Aging is characterized by volume deflation, facial descent and surface irregularities in the skin.
Dermal fillers treat volume loss, improve facial support, and reduce skin irregularities.
Scars may also be treated with soft-tissue fillers.
Use of an injectable agent for cosmetic enhancement was reported in 1899 by Robert Gersuny, who injected paraffin to create a testicular prosthesis (Kontis, Facial Plast Surg 2009). Materials with better biocompatibility are now available.
- Age-related volume loss and skin surface irregularities
- Severity of aging relates to intrinsic factors (genetics) and extrinsic factors of ultraviolet exposure, smoking, diet and lifestyle choices.
- Society favors a youthful appearance. Improved facial appearance contributes to psychological well-being and to positive social function.
- Have patient identify areas of concern.
- History of previous surgery or filler treatment
- Current medications and supplements, especially blood thinners and anti-platelet agents
- Medical history and allergies including prior response and reactions to similar products, underlying autoimmune disease, HSV infection and pregnancy
- Informed consent should be obtained.
- Photographs to document before and after treatment
- Skin testing for allergy not generally indicated except for historic materials such as bovine collagen