Fillers

Fillers

Hyaluronic acid fillers have become very popular for soft tissue augmentation over the past several years. They , now dominate  the anti- ageing market with a number of new products . Hyaluronic acid is a natural substance that is found in all living organisms. High concentrations are found in soft connective tissue .It is also present in some cartilage and joint fluids, and in skin tissue. The visible signs of the aging face is loss of associated subcutaneous volume over a period of time. Clinically, with this loss, one commonly notices  the signs ,most clinicians routinely see, when confronted with a patient concerned with the aging face – an increase in facial vasculature with pigment alterations, and also an increase in the lines and wrinkles of the skin. This is often associated with a thinning of the epidermis and dermal atrophy and loss of the elastic tissues present within the dermis and with actinic changes with loss of dermal collagen. The  type of treatment for this ageing changes can be multiple, from skin care products, to energy based therapies (Lasers, IPLand radiofrequency devices) to fillers and toxins. HA fillers plays a very important  part in the correction of changes associated with aging; especially those associated in the lower one-half of the face, from the nasolabial folds, to the vertical lip lines of the lips, the marionette lines around the mouth, and in the attenuation of the lip also. They are also used for volume enhancement of the cheeks.

Facial lines and furrows that can be corrected using hyaluronic acid injections include:

• Frown lines that run between the eyebrows (glabellar lines)
•  Smoker\’s lines which are vertical lines on the mouth (perioral lines)
•  Worry lines that run across the forehead (forehead lines)
  Crow\’s feet at the corner of the eyes (periorbital lines)
• Marionette lines at the corner of the mouth (oral commissures)
• Deep smile lines that run from side of the nose to corners of the mouth (nasolabial furrows)
• Cheek hollows and depressions
• Contouring of lips
• Deep Acne scars
• Some facial scars

RESTYLANE is the trade name for a wide range of injectable fillers with a specific formulation of non-animal source of hyaluronic acid (HA). Restylane was the first stabilized hyaluronic acid filler that hit the market. For smoothing wrinkles, sculpting of lips, and for facial enhancement, , Restylane injections are a preferred favourite. Approved by the FDA in December 2003, Restylane can give good results on facial wrinkles, particularly around the mouth and nose. Restylane gives long-lasting results, as the effects of Restylane treatments can last twelve months or more. Restylane comes as a clear liquid gel, as non-animal-based hyaluronic acid (a natural sugar compound).

INJECTION PROCEDURE – Restylane injections are administered in the doctor\’s office. The following protocol is done:-

1. The treatment area is first cleanedwith an antiseptic.

2. Local anaesthetic may be used to numb the treatment area.

3. Injection technique depends on the doctor but will be either the serial intradermal puncture technique (series of small injections with a very fine needle) or, tunnel or, threading technique (needle is withdrawn as the hyaluronic acid is injected). . The Restylane filler is injected beneath the skin. Hyaluronic acid in the filler adheres to the skin as the water contained in the acid helps to retain the volume under the skin\’s surface. The acid also acts as a magnet for water, which in turn helps to preserve the renewed volume of the skin.

4. Depending on the area of face treated, the skin may be lightly massaged. Depending upon the extent of the treatment, the procedure can take up to 45 minutes. Patients can go home shortly after the procedure

5. Immediately after injection the site may be red and swollen. This usually disappears within one week.

6. Another repeat treatments ( spaced at least a week apart) may be necessary to achieve the desired correction.
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Results are fully evident within one week’s time. Restylane is very successful for reducing or eliminating deep wrinkles that cannot be accomplished with other procedures such as chemical peels or microdermabrasion. Swelling may be sometimes pronounced, lasting for about three days. Normal activities can be resumed immediately, after the procedure, though patients are advised to stay out of the sun.