DERMAL FILLERS

DERMAL FILLERS

With the development of local anaesthesia and surgical
techniques toward the end of the 19th century

 The present use of biodegradable dermal fillers has travelled long way from the initial days with constant and continuous study and research. With the development of local anaesthesia and surgical techniques toward the end of the 19th century, more invasive cosmetic procedures became available, including soft tissue fillers. Fat was one of the first soft tissue fillers to be used after trauma and is still widely used today. However the use of autologous fat transplantation has become meticulously major and the results maybe variable.

INDICATIONS FOR DERMAL FILLER
CHAT FOR DERMAL FILLER

INDICATIONS FOR DERMAL FILLER

  1. indicated in mild to deep dermis for the management of wrinkles and folds
  2. perioral rhytids
  3. dorsum of the hands
  4. lips for lip augmentation
  5. contour deficiencies

Dermal injection

BASED ON THE MATERIAL PROPERTIES, BIODEGRADABILITY, DURATION OF EFFECT the fillers have classified into;

Autologous: Derived from the same individual (eg, autologous fibroblasts)

Heterologous: Derived from a different species (eg, bovine collagen)

Alloplastic: Non-biologic material such as metal, ceramic, or plastic (eg, polymethyl methacrylate [PMMA])

a.MATERIAL PROPERTIES

b. BIODEGRADABILITY

Biodegradable: Capable of being broken down, especially into innocuous products (eg, HA,PLLA)

Non-biodegradable: Substance or chemical that cannot be changed to a natural state (eg, PMMA)

Temporary: Effective for less than 6 months (eg, collagen)

Long-lasting: Effective for 6 to 24 months (eg, HA [12–24 months], CaHA [18–24 months

Semi permanent: Effective for 2 to 5 years (eg, PLLA [2–3 years])

Permanent: Nonfading results (eg, PMMA)

c. DURATION OF EFFECT

IDEAL CHARACTERISTICS OF A FILLER

Fillers are materials used to add volume to soft tissues. Characteristics of an ideal soft tissue filler;

  • Adds volume
  • Easy to use, giving an opportunity to shape the tissues
  • Has reversible results
  • Durable and good duration of effect
  • Safe to use, giving satisfaction to the patient and the physician
  • Has a natural effect
  • Does not cause the patient discomfort
  • Requires no time for recovery
  • Predictable
  • Does not cause allergic reactions or irritation


The two most important characteristics for any soft tissue filler are

a.viscoelasticity

Viscoelasticity describes the hardness or softness of a gel and is defined by its elasticity (elastic modulus, G’)—that is, how the filler is able to retain its shape when a force is applied—and its viscosity (viscous modulus, G”)—that is, how the filler resists gradual deformation by shear stress. These accumulated values identify the viscoelastic modulus (G*). The higher the G*, the higher the resistance to deformation and the greater capacity to keep its shape and, hence, a major lifting effect

Cohesivity describes the property of the gel to stick together when an external force is applied. Gels with higher cohesivity tend to uniformly infiltrate the tissues and are not fractionated by movements.

b. cohesivity.

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