What are
Founder of resorbable fillers, hyaluronic acid is a substance widely used in the field of aesthetic medicine, especially for:
- Correct skin blemishes typical of skin aging, such as wrinkles and small depressions.
- Give firmness and fullness to thin lips and falling cheekbones.
The vast availability on the market of fillers formulated with hyaluronic acid at different concentrations has made it possible to intervene on various fronts and to satisfy multiple aesthetic requests, ranging from the correction of small wrinkles to the volumetric increase of lips and breast.
Hyaluronic acid
What is hyaluronic acid?
Hyaluronic acid is a component of the so-called fundamental substance of the dermis: it is a glycosaminoglycan, that is a molecule formed by long unbranched chains of disaccharide units (alternating glucuronic acid and N-acetylglucosamine). By attaching to many water molecules, hyaluronic acid gives hydration, elasticity and softness to the tissues, protecting them from excessive stress.
The concentration of hyaluronic acid in the connective tissue of the skin is gradually reduced as age progresses: for this reason, a mature skin appears less elastic and less hydrated than young skins. Despite being a completely physiological and natural phenomenon, many women want to counteract the inexorable advancement of age, thus preventing wrinkles and other skin blemishes. The goal is to be (at least in appearance) much younger and nothing better than the hyaluronic acid filler seems to satisfy this desire.
Indications
Indications of the Hyaluronic Acid Filler
The hyaluronic acid filler seems the ideal solution to correct (and improve) small imperfections of the skin of the face, generated by the irreversible evolutionary process that so many worries and anxiety many women no longer young.
The hyaluronic acid filler is indicated in the following circumstances:
- Shaping expression lines, crow's feet, glabellar lines (which originate in the forehead, precisely in the portion immediately above the nose)
- Filling small cicatricial lesions (eg scars left by acne)
- Tighten thin, volumeless lips
- Volumizing falling cheekbones (in this case, the filler must be prepared with a higher concentration of hyaluronic acid)
- Remodeling of the face profile
- Correction of post-traumatic / surgical scars
In addition to being injected into the face, the hyaluronic acid filler can also be used to fill other areas of the body: for this purpose, the injections of this "prodigious" substance are performed to improve the appearance and volumize calves, breast and buttocks.
Classification
Types of Hyaluronic Acid Fillers
Based on the different times of resorption, it is possible to distinguish more types of fillers with hyaluronic acid:
Type of filler with hyaluronic acid | Duration of effect | Trade names of the best selling hyaluronic acid fillers |
Ultra-rapid absorption filler | 2-3 months approx. | Juvelift,, Restylane touch, Perfectha fine lines → find indication for the treatment of crow's feet and to mask small facial wrinkles |
Medium absorption filler | 5-6 months approx. | Juvederm 24, Restylane, Rofilan, Perfectha dern |
Slow absorption filler | 12 months approx. | Puragen, Restylane Sub Q, Perlane, Perfectha Deep → indicated to increase the volume of the lips, cheekbones and chin |
Ultra-absorption absorption filler | 24 months approx. | Perfectha Subskin, Hyacorp → indicated for the correction of scar lesions and for volumizing the breast or buttocks |
Note:
For long-lasting hyaluronic acid fillers the risks about possible side effects on the biological level increase. In fact, being in an environment rich in hyaluronic acid, the skin cells avoid producing them again and increase the degradation processes against them; not only that, long-acting hyaluronic acid macromolecules, due to their structural complexity, are recognized as foreign and trigger a local inflammatory response. This triggers the production of fibrotic tissue rich in type 1 collagen which, despite having a positive effect in terms of aesthetics in the short term due to distension of the skin, actually makes the skin older and less elastic with biological damage.
injection
Filler injection to hyaluronic acid
The injection of filler with hyaluronic acid is a non-invasive treatment which is relatively simple to perform, but which must be carried out only by medical personnel specialized in this area.
Of course, before performing the injection, it is necessary to make a preliminary visit with the specialist, in order to exclude the presence of any contraindications to this type of treatment.
Unlike collagen injections, hyaluronic acid fillers do not normally generate allergic reactions: for this reason, it is not necessary to undergo a preliminary intradermal test to assess any allergy.
Immediately after treatment, the treated face (or body) area may exhibit secondary effects such as redness and swelling, which may be associated with the appearance of small hematomas. However, these effects should self-resolve within a few days.
All normal daily activities can be resumed immediately and no recovery period is required.
Results
The results obtained with hyaluronic acid fillers are very good and always have a good level of satisfaction in patients.
In fact, these fillers make it possible to obtain a completely rejuvenated and replenished effect that does not give artificiality to the area of the face or body in which they are injected (soft-lifting effect). Furthermore, the results are immediately visible and this further increases patient satisfaction.
However, despite being almost immediate, the effects of aesthetic skin rejuvenation given by the filler to hyaluronic acid are not permanent; so much so that after a relatively short period of time (ranging from 4 months to 2 years, depending on the type of filler used), wrinkles begin to appear again, and the lips (the cheekbones or other parts of the face and the treated body) gradually lose their volume. This happens because the body is able to metabolize the injected hyaluronic acid (hence the name "resorbable filler").
The gradual reabsorption of the filler by the skin therefore makes it necessary to periodically repeat the injections of hyaluronic acid after the disappearance of the effect.
However, it is important to remember the effects and the results obtained with the injections of filler with hyaluronic acid - although always good - can be different from individual to individual. Indeed, they depend on:
- Skin type.
