What are soft tissue fillers?

Soft tissue fillers are flexible substances that can be injected into the skin to improve the appearance of fine lines and wrinkles, plump lips, fill out hollow cheeks, improve scars, elevate deep folds, and repair various facial imperfections. The result is a smoother, more youthful appearance with minimal “downtime” and maximum safety. A variety of soft tissue fillers including bovine collagen, one’s own fat, and donor tissue, have greatly expanded the anti-aging treatments of dermatologists. Since filler substances do not involve major surgery, and are generally cost-effective, men and women are using these youth enhancing techniques more than ever.

What can soft tissue fillers do?

The aging process generally causes a loss of volume in fatty tissue as the underlying collagen and elastin fibers begin to deteriorate. This most commonly occurs around the eyes, mouth, cheeks, the jaw line, the brow, and bridge of the nose. These age-related changes produce crow’s feet, laugh lines, folds and furrows on the forehead, and “hills and valleys” on the lower third of the face. Soft tissue fillers have the unique ability to fill and contour an aging face, allowing the dermatologist to sculpt and restore vitality to your appearance.

How do soft tissue fillers work?

A filler substance is injected beneath the surface of the skin where it corrects the line or wrinkle by temporarily plumping and smoothing out the skin depression. Fillers can also be placed into the lips to create a fuller, more youthful look, or in the hollows of the cheeks to reduce a gaunt appearance. Facial scarring from acne or injury also responds well to soft tissue filler techniques.

What are the ABC’s of fillers?

Dermatologists have developed a variety of filler substances to address a wide range of cosmetic flaws as well as the needs and expectations of the individual patient. Each filler brings subtle, distinctive benefits. Some provide longer-lasting results, others allow for more precision with fine lines, and still others can gradually bring the face into better overall balance creating an overall rejuvenated appearance. Soft tissue fillers are often considered a first line against aging skin and are frequently used in combination with other techniques for facial rejuvenation.

Filling substances commonly used by dermatologists are:

Collagen – Introduced nearly 20 years ago, bovine collagen is one of the fillers that has proven effective over time. Some patients may be allergic to collagen produced from a cow, and therefore will receive a test dose. Its human-derived counterpart offers an alternative to patients who are allergic to animal products.

Botulinum toxin – While technically not a filler, very tiny amounts of botulinum toxin are injected into specific facial muscles to immobilize or relax the underlying cause of lines and wrinkles associated with expression. It is commonly used to improve forehead creases, furrows between the eyebrows, and crow’s feet.

Fat – Removed by a mini liposuction procedure from other parts of the body such as the thighs, buttocks, or stomach, one’s own fat has been used for years to reduce deeper wrinkles and contour the “hills and valleys” associated with an aging face.

Fascia lata – Originally used to raise deep scars, small pieces of human fascia (the material just under the fatty tissue) are inserted under the skin to plump it. Fascia lata allograft has recently become available in an injectable form and is used to improve scars, augment lips, and smooth wrinkles. It does not require prior skin testing and can be used in patients with bovine collagen allergies.

Implants – Polymers and collagen-related implants offer a longer-lasting option for shoring up deep facial grooves and folds, particularly around the mouth, nose, and lips. The material is inserted under the skin as strips, threads, or hollow tubes that serve as a permanent filler. These substances can also form the foundation into which other injectable fillers may be added.

What should I expect during and after treatment?

The soft tissue filler process is relatively simple, and can be performed in your dermatologist’s office. Before beginning treatment, and depending upon the choice of filler, your doctor may administer skin tests to determine if you are likely to have an allergic reaction to the filling substance. Prior to the procedure, your face is cleaned and a topical anesthetic may be applied to the treatment areas. A very small needle is used to inject the filler directly into the wrinkle. You may feel a stinging or burning sensation as the filler is being inserted. A series of treatment sessions may be necessary to fill and smooth the lines and wrinkles, or raise a depressed scar up to the level of the surrounding skin. Immediately after the procedure there may be some temporary swelling, redness, or minor bruising at the injection sites. This usually subsides and fades quickly. Makeup can be applied immediately after the treatment.

Are there any possible risks?

All medical procedures carry some risk. However, soft tissue fillers are generally considered a safe and effective procedure. Apart from an allergic reaction to the injected substance, side effects are few and typically relate to the local injection.

How long does the improvement last?

The length of time the improvement lasts depends on the type of filler used, the areas treated, and the ability of the patient’s skin to use the materials. Results are generally long-lasting with touch-up or maintenance treatments required after three to six months. Occasionally, touch-up treatments may be needed sooner. Correction of acne scarring tends to last longer.

For more information visit the American Society for Dermatologic Surgery or the American Academy of Dermatology.