They are Botox’s best friends in facial skin rejuvenation treatment. Let’s examine the role they play in this team. Also known as soft tissue fillers, dermal fillers are injectable substances in gel form used to treat, pretty effectively, the early signs of ageing. The treatment is straightforward: doctors (and only doctors. Make sure the professional treating you has the right qualifications) inject the filler in the specific location they aim to treat. The gel is precisely inserted in an “sunken” area, restoring the volume and adding structure to the skin, compensating for its lack of elasticity and the loss of fat and tissue that we suffer with ageing.  The result is a more supple facial expression and a smoother skin texture where fine lines, established wrinkles and even deep creases (like the nasolabial folds) are smoothed. Even the typical tear through can be efficiently softened with dermal fillers, clearing up the tired look it gives to your face. The beneficial results can be verified immediately after treatment. Due to its volumizing properties, dermal fillers are also used to go a little further and enhance or correct facial features. The most common applications are to enhance or correct asymmetries in the cheekbones, jaw lines and, of course, lips, but also to correct the nose bridge or even the eyelids. These products offer incredible possibilities without surgery and are worth a chat with your doctor. Fillers vary in their composition and therefore in the visual effect and longevity. Thus, certain products can be better suited for different anatomical regions. Very soft fillers have a shorter duration and work normally better for areas like the lips while fillers with more structure are better suited to regions that require more support like the nasolabial folds. The first fillers where commonly based on collagen, but the most of the more recent formulations are based on Hyaluronic Acid, a substance also found naturally in our body, that retains water in the skin. This property added an extra benefit for dermal fillers, because they are now highly hydrating and act as a skin cushion.These type of fillers are naturally absorbed by our body between 3 to 12 months, depending on a multitude of factors including the patients particulars, the location of the injection and the product itself. Juvederme® and Restylane® are examples of HA fillers with a good track record. Increasingly utilised are the more recent fillers based on microsphere technology. These fillers (also FDA approved for most of the treatments, but not for lips) are composed by microspheres (particles of solid material) that are combined with a gel carrier. They have a thicker solution and allow a longer lasting or even a permanent effect, depending on the product. Radiesse® fillers provide a longer lasting effect of around a year or even more. The structure of this filler is break down in two phases: first the body absorbs the gel and then the microspheres. During the process it promotes the ingrowth of collagen by the body which helps to rebuild the skin’s foundation and therefore prologue the effect. Artefill® is an example of a permanent filer. It combines a mixture of collagen and microspheres. In this filler, the microspheres are not reabsorbale, providing a permanent support to the regions treated. Attention though: consider carefully the right solution for you. This is both in regards to your complexion and required treatment, but also the skill and experience of the practitioner. I’m sure you want to create your best natural look, not look overfilled and puffed, so as such make sure you choose a qualified and experienced medical professional and, with his advice,  the right product for your particular case. So, a suggestion:  the first time you try this procedure opt for a nonpermanent product. If you don’t like the result, this will naturally disappear in some months or you can even ask your doctor to dissolve the filler with the proper enzyme, that breaks down or deflates the filler. If you love the result, have been doing it for quite a while and wish to make it permanent, then use a permanent filler. But consider this option carefully and take advice from your doctor, since a permanent filler can only be removed surgically. Also, be aware of possible side effects. Redness, swelling or bruising might occur in the local of injection and can last some weeks in the most severe cases. Allergic or inflammatory reactions, infection, numbness, lumps and even migration of the filler are rare, but can also happen, after the injection or for some of these occurrences, even months after the treatment. Finally, it should be considered that fillers are effective in resolving the ageing signs presented here, however if there is too much sagging skin, consider the possibility of a surgical procedure, like a facelift. However, your doctor will be best placed to advise you on the best procedure specific to your particular case. Juvederm® has a very useful information on its website, that helps you to prepare and tells you what to expect during and after the treatment. Have a look here:

Also in Juvederm® website, take a look at the before and after pictures.
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