top of page
Writer's pictureJoshua Kaatz

The Science Behind Fillers: What You Should Know Before Your First Appointment

 

Introduction


In the world of cosmetic dermatology, dermal fillers have emerged as a popular method for enhancing facial aesthetics. They offer a non-surgical solution to a variety of concerns, from smoothing out wrinkles and fine lines to restoring lost volume and contouring the face. However, as with any medical procedure, it's essential to understand what you're getting into before you take the plunge.


This blog post aims to demystify the science behind dermal fillers, providing you with the knowledge you need to make an informed decision about your cosmetic journey. We'll delve into what dermal fillers are, the different types available, how they work at a cellular level, and what to expect during and after the procedure. We'll also discuss the potential risks and the importance of consulting with a qualified cosmetic dermatologist.


At Alto Dermatology, we believe that an informed patient is a satisfied patient. So, whether you're considering fillers for the first time or you're a seasoned pro looking to deepen your understanding, this guide is for you. Let's dive in!


 

What are Dermal Fillers?


Dermal fillers, often simply referred to as "fillers," are substances designed to be injected beneath the skin surface to add volume and fullness. They serve as a powerful tool in the cosmetic dermatology field, helping to address a variety of skin aging concerns.


The primary purpose of dermal fillers is to restore lost volume, smooth lines and soften creases, or enhance facial contours. Over time, our skin naturally loses subcutaneous fat—the layer that lies just beneath the skin. This loss, coupled with the reduction of collagen and elastin—proteins that provide our skin with structure—results in facial lines and wrinkles.


Dermal fillers help to mitigate these signs of aging by filling in or plumping up these areas.

The use of dermal fillers for cosmetic enhancement is not a new concept. In fact, the history of their use dates back to the late 19th century, when doctors experimented with injecting paraffin into the skin. However, modern fillers are much safer and more effective, offering a range of options to suit different needs and skin types.


In the next section, we'll explore the different types of dermal fillers available today, their unique properties, and their best uses.


 

Types of Dermal Fillers


There are several types of dermal fillers available on the market today, each with its unique properties and uses. Here, we'll explore some of the most commonly used fillers:

  1. Hyaluronic Acid Fillers: Hyaluronic acid is a naturally occurring substance in our skin that helps keep it plump and hydrated. Fillers made from this substance can help improve the skin's contour and reduce depressions in the skin due to scars, injury, or lines. Popular brands include Juvederm, Restylane, and Belotero. These fillers are often used to smooth lines around the eyes, mouth, and forehead, as well as to add volume to the lips and cheeks.

  2. Calcium Hydroxylapatite Fillers: Calcium hydroxylapatite is a mineral-like compound found naturally in human bones. In filler form, it is a thicker substance and provides a great option for deeper lines and wrinkles. It is typically used for cheek plumping and contouring, and for smoothing moderate-to-severe creases such as nasolabial folds. Radiesse is a well-known brand of this type of filler.

  3. Poly-L-lactic Acid Fillers: Poly-L-lactic acid is a biocompatible (meaning it is safe to use in the body), biodegradable synthetic substance. It helps stimulate your skin's own collagen production. Sculptra Aesthetic is a notable brand of this type of filler, which is used to treat deep facial wrinkles and restore facial volume lost due to aging.

  4. Polymethylmethacrylate (PMMA) Fillers: PMMA is a synthetic, biocompatible substance that has been used in medicine for much of the last century. In dermal fillers, PMMA takes the form of a "microsphere" or tiny ball, that remains beneath the skin indefinitely to provide continued support. Bellafill is a popular brand of PMMA fillers.

  5. Autologous Fat Injections (Facial Fat Grafting): This process involves taking fat from one area of your body, purifying it, and then injecting it into your face. This can be a more invasive procedure than other fillers but can also produce longer-lasting, more natural-looking results.

Each type of dermal filler has its own unique benefits and potential side effects, which your dermatologist can discuss with you in detail to help you make the best decision for your skin and your aesthetic goals.


 

The Science Behind Fillers


Understanding the science behind dermal fillers can help demystify the process and give you a clearer idea of what to expect. So, how do these substances work at a cellular level?

When a filler is injected, it acts much like a sponge, absorbing water and swelling to fill in the creases or add volume where it's needed. But the effects of fillers go beyond the immediate visual improvement.

  1. Stimulating Collagen Production: Some fillers, like Poly-L-lactic Acid fillers and Calcium Hydroxylapatite fillers, stimulate the body's production of collagen—the protein that provides structure to our skin. As we age, our natural collagen production decreases, leading to sagging skin and wrinkles. By stimulating collagen production, these fillers help to restore the skin's youthful structure and resilience.

