Correction of Wrinkles with Facial Fillers

TEMPORARY FILLERS

Hyaluronic acid is actually a sugar chain in polysaccharide structure. It is found naturally in the human body, living beings. The function of hyaluronic acid, which is naturally present in the tissues, is to carry water to the skin and fix it. Acid, which is synthetic or of animal origin, can be easily accepted by the body. This substance has functions such as cell division, providing mobility of the joints and giving tension to the skin. Hyaluronic acid can hold a thousand times more water than its own volume and retain its shape for a long time where it is injected. It is produced under specific laboratory conditions and presented to cosmetic applications. It is metabolized and excreted by the body in an average of 6-12 months.

Since there is no allergic reaction in these fillers, no allergen test is required. There are many different brands in this group such as Restylane, Perlane, Puragen, Teosyal, Varioderm, Surgiderm, Juvaderm. In general, the composition is similar.

Sample products of various companies;

Restylane

Containing stabilized hyaluronic acid, Restylane is a modern filler used to remove lines and wrinkles, plump lips, and make the skin look younger. Restylane combines with the existing hyaluronic acid in the body to retain water, gain volume and provide fullness.

Restylane: for moderate wrinkles

Restylane Perlane (1 ml): For deeper wrinkles

Restylane Touch (0.5 ml): For fine wrinkles, crow’s feet and perioral wrinkles

Restylane Vital (1 ml): For hands, décolleté, neck and face

Restylane Sub Q (2 ml): For chin and under eye

Restylane Lipp (1 ml): Used for plump lips.

Puragen

Puragen is another filler containing hyaluronic acid. Puragen, which is not permanent, produced by the Mentor company, is effective for 8 – 12 months.

While other hyaluronic acid-based fillers such as Perlane, Juvederm, Restylane contain single cross-linked hyaluronic acid; Puragen contains double cross-linked hyaluronic acid. This extends the effective time of the composition. Puragen is injected into the dermis of the skin. Since it retains some water after the injection, it should not be given more than necessary. If retouching is to be carried out, it should be applied at least 2 weeks later. It does not require allergen test.

Teosyal

Teosyal is not of animal origin, it is a non-permanent filler containing hyaluronic acid.

Teosyal First Lines: It is used to fill fine skin wrinkles and crow’s feet lines around the eyes.

Teosyal Touch-up: It is used for moderate wrinkles between cheek – nose or between two eyebrows. It is applied to the middle dermis layer.

Teosyal 30 G Global Action: It is used for moderate wrinkles on forehead, cheek – nose or between two eyebrows. It is applied to the middle dermis layer.

Teosyal 27 G Deep Lines: It is used to fill the deep wrinkles between the cheek – nose and down the lip edges. It is applied to the middle dermis layer.

Teosyal Kiss: It is used for lip thickening.

Teosyal Ultra Deep: It is used for people with thick skin with deep wrinkles, to fill the hollow areas that are difficult to fill, such as to provide fullness on the cheekbones or to define the chin contour. It is applied to the deep dermis.

Rofilan FORTE

Divinyl sulfone and hydroxypropyl methylcellulose are used to form a strong crosslink in hyaluronic acid. In this way, its permanence is extended. The average effective period is 8 months. Application areas are glabellar (frown) wrinkles, nasolabial folds, lines around the mouth, lip shaping, crow’s feet.

Varioderm

It is a preparation containing hyaluronic acid and effective for 6-12 months. It does not have anysignificant advantage over other products.

Surgiderm

Surgiderm are non-permanent dermal fillers from Corneal company that contain hyaluronic acid. Local anesthesia or nerve blocking is required during the injection.

Surgiderm 18: It is used to remove fine wrinkles on forehead, crow’s feet and frown lines. It is effective for 6 months. It is an ideal hyaluronic acid preparation that can be used together with botulinum toxin applications. It is injected only into the superficial dermis of the skin.

Surgiderm 30: It is used in cheek wrinkles, nasolabial groove, lip edge wrinkles and deeper wrinkles to define the lip contour in order to provide volume on the cheeks and lips. It is effective for 9 months. It is applied to the deep dermis.

Surgiderm 24 XP: It is used in forehead and frown lines, nasolabial grooves, lip wrinkles, deep wrinkles to define the lip and lip contour. It is effective for 9 months. It is applied to the deep dermis.

Surgiderm 30 XP: It is used in deep wrinkles in the nasolabial groove, to provide volume on the cheeks, to thicken the lips and to define the lip contour. It is effective for 12 months. It can be applied to the skin in 2 – 3 layers.

