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Looking for a way to erase wrinkles and signs of aging, or correct minor facial imperfections, without undergoing invasive surgery? Fillers may be the solution you are looking for. In general, injectable fillers, which are classified as CE-marked Class III Medical Devices, must:
- comply strict safety and tolerability standards, i.e. be sterile, stable, biocompatible, non-immunogenic, apyrogenic, easy to inject and non-traumatic;
- only be injected by authorised medical personnel (plastic and cosmetic surgeons).
The numerous fillers on the market differ in their biological and chemical-physical characteristics and the choice isn’t so easy. For this reason it’s important to get information for an informed choice shared with your doctor.
Fillers, the two main categories
- Reabsorbable fillers: composed of substances which, when injected into the dermis (superficial, medium or deep), do not give permanent results, an example being those based on Hyaluronic Acid or Collagen. This means that once injected, the product is progressively metabolized and then reabsorbed by the body in variable times depending on:
– type of preparation used*;
– area treated;
– numerous individual factors (such as lifestyle, smoking, intense physical activity, frequent exposure to ultraviolet radiation).
The advantage of resorbable fillers is their progressive action, i.e. they gradually adapt to changes of facial features;
- Non-absorbable fillers: derived from polymers with alkyl amide and polyacrylamide bonds, while having permanent effects, they have given, and continue to give, problems and complications. In addition to the risk of infection, granulomas and skin fistulas, permanent fillers implanted in soft parts of the face don’t adapt to the evolution of the surrounding untreated tissues, creating major disharmonies over time. This is why they are increasingly discouraged by the scientific community, in favour of slow-resorbing fillers.
The benefits of Hyaluronic Acid fillers
Hyaluronic Acid is a polysaccharide already naturally present in human body, but whose natural production tends to decrease with increasing age. Discovered in the vitreous humour of the eye, until recently it was extracted from animals, in particular from rooster’s crest. Today, Hyaluronic Acid of avian origin is now replaced by a version of non-animal origin, specifically produced by bacterial fermentation.
Fillers with Hyaluronic Acid help to fill in lost volume, reduce expression lines and nose-labial wrinkles, and increase existing volume such as in the case of thin lips or sagging cheekbones. Some categories of injectables are also able to treat larger areas of the body, such as the calves and glutes, while fillers in the breast area are absolutely forbidden as the substance compromises proper screening for breast cancer.
In general, they help to deeply moisturise the skin, restoring vitality, radiance, freshness and stimulating collagen production. Injectable fillers are also increasingly used to correct facial disharmonies, such as the nose’s profile (known as rhinofillers), replacing plastic surgery, even though with non-permanent effects.
Hyaluronic Acid Fillers are in turn divided into three sub-categories:
- low-density fillers, indicated for superficial wrinkles and characterized by faster resorption;
- medium-density fillers, indicated for deeper wrinkles (such as nasolabial grooves or the marionette wrinkle);
- high-density fillers, also called volumetric fillers, indicated for supportive areas such as cheekbones and jawline.
* on the market there are fillers with Linear and Cross-linked Hyaluronic Acid. Cross-linking makes the filling effect more stable and long-lasting, creating a molecule that is more resistant to enzymatic attack by hyaluronidase (the enzyme responsible for its degradation). There are two main cross-linking agents, BDDE (butanediol-diglycidylether) and DVS (divinyl sulfone). The best cross-linked fillers on the market are those that presents imperceptible levels of cross-linking agent residuals.
If you want to undergo treatments with fillers based on Hyaluronic Acid, remember to always entrust only to authorized healthcare professionals, who will be able to guide you in the most suitable choice according to your physical characteristics and your state of health.