Types of fillers - Dermatology and aesthetics


Dermatology and aesthetics

Dermatology and aesthetics


Skin biorevitalization
  • Skin biorevitalization

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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