Surgilips: It is used for lip wrinkles, adding volume to the lips and contouring the lips. It is effective for 9 – 12 months. It can be destroyed more quickly in people with a fast metabolism.

Surgilift plus: It is produced especially for applying to the face, neck, décolleté and back of the hands.

Long-acting Fillers

Radiesse

It is an FDA approved filler containing calcium hydroxy apatite crystals, effective for an average of 5 years. Also available as preparations containing 1.3 ml. This material, which does not require an allergy test and needs to be injected into the mid-deep dermis, is successfully used in the removal of nasolabial lines (lines between the lips and cheeks), marionette lines (lines extending from the corner of the mouth to the chin), soft tissue augmentation and lip contouring.

Reviderm Forte

Its long-lasting effect comes from the combination of cross-linked hyaluronic acid and cephadex microspheres. The replenishment of hyaluronic acid is enhanced by the production of collagen fibrils stimulated by microspheres. This is called a double-acting mechanism of action. Small microspheres with electrostatic charge stimulate collagen fibril synthesis. In this way, Reviderm Forte is considered a semi-permanent wrinkle-filler product. An additional or second application may be required 3-6 weeks after the application. For this, some Reviderm Forte is increased during the first application, and the remaining amount is given at the next application, which makes the application perfect. After the first application, the results of the procedure are immediately visible, as collagen begins to be produced around the microspheres. The second application stimulates an extra layer of collagen. As a result, the lack of hyaluronic acid on the collagen infrastructure is eliminated. Application areas are glabellar (frown) wrinkles, nasolabial folds, lines around the mouth, lip shaping, forehead lines, acne scars. It is not preferred for fine wrinkles around the eyes

Beautical 2/5

Beautical 2/5 is a new generation polyacrylamide skin filler. The product contains a polyacrylamide cohesive hydrogel. It has a biodegradable analog structure, whose performance and half-life in vivo can be changed as needed. During the degradation of these analogs, a continuous release occurs from short, soluble PA chains. The gradual excretion of the PA chains gradually reduces the gel volume, giving Beautical a unique property. Beautical 2 is used to correct superficial lines, wrinkles and folds.  It is effective for 2 years. Beautical 5 is used to correct deep lines, wrinkles and folds, shape the face and increase volume. The effect period is 5 years.

Demalive, Dermadeep

It contains 60% stabilized hyaluronic acid, 40% acrylic hydrogel. While hyaluronic acid disappears over time, acrylic gel continues its filling effect by protecting itself. Therefore, it is considered to be permanent. While Dermalive is used for medium wrinkles; Dermadeep is used for deep wrinkles, post-operative deformities, collapses, soft tissue augmentation, chin tip and cheekbones. It does not require allergy test.

Sculptra(New Fill)

Sculptra, also known as New Fill, is one of the fillers containing Poly L Lactic acid. This substance is included in the structure of some suture materials. It does not only function as a filler, but also shows an extra feature by increasing the synthesis of new collagen in the area where it is located. Since it is easily accepted by the body and does not cause any allergic reaction, there is no need to test before application.

The effect starts to become visible after 1 month. New fill can be applied in thick lines, deep fossa and in cases where the volume of the face is reduced. Since it is absorbed late by the body, its effect lasts up to 2 years by creating fibrosis.

Permanent fillers

Not preferred in our clinic.

Bioalcamid

Bioalcamid is a permanent filler in gel form containing 4% alkylimide and 96% water. After injection, this material is also called ‘endo-prosthesis’, since bioalcamid is surrounded by the collagen in our body. This reaction is not an allergic one or a foreign body reaction as it is a very thin collagen layer wrapped and isolated by the body of bioalcamid. Often this period is 45 days, and there may be a 10% reduction in material volume with edema, but it is completely permanent after that. Bioalcamid has some differences from other fillers:

It can be injected in very large quantities (such as 500 – 1500 cc) compared to other fillers and then the injected endo-prosthesis can be removed if desired. It is recommended to apply several sessions with an interval of 2 months instead of injecting large amounts of bioalcamid at once, only in areas where the skin is thin, like the face.

Since there is no enzyme that breaks down bioalcamid in the body, and the material is resistant to oxidation and hydrolysis, the result is permanent.

Injection of the preparation does not require allergy testing.

It can be stored at room temperature.

