Aging causes loss of facial volume, descending soft tissue and decreased skin elasticity. The loss of facial volume is a result of diminishing dermal collagen, hyaluronic acid and elastin as well as fat atrophy and even skeletal bone loss. Facial contours change with age from high cheeks and a small chin to flattened cheeks and prominent jowls. Most fillers contain synthetic hyaluronic acid (HA) and are used in different areas of the face to enhance volume and reduce appearance of wrinkles. Hyaluronic acid is a naturally occurring substance in the skin extracellular matrix that provides structural support and adds volume and fullness to the skin. The effect of most commonly used fillers last 6-12 months.

In addition to HA fillers there is Radiesse which is comprised of calcium hydroxylapatite (CaHA) microspheres suspended in an aqueous gel carrier. Once injected it provides immediate volume correction but can also stimulate collagen synthesis in the skin for a long-lasting effect. Over time, the gel is absorbed and the body metabolizes the CaHA microspheres, leaving behind only your own natural collagen.

One of the risks with using fillers is unintentional injection into a blood vessel. The chances of this happening are very small, but if it does happen, the complications can be serious, and may be permanent. These complications, which have been reported for facial injections, can include vision abnormalities, blindness, stroke, temporary scabs, or permanent scarring of the skin. If you have changes in your vision, signs of a stroke (including sudden difficulty speaking, numbness or weakness in your face, arms, or legs, difficulty walking, face drooping, severe headache, dizziness, or confusion), white appearance of the skin, or unusual pain during or shortly after treatment, you should notify your health care practitioner immediately.

As with all procedures that involve an injection through the skin, there is a risk of infection. You should not use fillers if you have a skin infection until it has healed.

If you have a history of herpes, you may experience a herpes breakout after receiving fillers.

Injection in the back of the hand may result in temporary difficulty performing activities. Fillers may cause nodules, bumps or lumps in the back of the hand and can last up to 1 year. HA fillers can be dissolved with hyaluronidase whereas Radiesse can not be dissolved.

You should minimize strenuous activity and avoid extensive sun or heat exposure for about 24 hours after treatment and until any swelling or redness has resolved.

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