Filler - Dermatology and aesthetics


Dermatology and aesthetics

Dermatology and aesthetics


Skin biorevitalization
  • Skin biorevitalization
    • Types of fillers
    • Complications of fillers
    • Skin biorevitalization
    • Treatment program for biorevitalization

Skin biorevitalization

The idea of ​​beauty has always been associated with the image of a smooth, luminous and youthful-looking skin: the skin is the organ that tells the inner and psychological discomforts and on which the signs of aging reverberate, signs that take the wrinkle name. Specifically, linear or dynamic wrinkles can be distinguished (because they are related to the movement of mimic muscles), frequent in the female sex and localized mainly at the periocular level (crow's feet), intraocular, perilabial (vertical on the upper lip or around the mouth) and transverse of the forehead; glyphic wrinkles, consisting of an accentuation of the normal skin texture evident above all on the cheeks; wrinkles, due to prolonged positions taken by the face (typical sleeping positions); nasogenic folds, more or less deep incisions that start from the wings of the nose and reach the outer edge of the mouth.

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Types of fillers

Fillers (literally "fillers") are commonly used to treat the different types of skin wrinkles and facial furrows, but also to increase the volume of soft tissues (depressed scars, cheekbones, lips, etc.) or better delimit the contours of the face. ), consisting of materials of different origin and injected with very fine needles into the superficial or deep dermis in the area to be treated; most of them allow to obtain a temporary effect, variable in effectiveness and persistence according to the material used.

The precursor of today's fillers was, at the end of the sixties of the twentieth century, the injectable silicone in the form of oil, the use of which is currently prohibited as it can lead to chronic inflammatory reactions and significant fibrosis. Today's fillers can be divided on the basis of their origin into heterologous, homologous, autologous and synthetic, while on the basis of the persistence of the effect, reabsorbable fillers are distinguished, consisting of biocompatible substances subject to gradual reabsorption and therefore must be re-injected at a distance time to maintain the effect, semi-resorbable fillers, for which the implantation in the tissues has a longer duration, finally permanent fillers, which have the peculiarity of not being reabsorbed by the body.

Absorbable fillers The most commonly used are certainly collagen and hyaluronic acid.

Injectable collagen, of bovine origin, has been tested since 1976 and has spread over time, with subsequent modifications regarding its formulation. It is an excellent absorbable material, very fluid; offers good aesthetic results, but has a less lasting effect than other biocompatible materials and, due to the possible allergic reactions that may occur, requires two preliminary skin tests after one month from each other before proceeding to the definitive system.

Hyaluronic acid is a glycosaminoglycan present in the extracellular matrix of the dermis and in numerous other tissues (vitreous body of the eye, joints, muscles, synovial fluid etc.) already in the fetal phase, but which progressively decreases during development; in the dermis it performs support functions since, by binding to other substances, it forms macromolecular complexes that give firmness to the skin and hydration (in fact it has the ability to bind water).

The hyaluronic acid used for the fillers can be of avian or bacterial derivation and is immunologically inert, non-toxic, biodegradable and bioabsorbable; since it is a substance that undergoes rapid degradation, it undergoes a cross linking process that allows to improve its viscoelastic properties and persistence.

Given the similarity of structure between the hyaluronic acid of the various animal species, the possibility of allergic reactions to the substance is absolutely remote, so much so that no sensitivity test is foreseen before proceeding with the treatment.

Hyaluronic acid is contained in pre-packaged syringes, ready for use, and is injected into the superficial and middle dermis; the mechanism of action consists in an immediate volumetric filling (due to the viscoelastic properties of the product) and in the ex novo synthesis of collagen by stimulation of fibroblasts. Although it is a reabsorbable material, its duration is quite long (6-12 months). The result is particularly "natural" and the disappearance of the substance is very gradual.

Semi-permanent fillers The products of this type currently on the market are constituted by suspensions of polymethylmethacrylate microspheres in fluid collagen or by particles of acrylic hydrogel dispersed in hyaluronic acid. While collagen and hyaluronic acid are completely degraded, the non-resorbable part remains inside the tissues behaving like a real implant.

Permanent fillers They are mostly made of acrylic material (polyacrylamide hydrogel). In such cases the injected material remains throughout the life in the patient's tissue, behaving like a real implant.

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Complications of fillers

In the case of resorbable fillers, complications are very rare and mostly temporary: they consist of hypersensitivity reactions such as edema, erythema and sometimes granulomatous nodules persisting for a few months, abscess formation or painful cysts at the injection site, rarely skin necrosis glabellar by vascular compression by the implant.

In the case of semi-permanent and permanent fillers, on the other hand, granulomatous reactions from foreign bodies, including important and widespread, mostly persistent, were frequently found. Furthermore, permanent materials, especially if infiltrated in large quantities, can "migrate" over time and penetrate into the surrounding tissues.

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Skin biorevitalization

Bio-revitalization is an innovative method that counteracts and prevents skin aging not by temporarily eliminating a single blemish (wrinkle), but by intervening on a widespread surface of the dermis of the face, neck, décolleté, hands, stretch marks and scars. The treatments can act in a specific or integrated way to obtain the revitalization and stimulation of the dermis and epidermis, which achieve a better compactness, elasticity, luminosity and firmness of the skin and a decrease and prevention of wrinkles.

Bio-revitalization can be carried out by micro-injections of free cross-linked hyaluronic acid or so-called detox substances.

In the first case, hyaluronic acid promotes the proliferation and migration of fibroblasts, deeply hydrating the skin. This substance is in fact responsible for the compactness of the tissues and capable of binding huge quantities of water around it, and its use allows to maintain the adequate and natural hydration of the skin and consequently the turgidity clearly visible in young age. Thanks to its molecular weight, which makes it bio-interactive, and to its residence time in the tissues, the injection of hyaluronic acid essentially allows you to recreate an ideal physiological environment, i.e. to restore and maintain over time the conditions that occur when you he is young. The action is prolonged over time (long acting) because, thanks to a concentration equal to 40-70 times that of endogenous hyaluronic acid, the substance remains in the tissues for a long time; in fact, after its homogeneous and gradual distribution, it follows a slow dilution which brings it back to physiological concentrations and the consequent natural process of catabolization.

As for detox revitalization treatments, a polyvitamin complex based on 5 groups of active ingredients is used: the exogenous supply of specific detox ingredients such as vitamins (A, C, E, D, B, K), amino acids (lysine, proline, glutamine etc.), mineral salts (potassium, sodium, calcium, magnesium, selenium, copper), coenzymes (Q10, glutathione, NADH) and nucleic acids (RNA and DNA) effectively counteracts oxidative damage.

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Treatment program for biorevitalization

It is possible to define a personalized treatment program according to the initial conditions of the patient's skin and the response to the first implants.

In principle, four initial treatments are scheduled a short distance from each other (one week), followed by some maintenance sessions at a distance of about two or three months. By following these treatment programs the patient will be able to appreciate, in addition to a natural relaxation of the skin, also a greater degree of firmness, firmness and elasticity of the skin, peculiar characteristics of a young tissue.

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