Since the thin collagen layer surrounding it is fixed at the injection site of the implant material, it does not displace from the site of injection to the surrounding tissue. There are 3 different forms of bioalcamid. Lip, face and body. The contents of these forms are the same, but their elasticity is different. Since Bioalcamid is not injected into the mucosa, it is not used to thicken the lip, but to define the lip contour. Bioalcamid can be used for aesthetic purposes or it can be used in high amounts, so it is successfully applied in correcting deformations, gaining the volume of depressed hollow areas, chest deformities, and volume problems in the extremities.

Artekoll

Artecoll is an injectable substance that acts on facial wrinkles and other skin disorders for a long time. Artecoll 2/3 denatured bovine collagen is the form of a substance known as polymethylmethacrylate at a ratio of 1/3 into spheroids with a diameter of 30 microns. Since these globules are stored in the tissue, their absorption and rejection are not possible.

Collagen in Artecoll is absorbed after 3 months, but PMMA globules become permanent and new tissue formation around it ensures the permanence of Artecoll. Artecoll shows the process of settling in the applied area within the first 20 days. The real desired effect starts after that and fully emerges within 3 months.

After Artecoll is applied, it settles in the skin and is covered with fibrin fibers made by fibroblast cells, within 3 months at the earliest. Efficiency and success can be increased, especially with an additional application after 3-4 months. It requires an allergy test to the forearm 14 – 28 days before the application, although it is often negative, 1 – 2% allergic reaction can be seen.

Artecoll is an extremely effective method especially in the lines extending between the forehead, between the eyebrows, the lines above the lips, and the corner of the nose and mouth. It is used for filling in the collapses that occur under the eyes. It is also used to fill the collapses that may occur after plastic surgery operations.

It is used to fill acne scars. It is also used to enlarge and shape the lips.

Plasma BT

With Plasma CT, without stripping the epidermal tissue, microchannels are opened in the skin as if it were needle-pricked, and these are tightened and recovered as wounds heal and collagen is deposited. Since the tissues around these microchannels are intact and there is no thermal damage, a rapid healing occurs. While the created microchannels heal, they contract and heal like wounds formed in other parts of the body, and recovery, tightening, removal of wrinkles and reduction of acne scars are provided in the uppermost layer of the skin. The regeneration and restructuring of collagen fibers continues for one year after the procedure.

The application is carried out as cold application or with mild anesthetic creams. It is a painless procedure, there may be much less discomfort than epilation. Afterwards, redness and tenderness occur in the application area. Sensitivity completely disappears within the same day. Redness starts after application and disappears in 2-4 days. At the end of 2 days, very little crusting may occur. The crusting will go away in about 4 days.

Depending on the problem, the procedure can be repeated for 1-3 sessions at intervals of three to four weeks.

 

Treatment of Acne Scars

Scars from acne can be minimized without surgery. With fractional laser, scars will be greatly reduced within 2-3 sessions on average. The short redness period after the application allows patients to return to their daily lives easily.

Treatment of Surgical Scars, Keloid, Scorch

There is no medical method that can completely remove scars. However, with the fractional laser, raised scars from the skin can be softened, lowered to the skin level, redness can be improved, and even mature scars can be made better. It is also very effective in reducing the sequelae caused by burns and softening the grafts.

Facial Rejuvenation, Wrinkle Treatment

Fractional laser is a very effective method in the treatment of wrinkles and making the skin better, lively, brighter. Especially superficial and moderate wrinkles can be healed with this procedure, while deep wrinkles will lighten up. The pores are narrowed and tightened. 3-5 sessions should be done at intervals of 3-5 weeks.

Hand Rejuvenation

As a result of regular applications with Plasma BT, wrinkles on the hands are improved. Age spots on hands can be removed with Co2 laser.

Plasma CT Mole (nevus) Treatment

In addition to surgery, moles, in other words, nevi can also be treated with Plasma CT. Moles to be removed with Plasma CT should be benign. Epidermal and dermal nevi can be treated with laser, while lesions with very deep roots and skin cancers should be surgically removed. Benign moles can be treated with Plasma CT in one procedure without leaving any scars.

Plasma BT Blemish Treatment

Blemish treatment is a time-consuming procedure. The type of blemish is very important. Sunlight triggers this condition. Sun spots, melasma, pregnancy spots, age spots can be treated with laser.

Treatment of Senile Lesions

With Plasma CT, senile lesions such as senile keratosis, hyperkeratosis, papilloma can be treated.

Plasma BT Stretch Marks (Striae) Treatment

Stretch marks (striae) are scars that develop due to the tear of the skin and subcutaneous tissue. There is no complete treatment for stretch marks like scars, but the prominence of marks can be reduced in 5-6 sessions with Plasma CT.

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