Fillers

Fillers facial aging

The ageing of the face is largely due to the loss of volume caused by the progressive decrease, over the years, of the skin’s hydration and of the subcutaneous fat. During ageing, in fact, the soft tissues of the face tend to become reduced in consistency, with a resulting thinning of the skin and the loss of firmness, consistency and elasticity. This leads to a sagging and flattening of the shape of the face.
Many signs of a lack of harmony in the face and of ageing are therefore linked to a lack or loss in volume and can benefit from treatment with a filler, that is, using filling substances. The aim of the treatment is therefore to restore the reduced volumes or emphasize the natural volumes (like cheek bones, lips, chin, etc) or to fill furrows and wrinkles (like the nasolabial folds, tear troughs, labiomental folds or the vertical lip lines).

Use of fillers

Fillers are widely used in aesthetic medicine and surgery for their excellent corrective capacities and the small number of collateral effects. The materials used by us are exclusively biocompatible, temporary and totally reabsorbable, in order to guarantee absolute medical safety and the possibility of an aesthetic adaptation when there is a change in the characteristics of a face.

The use of fillers today allows us to achieve really convincing results, especially when they are accompanied by other surgical techniques or non surgical minimally-invasive ones.

Hyaluronic acid

By far the most used material is hyaluronic acid; a substance which is normally present in the connective tissue, but there are also other substances that give excellent results, like calcium hydroxyapite. The duration of the correction with today’s fillers is decidedly good (about 1 year and up to 2 years with the more consistent materials). The hyaluronic acids on the market today have a very high standard of safety, but one must remember, in any case, that completely safe products do not exist: even a biocompatible substance causes a reaction when it is injected into the tissues. Even fillers, in particular those with a more complex molecular structure, which is useful to resist natural degradation for a longer length of time or to create greater volume, can produce some intolerance.

Contraindications of fillers

Modern fillers, however, do not require any allergy tests. The treatment is not recommended in the case of skin diseases in the area to be treated, of ongoing viral or bacterial infections in the area to be treated, of skin diseases of an auto-immune nature, or in the case of pregnancy or breast-feeding. Furthermore, the treatment is not recommended in the case of previous adverse reactions to the material in question or in the presence in the tissue to be treated of permanent materials of an unknown nature.

There are many materials on the market today which can be used as fillers of the soft tissues. As a choice of quality and a scientific guarantee, Dr Salti only uses those products that have an important scientific bibliography and are produced by companies that guarantee scientific methodology and medical safety.

Fillers treatment

The fillers are in prefilled sterile, mono-dose syringes and are injected in the physician’s facility with a very thin specific needle, after an anaesthetic cream has been applied to the area to be treated. On an average, the session lasts about 10-20 minutes. In some cases, if you are especially sensitive, local anesthesia can be performed (such as that practiced by the dentist), or, alternatively, can be applied an anesthetic ointment. Immediately after the treatment can persist for some time, a certain redness and sense of tension. A slight swelling is normal for a few hours, and may last longer in some cases or in case of increase of the volume of the lips. Immediate may be palpable a drawstring or small nodules of harder consistency that are no longer noticeable after a few days. Can sometimes have residual bruising, which disappear in a few days, and that may be masked with a concealer or with the bottom-dyed. If you suffer from cold sores it is possible that the injections may contribute to the onset of a herpetic episode; a prophylactic treatment may be indicated in these cases. Immediately after the session, you can resume normal work and social activities. After treatment is recommended not to expose themselves to the sun or tanning lamps for 7-10 days and avoid aggressive beauty treatments (waxing, abrasion, electrolysis). The results are noticeable immediately after the session.

Effects of fillers

With proper treatment, in adequate amounts and in appropriate fora, the effect is very natural and not artificial. It 'also possible to divide the intervention in more sessions, so as to obtain the desired effect in a gradual manner and thus refine the results. Obviously, as with any medicine and cosmetic surgery treatment, the result depends greatly on the initial situation, so it is important to realistically assess the possibilities and limitations of the procedure, as well wait a few days before you can appreciate the final result, once the product has been well integrated into the tissue and the swelling disappeared.

Injections of fillers do not act on mimic mobility and do not change the facial expression.

Once injected into the tissue, the material is gradually degraded and eliminated completely thanks to the enzymatic and oxidative mechanisms present in the tissues. On average, the persistence of a satisfactory aesthetic correction tends to be 4-6 months after the first treatment and of 8-12 months for the following treatments, depending on the type of filler, of the characteristics of the area subjected to treatment, the care of the skin by the patient and other factors (degree of hydration, solar / UVA exposure, smoking, diet, hygiene of life) that tend to accelerate the resorption. The average length in highly mobile areas such as the lips is slightly smaller than that of the less dynamic areas. Numerous scientific studies have shown a partial maintenance of a distance of time correction for a neosynthesis of collagen induced by hyaluronic acid and fillers in general. Treatment with a filler can also benefit from complementary treatments, useful to optimize the result, it will be suggested on the basis of your individual features, and is the ideal solution for those who want to avoid surgical and changes too sudden and significant interventions, with possibility of a return to the initial condition in the event of a decision not to re-operate.

Side effects of fillers

Any medical procedure, even the least invasive, can involve any side effects, such as local reactions (swelling, redness, some irregularities, small bruises), the reactivation of a herpetic lesion (especially in the case of treatment of the lips), an acute inflammatory reaction or even chronic (almost always related to the presence of previous non-absorbable materials), the formation of granulomatous nodules, probably due to a chronic inflammatory reaction of bacterial basis (so-called biofilm), or vascular lesions with risk of ischemia in the area of the skin treated.

Dr. Salti is part of the National Consensus Conference on Filler (which brought together leading experts in the field) and in accordance with official guidelines on the use of fillers is not using and strongly discourages the demand from part of the permanent fillers patients.

