Currently there are a number of biological substances available used as fillers primarily in the face to reduce or conceal small lines or imperfections in the skin. The areas in which the best results are obtained are:

• Furrows between the eyebrows and on the forehead.

• Lines at the corner of the eyes (crow's feet).

• Creases from the cheeks to the lips (nasogenian folds).
  

• Wrinkles or fine lines at the corners of the lips.
  

• Outline, highlight and volume of lips.
  

Advantages. Fillers are non-surgical methods that can provide flattering benefits to a patient's appearance without the need for surgery. Their application is an outpatient procedure that can be safely performed in the doctor's office. Fillers represent a a subtle way of naturally improving one's facial appearance; however they are not a substitute for facial rejuvenation surgery when this is indicated (they do not treat sagging facial skin and muscles, eyelid bags or folds in the neck). In other words, they serve a different purpose, but in good candidates the results are noticeable and immediate.

Products. There are currently a number of different substances used as fillers, some are synthetic and permanent and others, of natural origin, are absorbed in two or three years. We recommend the latter, as they generally do not trigger allergic reactions and are of biological origin. The most frequently used substance and that which has proven to most effective is with a doubt hyaluronic acid.

Hyaluronic acid. Is marketed under different commercial names but the active substance is the same. Hyaluronic acid is a naturally-occurring substance in the body whose principal function is to hold in moisture, it is also a major component of the connective tissue matrix in the dermis. The advantage of this product is that it does not require previous tests to rule out allergic reactions. Youthful skin is rich in hyaluronic acid, but as it ages the function and distribution of this substance changes as the characteristic signs of aging appear. This product acts by enriching the natural reserves and restoring lost volume, softening the signs of the passing of time.

Before and after photos following the application of facial fillers

Application. As with all plastic surgery procedures, facial fillers must be applied by qualified and trained health professionals, who must be judicious in its use and individually assess each patient on the basis of four important parameters:

1. The type of product, as there are at least three different variants of hyaluronic acid with different viscosities depending on the areas to be treated.
2. The site of application (between the eyebrows, crow's feet, cheeks, facial lines, lip augmentation).
3. The amount of product to be injected.
4. The depth of the application, that is, in the epidermis, hypodermis, or dermis.
   
   

This treatment is very useful and provides very good results; however if the product is not applied correctly it may leave abnormalities in the facial contour, or overcorrections that can appear unattractive and are difficult to correct.