm filler is a hyaluronic acid-containing filler produced by the Allergan company. There are filler types named as Juvederm Ultraplus, Juvederm Smile, Juvederm Voluma, Juvederm Volbella, and Juvederm Volift. Voluma, Volift, and Volbella, which are among the fillers produced by the company by using Vycross technology, have this characteristic. This characteristic reduces the intensity of hyaluronic acid by making the cruciate ligaments stronger and more effective. Also, this filler keeps less water because of its less hydrophilic characteristic, thus less oedema, swelling occurs in the patient.

This situation provides comfort for both the patient and the doctor. While one of these fillers Voluma is used in cheekbone, cheeks, tip of the chin, and nasolabial lines; Volift is used in lip mucosa, and bringing volume in the lip; and Volbella in lip and mouth around. Also, each 2 fillers provide opportunity for painless application of augmentation due to licodaine they contain.

Total Changes Can Be Performed On The Face With Juvederm Filler

By combining the Juvederm fillers in different ways, a volumetric correction or non-surgical facial aesthetics can be performed to the patient. For this application, Voluma, Volbella and Volift fillers are used. In the wrinkles on forehead and around eyes Juvederm Volbella is performed; under eyes are also corrected with this filler. The procedure of bringing volume in temporal region, cheek bone region, and cheeks is performed by using Juvederm Voluma. In addition, by using Juvederm Volift in the brows and cheeks, brow lift and facial tightening can be generated. In this application, a total approach to the patient is required. For that kind of application, it is necessary to use at least 3-4 fillers.

Cheek augmentation application can be performed very successfully with Juvederm. With the cheek augmentation, cheekbones can be made clearer, and an un-lifting can be provided on the cheek. Sunken cheek and lower part of cheek can also be corrected with the cheek augmentation.

Semi-Permanent Fillers

The effectiveness time of these fillers changes between 3-5 years. Each substance has a different effect mechanism. These fillers are applied more in the cheek and nasolabial lines. Applying in lips is not a situation I prefer. We can count these fillers as Radiesse, Sculptura, and Beautical 2/5.

Radiesse

Radiesse is a calcium hydroxyapatite-containing, quite safe filler. Radiesse is usually used in the cheek, lines between nose cheek lip, chin, and making the cheek bones clearer. Application is performed into the lower layer of dermis. In about 1 week after application, the filler enters into the cells and more natural appearance is formed. Radiesse filler does not cause allergy. It is more permanent than the hyaluronic acid-based applications.

Aquafilling

Aquafilling is long-acting filler that is applied in body region, completely water-based, has permanence for 5-8 years, and in jelly consistency. Aquafilling filler is used in the non-surgical breast augmentation procedure, non-surgical hip butt augmentation, and correction of leg curvatures non-surgically. Moreover, it is a high volume filler type that is injected in an existing hollowness or in the area without volume in order to bring volume.

Aqualift

Aqualift filler is also similarly water-based, and contains hydrophilic gel. It is used especially in body region, breast, calf, buttock augmentation as in the aquafilling applications. It has approximately 5-year permanence. Aqualift application is also performed with local anesthesia in the body regions. Aqualift filler does not also cause any immunologic reaction, allergic reaction; it is a safely-used filler.

Permanent Fillers

Bioalcamid

Bioalcamid is a permanent filler in the form of gel and containing 4% of alkilimid and 96% of water. Because the bioalcamid is surrounded by the collagen in our body after injection, this filler is also named as ‘endo-prosthesis’. This reaction is not an allergic reaction or foreign body reaction; it is being surrounded with a very thin collagen layer and isolated of the bioalcamid by the body. Mostly this process is 45 days, and until this process there may be 10% of reduction in the material volume along with oedema, but then it is completely permanent.

There are some differences of Bioalcamid from the other fillers:

·         It can be injected in great amounts compared to the other fillers (for example, as 500- 1500 cc), and then when desired the injected endo-prosthesis can be removed. However, in the areas where the skin is thin like facial region, instead of injection of the great amount of bioalcamid at one time, it is suggested to perform application a few sessions with 2-month intervals.

·         Because there is not an enzyme demolishing the bioalcamid in the body, at the same time because the material is resistant to oxidation and hydrolysis, the result is permanent.

·         Its injection does not require allergy test.

·         It can be kept in room temperature.

·         Because the surrounding thin collagen layer is fixed in the area where the implant material is injected, the injection does not move from its region towards the surrounding tissue.

There are 3 different forms of Boalcamid. Lip, face, and body. Contents of these forms are same, elasticities are different. Because the Bioalcamid is not injected into mucosa, it is used not in lip thickening, in making lip contour clear.

As well as Bioalcamid can be used in cosmetic purpose; due to it can be used in great amounts, it is applied successfully in correction of deformities, bringing volume in the depressed hollow regions, breast deformities, and volume problems in extremities.  

Artecoll

Artecoll is an injectable material that has impact on facial wrinkle and other skin disorders for a long time. Artecoll is the shape made into globules in 30 micron diameter of the 2/3 of denatured bovine collagen and 1/3 of a material known with the name of polymethyl methacrylate. Due to these globules are stored in tissue, its absorbtion and rejection is not possible.

The collagen in Artecoll is absorbed after 3 months, but the PMMA globules are permanent and the new tissue formation occurred around it provides the permanence of Artecoll. Artecoll shows process of placin in the region applied within the first 20 days. The actual desired effect begins from this, and completely appears within 3 months.

After Artecoll is applied, placing in the skin and being sourrounded by the fibrin fibers generated by fibroblast cells complete in 3 months at the earliest. Especially with an additional application performed after 3-4 months, effectiveness and success can be increased. It requires an allergy test to the fore arm 14-28 days before application; even if it is mostly negative, 1-2 % of allergic reaction can be observed.

 

Wondered Questions About Fillers

When fillers are applied, how long does their effect continue?

It continues according to the feature of the material used, as 6-12 months in the hyaluronic acid-containing preparations, 1-2 years in Poly L Lactic acid-containing applications, 3 years in the hydroxyapatite-containing preparations, and lifelong in the permanent fillers.

How long do filler applications take?

An application takes 15-30 minutes in average. It is performed extremely easily just the same as botox.

Does pain occur in the course of application?

A pain does not occur so as to bother the person, if desired, it can be applied numbing cream 30-60 minutes before application, in some applications local anesthesia can be performed.

Does a bothering situation occur on the face?

Because the application is performed with and injection methos, a slight swelling may occur, it will be beneficial to apply ice afterwards. Especially in the lip ijections, swelling will be more.

Does a situation obstacle for going to work occur?

The application can be performed in any time, in lunch break, and then you can relievedly turn back your work.

What is filler application with cannula?

While applying filler, needles are used in general. Although these needles are extremely fine, sometimes they may cause bruises in the patients with sensitive skin. To avoid this situation, filler application is also performed with the tips called cannula that is as fine as needle, but of which tip is not sharpened. Thus, swelling and bruise do not occur.

According to what do the prices of fillers vary?

Filler prices vary according to the type, brand, time of the filler used, how many to be used, and the place of application. While sometimes one filler can suffice, there may be need for more number of filler according to your state. In this case, the price cost will change. For this you should get examined.