Injections of hyaluronic acid and facial aesthetics

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In recent years, a multitude of products of all concentrations have appeared on the market, and can meet almost all needs. There are more fluid hyaluronic acids to smooth fine wrinkles, more concentrated to fill deep furrows, more reticulated and thicker to reshape the face and restore volume, others non-reticulated to rehydrate and revitalize the skin, etc. …

Hyaluronic acid in anti-aging

It is a substance naturally present in the skin in large quantities from childhood. It gradually disappears with age inducing objective physiological aging with a good deal of dehydration because hyaluronic acid has the particular property of retaining water in the dermis.

Thus we can respond to all aspects of aging of the face or to the wishes of modification of its forms. This aging of the face is characterized by three main phenomena:

  • sagging facial skin due to loss of elasticity and skin dryness

  • the modification of volumes such as that of the mouth or the cheekbones (which tend to decrease) and that of the furrows of the face (which tend to widen)

  • the appearance of wrinkles and fine lines.

Indications for filler injections

Sagging or excess skin is mainly treated with surgical techniques (lifts). However, the lighter methods can delay the surgery or complete it, acting on the other components of facial aging: these are the abrasion methods and the filling methods.

The former work by removing the superficial layer of the dermis, marked by fine lines, and by regenerating new, clearer skin. These are peels, dermabrasion and resurfacing lasers.

The seconds (the ones that interest us here) bring a material coming fill furrows or wrinklesgive volumes.

Hyaluronic acid is therefore used as a “filler”:

  • in its very fluid form as a bio-revitalization factor in superficial intradermal injections on the entire face, neck, décolleté: it’s mesolift. It is then associated with vitamins, minerals and antioxidants.

  • in its stabilized form (denser and more viscous) as injected degradable implant in the middle and deep dermis under wrinkles and depressions

  • in its very thick form to plump up and restore volumes insufficient (mouth, cheekbones, forehead, temples, etc.).

Qualities of the filling product

Hyaluronic acid has many qualities that explain its success:– non-allergenic, total biocompatibility– only exceptionally causes inflammation (almost more side effects with the latest generations of products)– stable after injection, no migration– sufficient lifespan, while remaining 100% resorbable– good cost/effectiveness ratio.

At what age ?

There is no age limit for these treatments. We can start treating fine lines between the ages of 30 and 40 if necessary. The treatment is simpler, and we also obtain a preventive action on the accentuation of wrinkles.

A face can be reshaped at any age, certain corrections, such as the volume of the lips, the shape of the nose or the chin, etc., are also made in young people.

First consultation before a hyaluronic acid treatment

The first consultation must include important steps:

  • Essential questioning: understanding the request, history of products already injected, herpes history

  • Allergic field research: collagen allergies and other allergies, drug anaphylactic shock, streptococcal allergy

  • Search for contraindications: known hypersensitivity to hyaluronic acid, autoimmune diseases, keloid scar

  • Informed consent and information on therapeutic alternatives, possible side effects, with an estimate providing for treatment and alterations

  • Taking before and after photos.

Injection sessions for the face

During the first treatment, we generally practice a main session followed by a touch-up after 1 month. The consequences are simple and if the doctor is careful, bruising remains rare. Only a few transient redness or swelling (for lip injections in particular) may be noted for a few hours.

The maintenance of the results is done by a session at 5-6 months at the beginning, then between 8 to 12 months thereafter. The new hyaluronic acids last practically twice as long today as the injectable products of 25 years ago (collagen and others).

For more comfort, local anesthesia is possible, either as at the dentist, or by prior application of an anesthetic cream. We will avoid coming with makeup to these sessions for better asepsis.

Results with injectable hyaluronic acid

While remaining resorbable (and therefore safe), hyaluronic acids give an immediately visible result which will be stable for the first few months. It will then decrease very gradually. Resistance over time is generally better on the surface (wrinkles) than on the depth (volumes). It is for this reason that there are thicker and more cross-linked products, dedicated to last longer in these deeper areas.

It is notable that treatments carried out regularly make it possible to obtain more and more complete results, and of longer duration. Overall, if the doctor is efficient, experienced and careful, the results are generally very satisfactory. Of course, you have to tackle things that are achievable and not embark on risky treatments so as not to be disappointed. This is where the practitioner’s experience makes all the difference.

Possible side effects

There are very few with the new generation of this product. After a filler injection, redness from irritation may exist for a few hours, especially in sensitive and irritable skin. In some cases a slight swelling may remain under the injected area for 2 to 3 days. Sometimes a small bruise may appear during deeper corrections, especially in people with fragile vessels and prone to bruising. Fortunately this is rare, is easily made up and disappears spontaneously.

On some very fine skin, a slight bluish trace can be seen if the injection is very superficial. She will disappear in a few weeks without a trace. Granulomas (small inflammatory balls under the skin) have instead been described with other injectable products. They are extremely rare with hyaluronic acids, and resorb with time and appropriate treatments.