Restylane e Restylane Perlane

Restylane® e Restylane Perlane® are currently the reference standard of hyaluronic acid fillers, as products from more time on the market and with the greatest number of treatments performed in the world (almost 15 million). It is of gels containing stabilized hyaluronic acid of non-animal origin (NASHA), of natural and produced via biotechnological origin, with excellent biocompatibility as absolutely purified and minimally modified, and therefore with minimum possibility of inflammatory reactivity. Restylane is able to restore the volume and fill the tissue, with a consequent reduction of some signs of aging. It is used for the treatment of nasolabial furrows, lips, cleft lip and chin wrinkles, for the redefinition of the orbital arches and for the correction of dell'occhiaia furrows. Perlane has a more consistent molecular structure and is more suitable for corrections where it is required a greater volume. These fillers can in fact accentuate and redefine naturally all facial contours Many studies published in the medical literature have demonstrated their great effectiveness and safety. Dr. Salti was among the pioneers in the use of these products (since 1996), and author of one of the first clinical studies published in the international literature, and continues to use Restylane and Perlane with excellent results. The effects are immediate and their duration in the fabric varies between 6 and 18 months, but with repeated use are witnessing a gradual revitalization of the tissue treated with the disappearance of the origin problem thanks to the natural synthesis of new collagen induced by the material . Side effects are mostly of a local nature and transient (swelling, redness, some small bruise) and tend to resolve spontaneously.

Juvederm

Juvederm® is the name of a family of high quality hyaluronic acid gel, hyaluronic acid products with biotechnological derived and widely used all over the world. Juvederm is a filler able to restore the volume and fill the tissue, with a consequent reduction of some signs of aging or emphasis of the natural characteristics. The areas of application are those of its filler, but we consider it particularly indicated in cases in which you want to associate to a great duration of the correction a plasticity and a plant impalpability, then for superficial wrinkles or where you want a very soft correction . Juvederm is also our material of choice in the treatment of the lips, for its ability to offer a soft and sensual volume correction. The results of the treatment are immediate and its duration in the tissue can reach 12 months, as demonstrated by the clinical studies. Repeated use of the product induces a gradual revitalization of the tissue treated with the disappearance of the source problem thanks to the natural synthesis of new collagen. Side effects, as with other fillers, are essentially local in nature and transient (swelling, redness, some small bruise) and tend to resolve spontaneously.

Emervel

Emervel® is the latest innovations in terms of hyaluronic acid fillers. It is a line of high quality products, which includes the entire range of useful products to treat all levels of the fabric, from the most superficial planes, with specific fillers for fine wrinkles, in the deep ones, with fillers with volumizing capacity. The treatment does not differ substantially from what you run it with the other products based on hyaluronic acid. The results are immediate and very plastic in the mucosa of the lips, where the effect of softness and sensuality. The result is progressively improved by the repetition of the treatment that leads over time to a smaller need of material. side effects and possible problems are, as for all the filler we use, mostly of a local nature, often related to needle trauma, and transient.

Restylane Sub-Q, Juvederm Voluma e Emervel Volume

Restylane Sub-Q®, Juvederm Voluma® e Emervel Volume® are biocompatible gel of hyaluronic acid compounds indicated for the volumetric correction of the face profiles. The cheekbones, the malar regions, chin and jaw line are the signs more but all areas consist of soft tissue can be volumetrically correct with these materials. It is hyaluronic acids characterized by a strong volumizing power that are implanted deep into the tissue and the duration of which is about 9-18 months. The correction can be maintained with subsequent treatments, which usually require less material to achieve the same result. As the products of these characteristics, the side effects may be slightly more pronounced, and then the swelling and the presence of some bruising may last a few days.

Radiesse

Radiesse® is an injectable fillers based on calcium hydroxyapatite conveyed by a conveyor gel. The calcium hydroxyapatite is a biocompatible substance and totally resorbable normally present in our body in the bones, and is used in orthopedic surgery, dental, maxillo-facial and plastic for many years for bone reconstructions. Its use in medicine and cosmetic surgery is more recent but already well established for its performance characteristics. The peculiarity of this product is in fact that, once injected, in addition to the effect of filling for occupation of space as any fillers, also it functions as a stimulus structure around which the body produces new connective tissue. This distinctive biological behavior determines the fundamental characteristic of the product, ie its long life which normally is about 18-24 months, during which time the material is completely biodegraded leaving a remodeled tissue, which allows not to return to the starting situation. All this makes hydroxyapatite optimum filler for the increase of the volumes, in particular of those supported by bone blocks (cheekbones, chin, jaw line) but also for the correction of those areas that tend to empty with the years, as the nose-giugali nasolabial furrows and cheek. Its use is contraindicated in the lips. Radiesse is injected, after premixing with local anesthetic, through needles or micro-cannula in the subcutaneous floors or even in the vicinity of the bone, for which the material has affinity. The session usually lasts 10-20 minutes and leaves as possible transient side effects a bit 'of swelling, redness, or some small bruise. Precisely because with this material tends to perform volumizing type fills, often more sessions are programmed so as to obtain a consistent result but progressive and therefore does not create an excessive impact.

Ellansé

Ellansé® is a recently introduced on the market product, whose constituent is a molecule called polycaprolactone, which is used in medicine for many years as a resorbable suture. It is a substance from the peculiar filling characteristics and stimulus on the connective tissue, whereby the treatment effect is not only the volume but also the immediate creation of new tissue. In practice the results are progressively better with the passage of time. E 'produced in different formulations, with a different time duration. The production characteristics enable to choose the type of product best suited to the problem you want to work and duration in the desired time.

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Foto filler