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Fillers: 10 popular questions about who exactly needs them and why they are dangerous

A still from the movie “Cowboy Bebop”

One of the most common requests to the beautician and also one of the biggest fears of patients is fillers. The author of this text, although he has been working in the beauty industry for a long time, did not fully understand how to make friends with this “monster” (and whether it is necessary to be friends with him). Therefore, for help I called dermatologist-cosmetologist Marina Andrievskaya, a doctor of the highest qualification category. So I asked him the simplest and at the same time complex questions about fillers.

Marina Andrievskaya


What types of fillers are there and how are they different?

Today, five main types of fillers are used in cosmetology.

• collagen based fillers,

• hyaluronic acid based fillers,

• poly-L-lactic acid based,

• calcium hydroxyapatite based,

• It is based on polymethyl methacrylate microspheres.

The most demanded and popular are hyaluronic acid-based fillers. This ingredient is “natural” to the body (it produces itself), is completely compatible with its tissues, and dissolves on its own over time. All this allows you to avoid rejection and other negative reactions. Meanwhile, 80% of the world’s hyaluronic acid is produced at the Bloomage Biotechnology factory in China.

Hyaluronic fillers often differ in the degree of purity, density, plasticity and concentration of acid. That’s why there are so many, and each filler has its own purpose. There is no universal medicine.

Soft fillers are used to fill wrinkles and creases in the dermis. Lips, nasolabial folds, nasolacrimal groove, labiomental fold, etc. denser for shaping. Cheekbones, chin, lower jaw angles, etc. When correcting, the most dense fillers are used for bone injection.

Bella Hadid. Photo: Getty Images

The degree of purification of hyaluronic acid plays a very important role: this is the most energy-consuming and expensive process. This stage is important to prevent immune reactions and side effects if the filler remains in the tissue for a long time. Therefore, you should not compromise on the quality of the medicine.

High-quality filler cannot be cheap.


Where are fillers placed?

The main markers of youth and beauty are, above all, skin elasticity and tissue volume. This is why fillers are so popular. They can solve many problems at once and are actually used in almost all layers of the face: intradermal, subdermal (on the subcutaneous fatty tissue) and supraperiosteal (on the bone). It depends on the area to be corrected and the patient’s wishes. It should be noted that the introduction of a hyaluronic acid-based filler into the abdominal cavity is contraindicated in patients with deformational-edematous type of aging, as it can cause long-term complications in the form of edema and swelling of the face.


What can you change on your face with fillers?

With the advent of fillers, the dream of the ideal (depending on your taste) look and reality has become closer than ever. Contour plastic surgery allows you to achieve ideal lines by adjusting the proportions of your face. And in adulthood it can compensate for the lack of volume in almost any area and prolong youth.

Lindsey Lohan. Photo: Getty Images

You can change almost everything: the shape of the forehead, the position of the eyebrows, restoring lost volume, cheekbones, cheeks, angles of the lower jaw, the shape of the nose and, of course, lips. Fillers can also be used to eliminate prominent wrinkles and folds. But I would like to note that the main thing is to do it in moderation, in the name of beauty and according to indicators, absolutely without fanaticism.

Fillers based on calcium hydroxyapatite and polylactic acid initiate natural rejuvenation and tissue regeneration processes by stimulating the production of own collagen and elastin. These types of fillers are now only gaining momentum in terms of their popularity and demand. And that’s great, because I think the era of natural facial correction has begun.

The main wish of patients is no longer to change their appearance, but to work with the quality of their skin.


How long does the effect of fillers last?

Everything here is very individual and depends entirely on the characteristics of the patient’s body and life activity. Every person’s blood contains an enzyme called hyaluronidase, which is an antidote to hyaluronic acid, so its concentration in the blood affects the rate of removal of HA-based filler. I would also like to note that the filler has different costs in different layers. The fastest way to remove the filler from the body is through bone injection; it takes a little longer to remove it from the subcutaneous fat tissue. Scientists have proven that fillers in the periorbital area last not one to two years, as promised by manufacturers, but up to ten years.

Hailey Bieber. Photo: social networks

Biodegradation (removal) of the filler is accelerated by thermal exposure (going to the bath/sauna, being in active sun or solarium), facial massage and intense sports.


For whom are fillers contraindicated?

