FACE AND LIP FILLING

WHAT IS THE AIM OF USING FACIAL FILLERS?

At the facial areas, the filler injections are most commonly used for the treatment of deep wrinkles existing around eyes and especially between eyebrows, the sad lines at the nose edges, the under-eye hollows and tear duct pits, the fine wrinkles around mouth and the marionette lines (pits), and for adding volume to areas as the lips, temple, chin and the cheekbone.  These filler applications, being different from the filler applications which are effective on the wrinkles formed due to mimicking, are effective on the static wrinkles, ie the wrinkles existing independently from the mimicry.

Since the safe products are produced from the constituents that can be metabolized in the body, their durations of action are not too long.  The synthetic (including persistent particles) products have a longer duration of action.  However they are less likely to be preferred among the physicians, since they may cause allergy and reactions.

WHAT ARE THE FACIAL AND THE LIP REGION FILLERS?

Many natural and synthetic substances are available for being used as fillers. These products are not used in the patients with immune system disorders, in pregnant women, and in ones using cortisone. The number of sessions vary depending on the desired amount of volume, and the tissue characteristics of the person to whom the application will be done.

Hyaluronic Acids

Among filling materials, this group is the most commonly used one in the world, and it’s accepted to be the most safe.   Hyaluronic acid naturally exists in many tissues in the body.  Application of this group of products rarely causes side effects such as redness, swelling or mild bruising; however if they exist, they disappear within several days.  Foreign body reactions are much lesser compared to the other groups of fillers.  On average, their effectivities persist around 9-12 months.  This group of products may be separated to two subgroups as monophasic and biphasic, according to their syntheses.  The monophasic ones are slightly harder, and their adhesion to tissue is lesser compared to the biphasic ones.  The biphasic ones have a better tissue adhesion, and they yield more natural and softer outcomes.  Therefore in all my injections, I prefer biphasic products approved by the FDA (American Food and Drug Administration).  All of these series include local anaesthetic (regional anaesthetic) for the patient’s maximum comfort during application.

The effects of hyaluronic acid applications on facial depressions and wrinkles exist as soon as the procedure is applied. On the other hand, the repetitive applications of hyaluronic acid also lead to persistent reductions in the wrinkle number and depth, by increasing the natural collagen production in skin.

Under-Eye Light Filler

The light filler includes hyaluronic acid which is one of the constituents of skin, 8 amino acids which form a complex for skin reconstruction, 3 antioxidants, minerals, vitamins, and lidocaine for the patient’s comfort.  Hyaluronic acid exists naturally in our body, and it provides a favorable skin hydration by trapping water in its deep layers.   This potent moisturizing agent starts to decrease with the advanced age.  As a consequence the skin dries, weakens, and the wrinkles appear.  These products, which also make difference regarding the site they work, the problems they eliminate and their long-lasting persistences, are exactly natural and produced from a bacteria existing in the human body.  In other words, they are fully compatible with the human body.  Their persistence is around 12 months.

Collagen Fillers

This group includes filling materials generally obtained from beef collagen. This group, which had been popular 20 years ago, is not preferred much today because of the improvement in hyaluronic acid technologies, and the allergic reactions they may cause. For many products included in this group, testing for allergy has to be done before the application.

Synthetic Fillers

The persistences of the products included in this group are longer compared to hyaluronic acids.  Calcium hydroxyapatite and poly-L-lactic acid are the most commonly used types of synthetic fillers.

According to the data of the producer firm, the persistence of calcium hydroxyapatite is 2 to 3 years; however this period is around 1 year in practice in most of the time.  It is the soft tissue-applicable state of a material the content of which is present in the bone structure.  Because of this structure, eye contour or lip applications are impossible. It can be applied to cheek, chin, or deep tissues as cheekbone.  The possibility of it to cause redness, sensitivity, foreign body reaction, and beading called as granuloma is slightly higher compared to the hyaluronic acid group.

The persistence of poly-L-lactic acid is also around 2 to 3 years.  This product, which has to be applied to deep tissues, increases the synthesis of collagen more than the other fillers do; therefore the amount that has to be applied may also decrease in repetitive applications. It’s impossible to apply it to lips and around eyes. Being similar to the Radiesse filler, it’s possibility to cause redness, sensitivity, foreign body reaction, and beading called as granuloma is slightly higher compared to the hyaluronic acid group.

HOW MUST AN IDEAL LIP FILLING BE?

There are some proportions for aesthetic lips. For instance from the side view (profile), the upper lip has to be placed 1-2 mm more forward compared to lower lip, while from the frontal view, the lower lip has to be slightly thicker than the upper lip.   After filling has been performed, your lips must not curl while speaking due to the effect of filler, and the filler must not be felt while kissing one another.  In brief, they have to be as natural as your self tissue.  For this, it’s essential to use a convenient technique and material.

HOW IS THE LIP FILLING DONE? WHEN DOES THE SHAPE FIT ENSUE?

Lip filling is applied by making injections into the convenient areas, after your lips have been anaesthetized with a cream. In order to cause a minimal discomfort, a lip filler including an anaesthetizing agent (with lidocaine) has to be preferred.  It gains its shape as soon as it’s done; however a mild swelling may exist in the first three days.  The shape fit completely ensues around 3 to 5 days.  Bruising develops too rarely in the procedures of lip filling, and it’s generally not seen.

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