The popularity of soft tissue augmentation with dermal fillers and autologous fat implantation is increasing because of minimal downtime, immediate results and availability of an array of newer agents. It is mainly indicated for the treatment of soft atrophic acne scars with loss of dermal tissue. Dermal fillers placed under the scars, elevate them and bring the surface of the scars in level with the surface of surrounding skin. They include: collagen based fillers (i.e. Zyplast and Cosmoderm), hyaluronic acid based fillers (i.e. Restylane and Hylaform), and calcium hydroxyl apatite fillers such as Radiesse. Moreover, promising dermal fillers are in development that will offer superior capabilities in the future.
The ideal dermal filler should be easy to administer, provide reproducible cosmetic results, remain in the dermis for a significant period of time, and have a superior safety profile. Injection of fillers usually requires the use of either a topical numbing cream or a local injection of numbing medication. Then, using a small needle, the dermal filler is injected into each wrinkle or scar that requires treatment. Some mild burning and stinging is normal and quickly resolves.
The results can last from three months to five years, depending on the filler being used. Collagen provides the shortest duration with effects lasting anywhere from three to six months. Restylane tends to last a bit longer with effects lasting from six months to one year. Radiesse can provide results that last greater than 3 years. Side effects are uncommon but can include limited allergic reactions (hypersensitivity), ulceration, reactivation of herpes infection, bacterial infection, localized bruising, and granuloma formation.
Hypersensitivity reactions to the older collagen-based dermal fillers were frequent and required skin testing ahead of the treatment, but are becoming less common with the use of human collagen (Cosmoderm, Cosmpolast) instead of cow derived collagen (Zyderm, Zyplast).
Ulceration is rare and occurs when the filler is injected into a blood vessel; cutting off the blood supply to the overlying skin. Bacterial infections are rare and may be treated with antibiotics. Localized bruising is temporary and may be reduced by applying ice before and after injection. Granuloma formation may require steroid injections, or surgical extraction of the granuloma.
The ideal dermal filler should be easy to administer, provide reproducible cosmetic results, remain in the dermis for a significant period of time, and have a superior safety profile. Injection of fillers usually requires the use of either a topical numbing cream or a local injection of numbing medication. Then, using a small needle, the dermal filler is injected into each wrinkle or scar that requires treatment. Some mild burning and stinging is normal and quickly resolves.
The results can last from three months to five years, depending on the filler being used. Collagen provides the shortest duration with effects lasting anywhere from three to six months. Restylane tends to last a bit longer with effects lasting from six months to one year. Radiesse can provide results that last greater than 3 years. Side effects are uncommon but can include limited allergic reactions (hypersensitivity), ulceration, reactivation of herpes infection, bacterial infection, localized bruising, and granuloma formation.
Hypersensitivity reactions to the older collagen-based dermal fillers were frequent and required skin testing ahead of the treatment, but are becoming less common with the use of human collagen (Cosmoderm, Cosmpolast) instead of cow derived collagen (Zyderm, Zyplast).
Ulceration is rare and occurs when the filler is injected into a blood vessel; cutting off the blood supply to the overlying skin. Bacterial infections are rare and may be treated with antibiotics. Localized bruising is temporary and may be reduced by applying ice before and after injection. Granuloma formation may require steroid injections, or surgical extraction of the granuloma.