- Hyaluronic acid concentration.
- Type of injected filler.
- Area to be treated.
Furthermore, the duration of the effect promoted by injections of filler to hyaluronic acid is heavily influenced by factors such as stress, smoking, nutrition, lifestyle habits, sedentary lifestyle and exposure to natural / artificial UV rays.
Side effects
Over the years, hyaluronic acid has won the title of leader among all filling dermal agents (fillers). In fact, the anti-aging effect promoted by the injections of this substance is surprising: it volumizes, softens, moisturizes and - above all - rejuvenates aging skin due to stress, smoking, UV rays and age. Despite these positive aspects, the hyaluronic acid filler is not without side effects.
In fact, immediately after the injection, the skin tends to react giving rise to hematomas, ecchymoses, edemas, numbness and bruises which, even if rather fleeting and generally mild, can cause considerable aesthetic discomfort.
Furthermore, in some circumstances, some rare cases of severe post-injection trauma have been reported. Among these, we recall:
- Persistent redness;
- Intermittent edema;
- nodules;
- Itch;
- Abscess formation.
Curiosity
When the aesthetic side effects caused by hyaluronic acid filler injections far outweigh the benefits, it is possible to reverse the treatment by inoculating the enzyme hyaluronidase: it is an enzymatic complex capable of accelerating the natural degradation of the hyaluronic acid charge injected.
Finally, although the injections of filler to hyaluronic acid are well tolerated and do not require the execution of a preliminary intradermal test, it should not be forgotten that cases (although extremely rare) of the onset of allergic reactions have been reported following the administration of such fillers.
Did you know that ...
The use of high molecular weight hyaluronic acid and / or some long-acting polymers causes a side effect unknown to most. In particular, there is a paradoxical effect whereby the skin, although looking aesthetically younger, undergoes structural alterations at a microscopic level that make it older. We try to better understand the problem:
- By injecting these substances, instead of stimulating the skin to produce the structural elements it needs, the substances "ready to use" are supplied directly from the outside. In this way the synthesis capacity of fibroblasts is reduced, which become less active in producing hyaluronic acid at a dermal level;
- The abundance of hyaluronic acid in the post-injection period leads to hyper-activation of proteins specialized in the degradation of this substance (metalloproteinases);
- Hyaluronic acid polymers with high molecular weight / long duration stimulate the formation of fibrotic collagen (see "Classification" paragraph).
This creates a sort of "dependence" on hyaluronic acid fillers, so once the treatment has begun it must be continued and strengthened over time (if you do not want to remain with a much worse skin than when you started).
For this reason, in young subjects, we increasingly opt for the injection of low molecular weight substances (eg fragments of hyaluronic acid), flanked by antioxidants and by factors capable of stimulating the activity of spontaneous regeneration of the skin. The same effect of stimulation and regeneration can be obtained through the use of supplements rich in substances with antioxidant and anti-inflammatory action, collagen and hyaluronic acid.
Disadvantages
In addition to any pain perceived during the injections, to the potential appearance of side effects and / or allergic reactions and to the creation of a possible "dependence" on hyaluronic acid mentioned above, another disadvantage of this type of filler is undoubtedly represented by the cost, quite high and by no means negligible. Indeed, it cannot be asserted that the hyaluronic acid filler is an economic solution against aging, since the price of each individual injection varies from 300 to 600 euros.
Contraindications
Although the serious side effects derived from hyaluronic acid injections are infrequent, it is strongly advised against administering the filler during pregnancy and lactation. Furthermore, the hyaluronic acid filler is contraindicated in the presence of skin diseases, current Herpes infection, autoimmune skin disorders and collagen diseases.
Effect maintenance
How to maintain and enhance the anti-wrinkle effect of the Hyaluronic Acid Filler
We have seen how some incorrect behavioral habits - such as drinking alcohol, smoking or not practicing any form of sport - can decrease the duration of the soft-lifting effect promoted by the filler to hyaluronic acid.
Again, to support the hyaluronic acid filler, it is recommended to take some supplements with antioxidant and anti-aging action by mouth. For this purpose, substances such as vitamin C and E, echinacea, resveratrol, collagen, hyaluronic acid and lipoic acid help to keep the skin elastic, compact and hydrated for longer, effectively counteracting the signs left by aging.
In conclusion, the combination of anti-wrinkle creams + anti-age supplement (eg X115 New Generation Skin Care) is an excellent solution for visibly enhancing the antiaging effect obtained from the filler to hyaluronic acid.
Clearly, following a healthy and balanced diet, practicing a sports activity every day, relieving stress, not drinking alcohol and quitting smoking turn out to be small and simple tricks to naturally counteract the decay of the skin, visibly improving its tone.
Alternative treatments
Alternatives to Hyaluronic Acid Filler
Hyaluronic acid injections can be replaced with other resorbable fillers, such as bovine collagen, autologous collagen, agarose gel and L-polylactic acid.
Another alternative to fillers based on hyaluronic acid is lipofilling (or autologous fat transplant): it is a technique of aesthetic medicine indicated to redesign the profile of the face and body. Lipofilling is a treatment which consists in transferring part of one's own adipose tissue (fat) into tissues "emptied" from aging. Similar to the hyaluronic acid filler, even the lipofilling clearly contrasts the signs of aging, volumizing cheekbones, cheeks and lips, and smoothing out more or less marked wrinkles.