As with every injection procedure, filler injection has contraindications:

  • the period of exacerbation of any chronic disease,
  • Flu, ARVI and other infectious or inflammatory processes,
  • pregnancy, breastfeeding,
  • diabetes,
  • Taking antibiotics and blood thinners during the planned intervention,
  • skin diseases at the injection site in the acute stage,
  • HIV, syphilis, epilepsy, oncology of any localization,
  • mental disorders, anxiety states;
  • Age up to 18 years old.
  • For lip contouring, you are not allowed to go to the dentist two weeks before and two weeks after the procedure.

As before any cosmetic procedure, it is necessary to consult a doctor to determine possible contraindications, choose the right medicine, and also determine the real indications for the insertion of the filler.

This can only be done by a specialist, based on the individual characteristics and needs of the patient.


How to prepare for the procedure?

No special preparation is required for contouring. The only important thing is that there are no contraindications that I described above. But I will give some recommendations to minimize undesirable events such as hematoma and swelling:

  • Do not drink hot tea or coffee on the day of the procedure to prevent vasodilatation.
  • Do not take hot baths the day before and on the day of the procedure,
  • Do not enter the Turkish bath/sauna or solarium for at least 24 hours.
  • do not drink strong tea, coffee and other tonic drinks, spicy foods and avoid active physical exertion on the eve of the procedure.

It is recommended that patients with bleeding disorders take hemostatic drugs 2-3 days in advance. Patients with a history of herpes virus infection are recommended to take antiherpetic medication 2-3 days before lip contouring.


Does swelling occur with all types of fillers?

Adriana Lima. Photo: Getty Images

After any filler is placed, post-traumatic swelling that occurs immediately after the procedure is a normal option. However, long-term delayed swelling can, as a rule, only be caused by fillers containing hyaluronic acid, since one hyaluronic acid molecule attracts eight water molecules. Also, the cause of long-term swelling may be a hypersensitivity reaction to the filler and manifest as swelling of varying intensity, which is usually eliminated by the use of anti-inflammatory drugs. However, repeated development of a hypersensitivity reaction often leads to granuloma formation. (a skin reaction that causes small, hard, raised bumps to form on the skin – Ed.)It is a condition that requires surgical treatment. If such a symptom occurs, the filler must be removed as soon as possible to prevent granuloma formation.

Hypersensitivity reaction is also called immune response or delayed onset edema. The immune system recognizes the filler as an antigen, which leads to the activation of macrophages and T-lymphocytes, as well as the accumulation of macrophages at the site of inflammation. Inflammation manifests as swelling and pain two to three weeks after filler injection. The pathogenesis of this phenomenon is unclear, but some suspected causes include filler toxicity, impurities, endotoxins, osmolarity and pH changes.

Therefore, you can not save on medications and inject cheap fillers.

Fillers based on calcium hydroxyapatite and polylactic acid are gaining great popularity. The preparations have the properties of a real collagen stimulator and at the same time do not absorb water, so they are suitable even for patients prone to swelling.


What should you not do after having a filling?

For two weeks it is not recommended to go to baths, saunas, solariums or massage the injection site. You should stay away from sports for two or three days. It is also recommended to rest the injection area as much as possible for a week. On the first day, you should avoid spicy, salty, hard and hot foods to avoid increasing swelling.

Photo: social networks

When shaping the lips and nasolabial folds, it is necessary to limit the movements of the facial muscles for the first seven days after the procedure. During this period, it is necessary to avoid kissing, excessive smiling, talking, chewing, yawning and other movements of the facial muscles. . It is also necessary to avoid applying pressure to the injection site. It is not recommended to sleep face down for the first 2-3 nights. If the procedure is performed in winter, hypothermia and long walks in the cold should be avoided.


With which processes can fillers be combined and which cannot?

Filler injections can be combined with almost all procedures on the same day, but preferably in different layers or different areas. For example, since botox is injected into the muscle and the filler is placed under the skin or on the bone, botulinum treatment and shaping can be done in a single procedure. These procedures work well in combination with each other and provide a more pronounced effect together than individually.


How and with what can fillers be removed?

The only antidote to hyaluronic acid fillers is hyaluronidase. It is used to remove unwanted or old filling or in cases of complications where the filling needs to be removed urgently for medical reasons. Hyaluronidase takes effect within a few hours: The effect can be evaluated the next day. Sometimes the procedure needs to be repeated after two weeks.

In some cases, surgery is required to remove the filler. When a beautician uses older generation fillers containing polymers. Many of these fillers are now banned because they cannot be removed from the body naturally.

Besides the difficulty of removing such fillers, surgery requires a longer recovery. Thus, postoperative stitches will only be removed after a month, and full recovery may take up to six months.

Source: People Talk

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