Filling wrinkles, scars and lips with hyaluronic acid

Natural substances based on hyaluronic acid are injected into the skin. The preparation is selected according to the needs of the skin and the desired result, whether this is smoothing a smaller number of wrinkles or adding volume for reshaping. The effects of fillers last for approximately 6 to 9 months; during this time, the body gradually breaks them down naturally. Minor bruising and swelling may occur after the injections. Swelling usually subsides within 24 hours and can be reduced by cooling the treated area.

Hyaluronic acid is one of the substances used as a natural filler and is also produced naturally by the human body. These types of fillers are physiological and are neither carcinogenic nor teratogenic. Although they are temporary, they are safer. More permanent fillers carry a greater risk of allergic reactions, foreign-body granulomas, rejection and similar complications.

What are dermal filler injections?
Dermal filler injections are used to augment, or increase, soft tissue volume. This minimally invasive method has become an established way of correcting changes in shape caused by ageing, sun exposure, injury, scarring or disease. At Terme Krka, we use natural fillers based on substances naturally present in the human body. They are safe and effective, provide reproducible results, are non-carcinogenic, do not cause foetal abnormalities, do not migrate and are relatively affordable.

When are dermal fillers suitable?
Dermal fillers can be used to correct or reduce the effects of skin ageing, which may appear as changes in facial contours and the formation of wrinkles caused by the gradual loss of subcutaneous fat and dermal collagen. Areas that can be smoothed and filled include lines between the eyebrows, nasolabial folds between the nose, cheeks and corners of the mouth, marionette lines at the corners of the mouth, wrinkles in the upper and lower lips, and smile lines around the corners of the mouth. Fillers can also be used to restore volume to sunken cheeks, reshape the chin and tip of the nose, or fill acne scars.

Are fillers suitable for correcting wrinkles at the corners of the eyes?
Wrinkles around the corners of the eyes are generally not treated with fillers because the skin in this area is very thin and injecting filler could cause visible bumps. These wrinkles are usually smoothed with botulinum toxin. Fillers are also less suitable when there are many wrinkles; such wrinkles can be treated more effectively with a facelift or chemical peel.

What is hyaluronic acid?
Hyaluronic acid is a substance naturally present in the middle layer of the skin, the dermis. Because of its remarkable ability to bind water, it plays an important role in maintaining skin volume. With age, the amount of hyaluronic acid in the skin decreases, as do the levels of collagen and elastin. As a result, the skin ages, loses elasticity and becomes dry and dehydrated. The use of hyaluronic acid can effectively improve its appearance. The hyaluronic acid used in filler preparations is produced through bacterial fermentation and is not of animal origin, which means it does not cause allergic reactions and is not pathogenic. Allergy testing before injection is therefore not required.

How long does the procedure take and how painful is it?
The procedure takes up to 20 minutes. People who have undergone the treatment generally describe the pain as mild to moderate.

Is the procedure performed under anaesthesia?
The decision to use anaesthesia depends on the area being treated and the type of filler. The treatment area can be numbed with an anaesthetic cream or a local anaesthetic injection. For more invasive procedures, local anaesthesia may be combined with sedative medication in tablet form. Cold compresses can also help relieve discomfort after the procedure.

Can swelling occur after the procedure?
Swelling may occur immediately after the procedure and may persist into the following day. Redness, tenderness and a stinging sensation may also occur. Bruising may be visible at the injection sites. If necessary, it can be concealed with make-up and usually disappears within one week. The treated skin should not be exposed to extreme temperatures for several days after the procedure.

What are the possible complications?
Complications are rare, but bleeding and bruising may occur. Bacterial infection is also possible and may be indicated by pain and redness developing within 24 to 72 hours after the procedure. In this case, the doctor will prescribe an antibiotic based on the results of a swab analysis. Other possible complications include viral infections, including reactivation of the herpes virus, local tissue necrosis caused by secondary closure of small skin arteries, which may be treated with warm compresses, massage and nitroglycerin paste, as well as cystic reactions to the implanted substance and foreign-body abscesses.

How can I prevent or reduce complications?
It is important to stop taking aspirin and other medicines that affect blood clotting before the procedure, as well as anti-rheumatic medicines and vitamin E. You should also avoid alcohol before the procedure. After the treatment, cool the injection area with cold compresses.

When are the results visible and how long do they last?
The results are visible immediately and may last from 3 to 12 months, depending on the area treated and the type of preparation used. For a longer-lasting effect, it is recommended to add a smaller amount of filler again after one or two months.