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Filler
What are the options?

Hyaluronic acid is a naturally occurring substance normally present in our skin and throughout our bodies. It can be manufactured artificially and the molecules cross linked. The leading brands of hyaluronic acid are Restylane™ and Dermal Filler – Juvederm Ultra™.

Both come in a variety of preparations with different properties for different types of wrinkles, folds and hollows. After injection, the duration of effect may last from three to twelve months depending upon the degree of cross linking of the molecules and the site of injection.

Many hyaluronic acid products now come mixed with local anaesthetic which reduces the discomfort associated with injection. Alternatively, local anaesthetic creams or injections can be used before the procedure. Hyaluronic acid is a very effective and safe product and currently the most commonly used product in the non-surgical aesthetic arena.

Polylactic acid is marketed as Scuptra™ or Newfill™. This product comes as a powder and is reconstituted before injection with saline or local anaesthetic solution. It is then injected into the skin in fine lines. It does not fill the tissue itself but stimulates the body to produce collagen or scar tissue. In doing so, it may produce some tightening of the skin. This has led some to describe use of this product as 'a liquid facelift'. We have extensive experience with the use of polylactic acid and have published and presented on the subject internationally.

We have found the degree of volume restoration to be variable and for that reason, within the context of aesthetic enhancement, we generally prefer hyaluronic acid. In the treatment of a condition known as lipodystrophy, we have found polylactic acid to be very useful.

Collagen products from bovine and porcine sources were very popular in the past. However, there is a risk of an allergic reaction and so patch testing is usually performed before using these products. Furthermore, concerns about the remote possibility of prior disease (such as CJD) have made the use of such products much less popular.

Permanent injectable fillers have been used for many years for cosmetic enhancement. Free silicone was used in the 1960s and 1970s. Although silicone implants are safe and effective, the use of liquid silicone injections is associated with a high complication rate. More recently, Bio-Alcamid™ – a synthetic, non-biological filler – has been used for specific medical indications. It too can be associated with complications and we do not recommend its use in the face for cosmetic enhancement.

Autologous fat transfer is a technique popularised by a New York plastic surgeon named Sydney Coleman and is therefore known as Coleman fat transfer. The technique involves aspirating some fat from an area such as your tummy. This is done through a small incision similar to standard liposuction. The aspirate is then spun in a centrifuge to concentrate the fat cells. These can then be injected into fine tunnels in your face or elsewhere. Some volume will be lost over time but recent groundbreaking research undertaken by our team demonstrates that up to 40% of the volume is retained permanently.

The beauty of fat transfer lies in its simplicity and safety. We are using material that is 100% your own. No foreign material is injected, no manufacturing variables are involved, and there is no risk of allergic reaction.

 

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