A. Objectives:

Due to thinning and sagging of the fat layer on our face, we encounter new wrinkles and deepening of existing folds. Filler applications for improving such problems, that is, for rejuvenation of the face, are relatively easier and can be performed without requiring an operating environment. A wide range of fillers are available as an option, depending on the person’s wishes. The most commonly used fillers for this day are hyaluronic acid-containing fillers. The second frequently used filler is the application of the fat from the patient’s own body. Both methods are widely used. The advantage of the fat application is that more fillers can be used and it is cheaper. The disadvantage is that it is less reliable in take rate and requires an operating room.

B. Procedure (Hyaluronic acid products)

1. This product is applied to various areas of the face to eliminate or reduce wrinkles and deepened folds by means of an injector.

2. In order to reduce the discomfort of the injection, the topical anesthetic may be applied to the skin in the form of a pomade or injection. In addition, the cold application on the target area can be tried to reduce pain. Some of the products in recent years include local anestetics inside to relieve pain during the painkillers.

3. Application sites on the face are primarily washed with an antiseptic solution.

4. The filler is a transparent gel injected under the facial skin using a very fine needle or cannula.

5. The depth of the injection depends on the depth of the wrinkles and their location.

6. Multiple injections may be performed depending on the location, depth and type of the wrinkle.

7. After each injection, the target site can be gently massaged to shape the contour with the surrounding tissues.

8. If the treated area is swollen immediately after injection, short-term ice may be applied.

9. Additional filler treatments may be required after the initial treatment to achieve the desired level of correction.

10. Periodic touch-up injections help maintain the desired levels of correction.

C. Risks / Disturbances

1. Injection-induced reactions can occur, although a very small needle will be used. There may be swelling, pain, itching, discoloration, bruising or tenderness after injection. If you use painkillers such as naproxen or aspirin, or blood thinners, you may experience bruising or bleeding at the injection site.

2. These reactions usually pass within a few days, rarely take 7-10 days.

3. As with any injection, there is a risk of infection in this intervention. The syringe is sterile and standard precautions have been taken for the injected material.

4. Temporary blisters may occur after injection.

5. Some patients may have an additional swelling or tenderness at the injection site. These reactions can sometimes last for up to 2 weeks and, if appropriate, you may require oral corticosteroids or other treatments as prescribed by your doctor.

6. In cases of such hypersensitivity or active infection (cyst, redness, acne), the same filler should not be used later.

7. There is a risk of inflammation at the site of application if you are considering a procedure such as laser and chemical peeling based on the skin response after the filler treatment or if the skin has not fully healed after such treatment.

8. Complications can occur from the color changes in the skin to the loss of the skin due to the effect of the vessels in the application area. It has even been very rarely reported that blindness due to vascular compression may very after applications around the eye.

9. Many people are satisfied after filler treatment. However, as with all cosmetic procedures, there is no guarantee that you will be completely satisfied. There is no guarantee that wrinkles and folds will disappear completely or that additional treatments will not be required to achieve the result you are looking for. There are two reasons for this: All filler applications are in fact against nature,  and secondly, each tissue may develop a different reaction to this application. The duration of action of the fillers varies depending on the region of application, but is temporary. Additional treatments will be required periodically and usually every 6 to 9 months. Additional injections may be needed to maintain the effect.

10. After treatment, exposure to the sun, ultraviolet rays and extreme cold should be minimized until swelling and redness of the treated area disappear.

D. Benefits

It has been shown that hyaluronic acid fillers are safer and more effective than collagen and other substances used as fillers in facial skin. The cosmetic effect can be 6 months or longer without the need for an additional application when the most appropriate site and application mode is selected.

E. Alternatives

This is a cosmetic intervention that is considered voluntary. It is not a compulsory treatment. Other alternative treatment methods with varying sensitivity and duration of action are the placement of synthetic permanent implants or bacterial toxins.

F. Cost / Payment

You will pay for the treatment by yourself. Since most of the filler applications are for cosmetic purposes, there is no reimbursement by the state or private insurances.

G. Rules to be followed after filler applications:

1- Avoid physical activity that requires effort up to 6 hours

2- Do not massage the treated area for up to 6 hours

3- Avoid outdoor activities in the sun and / or cold until swelling and redness disappear.

4- Sleep one night with the head high and lying on your back and / or slightly sideways

5- In case of mild pain, you can easily use painkillers such as acetaminophen or paracetamol instead of aspirin or aspirin containing drugs.

6- Do not use skin care products such as retinoid or glycolic acid for one day