  2. Absorption and Duration: The duration of the filler's effect depends on the type of filler used. Hyaluronic Acid fillers, for example, are gradually absorbed by the body over a period of 6 to 18 months, depending on the specific product and where it's injected. Other fillers, like PMMA microspheres, provide a permanent framework and are not absorbed by the body.

  3. Interaction with Skin Cells: Fillers not only interact with skin cells but also with other components of the skin, such as blood vessels and nerves. This interaction can influence the longevity and effectiveness of the treatment.

In the next section, we'll walk you through the procedure of getting fillers, so you know exactly what to expect during your appointment.


 

The Procedure: What to Expect


Understanding the process of receiving dermal fillers can help alleviate any anxiety you may have about your first appointment. Here's a step-by-step guide to what you can expect:

  1. Consultation: Your appointment will begin with a consultation. Your dermatologist will assess your skin condition, discuss your aesthetic goals, and help you choose the most suitable type of filler for your needs. This is your opportunity to ask any questions you may have about the procedure.

  2. Preparation: Before the injection, the area will be cleaned, and you may be given a topical anesthetic to numb the area and minimize discomfort during the procedure.

  3. Injection: Using a fine needle, the filler will be injected into the specified areas of your face. The depth of the injection depends on the type of filler and the area being treated. You may feel a slight prick and a sensation of fullness as the filler is injected.

  4. Massage: After the injection, your dermatologist may gently massage the area to ensure the filler is evenly distributed and looks natural.

  5. Post-Procedure Care: Once the procedure is complete, you'll be given instructions for post-procedure care. This may include avoiding strenuous exercise, excessive sun or heat, and consumption of alcoholic beverages for at least 24 hours post-treatment.

  6. Follow-Up: Depending on the type of filler used, you may need to schedule a follow-up appointment to assess the results and possibly receive additional injections.

Remember, everyone's experience with fillers is unique, and results will vary depending on the individual's skin condition, the type of filler used, and the area treated. It's important to have realistic expectations and to discuss these with your dermatologist.


 

Safety and Risks


While dermal fillers are generally considered safe, especially when administered by a qualified professional, it's important to be aware of the potential risks and side effects.


Common Side Effects: After the procedure, you may experience some temporary side effects such as redness, swelling, pain, bruising, or tenderness at the injection site. These effects typically resolve on their own within a few days.


Potential Risks: More serious complications, although rare, can occur. These include infection, lumps and bumps, discoloration or change in pigmentation, and allergic reactions. In some cases, fillers can also cause blockage of a blood vessel, leading to tissue death or even blindness. However, these risks are extremely rare, especially when the procedure is performed by an experienced professional.


Choosing a Qualified Cosmetic Dermatologist: The most important factor in minimizing risks is choosing a qualified and experienced cosmetic dermatologist. A skilled professional will understand the complex anatomy of the face, use only approved products, and follow all safety protocols to ensure your treatment is as safe and effective as possible.


It's also crucial to be honest with your dermatologist about your medical history and any medications you're taking, as certain conditions and medications can increase the risk of complications.


Remember, while dermal fillers can offer remarkable results, they are not without risks. It's important to weigh these risks against the potential benefits before deciding to proceed with treatment.


 

Conclusion


Dermal fillers offer a powerful tool for enhancing facial aesthetics, smoothing out wrinkles and fine lines, restoring lost volume, and contouring the face. However, as with any medical procedure, it's essential to understand what you're getting into before you take the plunge.


We've explored what dermal fillers are, the different types available, how they work at a cellular level, what to expect during and after the procedure, and the potential risks involved. We hope this guide has provided you with a deeper understanding of the science behind fillers and will help you make an informed decision about your cosmetic journey.


At Alto Dermatology, we believe that an informed patient is a satisfied patient. We're here to answer any further questions you may have and to guide you through the process should you decide that dermal fillers are the right choice for you.


Remember, everyone's skin is unique, and what works best for one person may not work as well for another. It's important to consult with a professional to discuss your individual needs and concerns. We look forward to helping you achieve your aesthetic goals!


References

  1. Enhancing structural support of the dermal microenvironment activates fibroblasts, endothelial cells and keratinocytes in aged human skin in vivo by T. Quan, Frank Wang, Y. Shao, L. Rittié, W. Xia, J. Orringer, J. Voorhees, G. Fisher. This paper discusses how the injection of dermal filler, cross-linked hyaluronic acid, into the skin of individuals over 70 years of age stimulates fibroblasts to produce type I collagen.

  2. In vivo Bio-Integration of Three Hyaluronic Acid Fillers in Human Skin: A Histological Study by C. Tran, P. Carraux, P. Micheels, G. Kaya, D. Salomon. This study analyses the bio-integration of three different types of hyaluronic acid dermal fillers in human skin.

Comentários


bottom of page