What kind of changes form in our face
together with aging?

Together with aging, thin and deep wrinkles, sagging form in our face. Among the reasons of this, gravity effect, sun beams, ultraviolet, our mimic movements, which we perform every day for hundreds of times, such as laughing, frowning, half closing our eyes, and being exposed to external factors such as smoking may be counted. In time, a decrease occurs also in some substances, which are present inside the skin and which cause our skin to look fresher and young. As a result of this, deep or thin wrinkles form around our lips, around our mouth, at eye sides (crow’s feet), at our forehead, and as descending downwards from both sides of the nose to corners of the mouth.

What are the fillers?

Materials used under the skin for the purpose of filling and ensuring fullness lines and deep wrinkles, which form as a result of sagging in our face, collapses forming due to aging (under the eyes, at cheeks, etc.), some hollow regions in the skin (scar, acne scars, etc.) and sometimes for the purpose of contour correction (such as sexy, smooth, and curly appearance of the lips) are called filling materials. These are products, produced of many various chemical substances and introduced to the market. However, since the injection of foreign substances to the body may cause problems, they are not preferred except a few reliable products (such as collagen, hyaluronic acid).

Are fillers used for the purpose of contour correction?

Yes. Biological fillers may be used also for the bringing out of lip curves and chin tip, the increasing of forehead convex, and the voluming of cheek bones.

How is the fillers classified generally?

Fillers may be generally separated into two such as the ones obtained from the body (such as fat, tissue cocktail, cartilage tissue) and foreign substances. Among the foreign substances, a lot of substances such as injected silicone, suture materials, fillers containing silicone particles, gelatin powder, bovine collagen, and hyaluronic acid.

Can all of these substances be used safely?

No. After liquid silicone injections, excessive allergic reactions, tissue deformations are observed and it is known that they cause death by mixing into veins.  Thus, silicone injections are not used anymore. After the injections with silicone particles, an artificial appearance is formed and form deformities may form under the skin. After being applied, other synthetic fillers may lead to infection or to permanent tissue damage, dependent on the allergic reaction they have formed, to deformation and to color changes in the skin.

Which fillers can be used safely as of today?

Bovine collagen and hyaluronic acid are the fillers, which are used today frequently and safely. However, bovine collagen forms an allergic response in the body, and is refused and excreted by the body in 3rd week. As a result of these reactions, swelling forms in the surrounding tissues and this swelling causes the wrinkles to recover for 1-2 months. That is to say that after collagen is given to the body; it is refused like a foreign tissue and excreted by the body fully. Before applying to the body, allergy test should be certainly performed. Its most important disadvantage is that its forming serious allergic reaction in some people and its complete disappearance 2-3 months after being injected. In cases to which it is applied without performing allergy tests, reactions, which may cause very significant and vital outcomes in the body by the over-reaction of the immune system, may develop. Thus, the usage of bovine collagen has been restricted as of today.

What is hyaluronic acid filling substance?

This filler, which is in the form of a clear, transparent gel, is the production of hyaluronic acid substance, which is normally present in the body, by biotechnological methods and its supply to the body such as reinforcement when it is deficient. Hyaluronic acid is normally present in ligament tissues of all living organisms (in plants, in animals, and in people), among collagen fibers, and is a ligament tissue element, which is in polysaccharide structure, which brings in fullness, brightness, and smoothness to the skin. The disappearance of hyaluronic acid within the skin structure in time is one of the most important factors in the aging of the skin and causes the skin to fade, to wrinkle, and to have thin lines. By the injection of this filling substance to the skin, the brightness, fullness, and elasticity of the skin are replaced.

To which regions is this filler applied?

Especially when used together with botilinum toxin injection, it is used in frowning lines between two eyebrows, in crow’s feet deformities, in nasolabial folds extending from both nose sides to the edge of the mouth, in thin wrinkles around the mouth, and in lines extending downwards from corners of the mouth, for the purpose of bringing out lip curve and of lip thickening, in décolleté region, in neck and hand dorsum lines. By being injected under the skin in regions, where thin wrinkles and folds are present, the smoothing and fullness of these regions are ensured.

Where are hyaluronic acid applications performed and how long do they last?

In these injections, which can be applied easily in clinic conditions, local anesthesia is used rarely. After the skin is cleaned by alcohol or other antiseptic substance, the filler is injected into skin by its special very thin pointed injectors, in a form which will fill in the wrinkles. The procedure is applied in about 15-20 minutes, without any side effects except mild swelling and redness at the injection site.

In which frequency should hyaluronic acid filling substance be performed?

This filler is excreted from the body by a slow absorption. This lasts about 6-12 months. Since normally the metabolism removes hyaluronic acid daily, filling substance at a very low amount is cleaned from the body slowly. Thus, it is a procedure, which requires to be repeated once in every 6-12 months. However, this period may change according to type of filler, the region treated, the structure and anatomy of the skin, and life style.

What are the side effects of the procedure?

Since it is substance, which is naturally present in the body, its forming allergic reaction is not possible. It is approved by FDA and is being used in America very commonly. After the procedure, a very mild swelling and redness may form. This mild swelling recovers automatically in 48 hours. The irregularities, which may form, or the sites, which require reinforcement, may be corrected by re-injection of filling substance 15 days after the procedure.

In which cases is hyaluronic acid filling substance not applied?

In pregnancy and breastfeeding periods, the application should be avoided since there is no sufficient information about the subject. Moreover, in herpes infections around the lips, the injection to this region should be delayed. It should not be applied at regions, where inflammation and allergic reaction are observed.